Europe is aiming to wipe out measles in the coming years, but several countries continue to report outbreaks. Measles is a highly infectious disease but can be prevented through vaccination. Ensuring that at least 95% of the population has had two doses of measles-containing vaccine (such as the MMR jab against measles, mumps and rubella), can suppress the spread of the virus.
Romania has faced repeated waves of measles outbreaks over the past decade, due to low vaccination rates. Now, the results of a retrospective study, conducted by the Romanian Association for Paediatric Education in Family Medicine (AREPMF) during 2019-2021, has revealed that vaccination rates may be even lower than had been feared.
Infant vaccination rates were below 50% for MMR vaccination, according to data from 12 family medicine practices (5,673 children aged between 9 and 11 months). The survey was conducted during a measles epidemic while Romania was offering MMR vaccines at 9 months, 12 months and 5 years. From November 2020, the country reverted to the more common two-dose schedule, offering MMR at 12 months and five years.
Uptake of the hexavalent vaccine, which protects against diphtheria, tetanus, pertussis, polio, haemophilus B and hepatitis B, was below 70%, while fewer than 65% of infants had their pneumococcal vaccine.
The AREPMF said parental attitudes towards vaccinations are being influenced by misinformation. This is reflected in Romania’s uptake of COVID-19 vaccines which is among the lowest in Europe. While 42% of people in Romania have had two doses of COVID-19 vaccine, just 9% have had their recommended booster.
Doctors have launched a nationwide campaign to encourage people to focus on routine vaccination, highlighting the dangers of preventable infectious diseases. Prof Mihai Craiu, a well-known paediatrician, warned of a surge in outbreaks in the coming year unless the situation improves. If we do not change the perception of Romanian parents, of the Romanian population, about prevention, the diseases will return next year and the year after, because the germs do not take a vacation.’
Speaking at an event hosted by the AREPMF, Dr Aysel Simin Floresc, an infectious diseases expert in Bucharest, urged the public to embrace prevention. ‘There are diseases that I used to read about only from specialised books and now we see them in the hospital,’ she said. ‘Vaccines bring not only medical but also economic benefits, because prevention supports the health system.’
Experts at the meeting said the pandemic had helped to temporarily suppress outbreaks due to social distancing, but high numbers of measles, chickenpox, flu and RSV cases may be on the horizon. ‘Vaccination is an act of personal protection, but also of civic responsibility, through the indirect protection of those around you,’ said Dr Raluca Ghionaru.
Dr Valeria Herdea, President of the AREPMF and Vice-President of the Romanian College of Physicians, called for a life-course approach to preventing ill-health. She said the media could play a role in encouraging people of all ages to adopt a healthy lifestyle.
‘The prevention of life-threatening infectious diseases, through access to vaccination throughout life can become a reality only through joint efforts to ensure equitable access to prevention services related to European standards for every Romanian citizen,’ she said.