Measles Vaccination and Outbreaks in Croatia from 2001 to 2019; A Comparative Study to Other European Countries

Due to the current burden of COVID-19 on public health institutions, increased migration and seasonal touristic traveling, there is an increased risk of epidemic outbreaks of measles, mumps and rubella (MMR). The aim of the present study was to analyze the epidemiological data on MMR immunization coverage and the number of measles cases in 2001-2019 in Croatia and a number of European countries. Results revealed a decreasing trend in vaccination in 2001-2019 throughout Europe. However, Croatia and Hungary still have the highest primary and revaccination coverage, compared to other analyzed countries. The highest number of measles cases was in 2017 in Romania. There was no significant correlation between the percentage of primary vaccination and the number of measles cases (r = -0.0528, p = 0.672), but there was a significant negative correlation between the percentage of revaccination and the number of measles cases (r = -0.445, p < 0.0001). In conclusion, the results of the present study emphasize the necessity to perform a full protocol of vaccination to reach appropriate protection from potential epidemic outbreaks. Furthermore, in the light of present migrations, documenting the migrants' flow and facilitating vaccination as needed is of utmost importance to prevent future epidemics.