European Immunization Week 2022 – celebrating progress and addressing new challenges in the control of vaccine-preventable diseases

Today marks the start of European Immunization Week (EIW), an opportune moment to celebrate the historic achievements in protecting lives and livelihoods made possible by vaccines, and to acknowledge their further potential to protect public health.

The hundreds of thousands of lives saved through COVID-19 vaccination in the WHO European Region are also great cause for celebration. At the same time, there are challenges to maintaining these achievements, which require vigilance and a new path forward.

Thanks to high coverage with the (DTP) vaccine, the Region has not experienced any large diphtheria outbreaks since the 1990s.

The Region was declared free of endemic poliomyelitis (polio) in 2002. Several poliovirus importations into the Region were detected in the intervening years, but each time the outbreaks were stopped and the Region maintained its status.

Detections of circulating vaccine-derived poliovirus (cVDPV) type 2 in Tajikistan in 2020 and Ukraine in 2021, and cVDPV type 3 in Israel in 2022, have triggered large-scale polio outbreak responses. WHO is working closely with health authorities to ensure the vaccine reaches all those who are still vulnerable. The outbreak response in Ukraine was disrupted by the war in the country, and has resumed to the extent possible in the midst of the ongoing conflict.

The 53 Member States of the European Region have agreed unanimously to eliminate measles and rubella as endemic diseases. According to the conclusions of the Regional Verification Commission for Measles and Rubella Elimination, which are based on country reports submitted for 2019, so far 29 Member States have eliminated endemic measles and 45 have eliminated endemic rubella. A total of 29 have demonstrated elimination of both diseases.

Progress in the elimination of cervical cancer is especially encouraging, with 38 of 53 countries in the Region now providing routine vaccination against human papillomavirus (HPV). The latest data from England, United Kingdom, one of the first countries to introduce the HPV vaccine, show that the HPV immunization programme in England has almost eliminated cervical cancer in women born there since 1 September 1995.

While celebrating the progress made, it is also necessary to address potential threats to these achievements. These include new challenges posed by the COVID-19 pandemic and the war in Ukraine.

While a few countries in the Region experienced nationwide interruptions in routine immunization services at the start of the pandemic in 2020, most were able to make up for lost time once services resumed and ultimately reached a high level of coverage. For the Region as a whole, coverage with the third dose of the DTP vaccine (DTP3) dropped by only 1% in 2020.

But this number conceals a much more complex reality at national and subnational levels. Existing disparities in vaccine uptake, and thereby in opportunities for good health and well-being, increased during the pandemic. Eleven countries reported a drop of more than 5% in national coverage either with DTP3 or the first dose of measles-containing vaccine (MCV1), and approximately one fifth of the countries in the Region experienced a substantial increase in disparity between highest- and lowest-coverage areas.

The war in Ukraine has forced millions to flee within the country or beyond it. Nearly half of the 5 million who have fled the country are children. Every one of them will eventually need access to their next scheduled vaccination, and many of them have missed vaccinations in the past that they urgently need to catch up on to ensure they are protected from diseases such as measles and polio.

In the months and years ahead, immunization programmes in the Region will have to maintain high vaccination coverage at every administrative level. This means ensuring high uptake of regular immunization services, facilitating catch-up immunization for children and adults who missed doses in the recent or distant past, and integrating into these services all newcomers, including migrants and refugees.

The European Immunization Agenda 2030 (EIA2030) was adopted in September 2021 by all Member States of the Region. It will help guide national immunization programmes to offer the benefits of vaccines to populations across the life-course and to overcome identified local challenges by providing a revitalized approach focused on tailored, local solutions and based on the principle of leaving no one behind.

The progress we have made as a Region in protecting children and adults from life-threatening diseases deserves celebration, but we must not take this for granted. Maintaining this progress is the responsibility of all, and will require collective effort during this decade.