Statement – No health security without immunization: investing in a healthy future means sustaining public health gains of the past

Joint statement by Dr Hans Henri P. Kluge, WHO Regional Director for Europe and Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia

Geneva/Copenhagen, 28 April 2025

Vaccine-preventable diseases are making a comeback across the European Region, putting millions of lives at risk.

From measles to whooping cough (pertussis) and diphtheria, diseases we once thought had been consigned to history are rising across Europe and Central Asia - comprising 53 countries. Our hard-fought progress over the past decades is under threat - not because we lack the tools, but because not everyone is being reached with lifesaving vaccines. Put simply, complacency is dangerous, even deadly.

As European Immunization Week begins, WHO and the United Nations Children's Fund (UNICEF) are calling on governments and communities to act now: protect past gains, close immunization gaps, and ensure vaccines reach everyone, everywhere. Only then can countries progress towards greater health security, social stability and prosperity for their citizens.

Thanks to vaccines, the Region has seen a dramatic drop in the burden of many diseases over the past several decades. It is unacceptable today that any child should die from tetanus or diphtheria, become paralysed by polio or blinded by rubella when we have the means to protect them.

Newer vaccines against pneumococcal bacteria, respiratory syncytial virus (RSV), COVID-19 and influenza, now protect against respiratory illnesses in children and vulnerable adults. Vaccination against hepatitis B and human papillomavirus (HPV) is reducing the risk of several types of cancer. Vaccination during pregnancy against pertussis, influenza, COVID-19 and RSV is helping women and their babies survive and thrive.

But routine childhood immunization rates are stagnating; in some countries they are declining. This trend should be viewed as one of the fast-emerging health threats across the Region. Every year, over half a million children miss out on routine immunizations, leading to an accumulation of children and adults vulnerable to vaccine-preventable disease.

The consequences are already visible.

In 2024, measles cases in the European Region surpassed 127 000, the highest number reported in 27 years. Pertussis cases reached 87 000 in 2023, the highest in 29 years. Reported diphtheria cases also increased to 578 in 2022 and 264 in 2023, compared to fewer than 100 in each of the previous 13 years.

The European Region has been free of endemic transmission of wild poliovirus for over 20 years. However, virus importations are on the rise, as detected through routine wastewater surveillance, posing a particular risk to any population where polio vaccination coverage is suboptimal.

If these trends continue, the resulting burden of vaccine-preventable diseases could hamper health systems' capacities to manage cases and reduce their resilience to address new health challenges as they arise.

That is why today WHO and UNICEF are calling on all countries in the Region to urgently preserve the precious public health gains made in the past by taking 3 concrete steps:

• keep funding vaccines and immunization services as a top health priority, including supporting research and development into new vaccines;
• make timely vaccination easily accessible to everyone, paying particular attention to reaching remote, rural or under-vaccinated communities; and
• build public trust in vaccines by communicating clearly, empowering health workers, countering misinformation and engaging communities on their own terms.

One size does not fit all. Different countries and communities will require different solutions. In some, mobile immunization clinics and door-to-door campaigns may be needed to reach underserved populations. In others, simple reminders or an easier appointment process within primary health care can make a big difference. In all countries efforts should include supporting health workers to confidently respond to questions about vaccination and improving dialogue with communities to understand concerns and counter misinformation.

We know what works: high and equitable vaccine coverage. It will help every country prevent outbreaks of disease, ease the burden on the health-care system and reduce needless suffering and death. Working together, we can reach those who are being left out and deliver the full benefits of vaccines for all - at all ages. Immunization for all, under the wider umbrella of health for all, is humanly possible.