Child vaccination rates decline across 16 EU countries following decades of gains

Long-term progress meets recent declines

A study published in The Lancet Regional Health-Europe examines childhood immunisation rates across all 27 European Union member states between 1980 and 2024. Led by Luigi Russo and Leonardo Villani of the Università Cattolica del Sacro Cuore in Rome, the research team evaluated World Health Organization and UNICEF data covering seven routine paediatric vaccines. While long-term immunisation coverage expanded substantially over four decades, the findings document an inflection point between 2019 and 2022 where rates stagnated or fell across most member states. The researchers noted that routine childhood vaccination has prevented more than 154 million deaths globally over the past 50 years, making current downward trajectories a matter of public health concern. Lead author Luigi Russo described the shift in written comments on behalf of the team.

“The main message is not that childhood vaccination in Europe has suddenly collapsed, but that in many countries the trend has changed. We observe recent warning signs superimposed on decades of substantial public health gains. It is essential that high coverage does not breed complacency.”

Wide coverage disparities across member states

The analysis identified declining coverage trends in 16 of the 27 EU member states for at least four of the seven evaluated vaccines. Six countries recorded coverage drops across all seven tracked immunisations: Bulgaria, Cyprus, Ireland, the Netherlands, Romania, and Sweden. Another five nations registered declines across six vaccines, including Croatia, the Czech Republic, Estonia, Lithuania, and Slovakia. Absolute immunisation levels also diverged sharply between countries by 2024. Luxembourg and Portugal maintained coverage rates of at least 95% across all seven vaccines, whereas Romania recorded coverage levels below 80%.

All 7 vaccines declining6

6 vaccines declining5

At least 4 vaccines declining16

All 7 vaccines declining

6 countries

6 vaccines declining

5 countries

At least 4 vaccines declining

16 countries

Data from the article text

Vulnerabilities across specific paediatric vaccines

The steepest recent contractions emerged in immunisations against polio and Haemophilus influenzae type b, with coverage rates dropping in 20 member states. Hepatitis B vaccination coverage fell in 18 countries, while third-dose diphtheria, tetanus, and pertussis rates decreased in 17 nations. By comparison, first-dose measles and rubella vaccines experienced relatively less unfavourable trends across the continent. National trajectories showed distinct patterns among Western European countries. Germany and Spain experienced coverage reductions across five of seven vaccines, with Germany maintaining slight upward trends only for hepatitis B and the first measles dose. France and Italy recorded increases in four vaccines alongside decreases in three.

Polio20

Haemophilus influenzae type b20

Hepatitis B18

DTP17

Polio

20 countries

Haemophilus influenzae type b

20 countries

Hepatitis B

18 countries

DTP

17 countries

Data from the article text

Pandemic disruption and international parallels

The downward turns began predominantly between 2019 and 2022, coinciding with the COVID-19 pandemic and related strains on healthcare systems. The study notes that disruptions to routine paediatric care, alongside growing vaccine hesitancy and misinformation, contributed to the observed declines. Similar patterns appeared in the United States, where data from the Centers for Disease Control and Prevention showed required preschool vaccination coverage falling from 95% in the 2019–2020 school year to 93% by 2022. United States preschool rates ranged between 92.7% for diphtheria, tetanus, and pertussis and 93.1% for polio. European researchers warned that continuing drops in coverage risk the resurgence of vaccine-preventable infectious diseases across the region.