A major study finds childhood vaccination rates in Europe have stopped rising and are now declining in many countries. Spain maintains high coverage but recent drops raise concerns about future outbreaks and public health risks.
After decades of steady progress, childhood vaccination rates in Europe are no longer rising. A new study in The Lancet Regional Health-Europe shows that coverage has stalled or dropped in many countries. Most still report rates above 90%, but the recent shift is a clear signal for public health officials.
Researchers looked at seven major vaccines across all 27 EU countries from 1980 to 2024. They found that since 2019, 16 countries have seen declines in coverage for more than half of these vaccines. The sharpest drops were in the vaccines for Haemophilus influenzae type b and polio, with 20 countries showing downward trends. Hepatitis B and the combined diphtheria, tetanus, and pertussis vaccines also fell in 18 and 17 countries, respectively. According to World Health Organization and UNICEF data, only Cyprus, Hungary, Iceland, and Portugal reached the 95% coverage target for both doses of the measles vaccine in 2024. The EU/EEA average was 93.8% for the first dose and 87.8% for the second.
In 2024, Luxembourg and Portugal were the only EU countries to reach at least 95% coverage for all seven childhood vaccines analyzed.
Spain continues to report some of the highest vaccination rates in Europe, with 2024 figures ranging from 92% for polio to 97% for measles and rubella. Still, the study notes a recent slowdown or slight decline. In five of the seven vaccines tracked, both Spain and Germany showed negative trends, raising questions about how long herd immunity can hold. The European Centre for Disease Prevention and Control (ECDC) reported 2,339 measles cases in the EU/EEA last year, with 73% of those infected being unvaccinated. This highlights the real impact of falling coverage.
The study’s authors, Leonardo Villani and Luigi Russo, say the situation is not yet a crisis. But they warn that high coverage alone is not enough. Even small, steady declines can weaken community protection, especially if rates drop below the 90% or 85% needed to prevent outbreaks of diseases like measles or polio. Recent reports from the ECDC and GPEI echo this warning, stressing that minor drops in vaccination rates can have serious public health consequences.
Trends vary across Europe. Hungary, Denmark, France, Portugal, and Italy have managed to increase coverage for at least half of the vaccines studied. Bulgaria, Cyprus, and Czechia have seen declines across all immunizations. Romania’s coverage remains below 80% for every vaccine, while Bulgaria is around 94%.
Romania stands out as a country with coverage below 80% for all seven vaccines studied in 2024, and is among those with negative trends for every immunization. Sixteen EU countries showed declines in at least four vaccines, highlighting that the negative trend now affects a broad group of countries, not just isolated cases.
The reasons for these changes are varied. The study points to disruptions in routine vaccination during the COVID-19 pandemic, especially from 2019 to 2022. Misinformation and the rise of populist movements have also fueled vaccine hesitancy in some areas. The authors note that no single factor explains the declines—economic barriers, social inequality, and communication failures all play a part.
Spanish experts urge caution in reading the numbers. Jaime Jesús Pérez Martín, president of the Asociación Española de Vacunología, points out that changes in data collection or registration systems could affect the trends. He says both the direction of the trend and the absolute coverage need to be considered together.
Pediatrician Francisco Moraga-Llop notes that vaccination coverage has been slipping for a decade, with measles making a global comeback since 2017. In Spain, coverage is still high but not perfect. Earlier this year, the World Health Organization withdrew Spain’s measles-free status after renewed local transmission.
Other recent research has raised similar concerns. Last year, another study in The Lancet found that vaccination progress had stalled or reversed in many countries, including Spain. While the biggest setbacks were in developing regions, the trend is now visible in wealthier countries too.
Otavio Ranzani, an epidemiologist at the Sant Pau Research Institute, says the most worrying part is the reversal in countries that once led in vaccination. He points out that as vaccine-preventable diseases become rare, people forget their dangers, which can weaken support for immunization programs.
Villani and Russo see the current trends as an early warning. They stress that the diseases targeted by these vaccines have not disappeared, and keeping coverage high is essential to prevent their return. The message is straightforward: vaccines save lives, but the progress of the past fifty years is not guaranteed.
Europe now faces the challenge of addressing these vulnerabilities before they grow. Spain’s experience shows that even countries with strong immunization systems can face setbacks. Public health gains require ongoing effort, and a loss of trust or access can quickly undo years of work. For a look at how public health disruptions can affect daily life in Spain, see this recent case of regional closures due to severe weather.
