Inform, protect, immunise: tackling measles by engaging underserved populations

Measles has re-emerged in Europe. The number of measles cases has quadrupled since 2008, and several countries experienced large outbreaks in 2010 and 2011. The 2015 measles and rubella elimination target date set for Europe is looking progressively more challenging, especially in light of the economic crisis. ECDC organised a meeting bringing together health care professionals, public health experts and representatives from the civil society to share best practice and discuss practical solutions to current situations of measles outbreaks, particularly in communities of underserved populations. Vaccination is in fact part of a broader framework of health issues which are affected by the socioeconomic status of the communities, which needs to be taken into account. The key meeting outcome was a list of ten interventions that could contribute to increasing vaccination uptake in the EU: 1. Invest in education for physicians and nurses to communicate more efficiently and emphatically to their patients; 2. Make remembering easier, e.g. by strengthening efficient alert and reminder systems to remind people about vaccination; 3. Include measles under broader concern about children’s health and support the mother’s role as key opinion leaders on health issues in their families; 4. Address stigma and discrimination; 5. Cooperate with field workers; 6. Make vaccination more accessible, for example, offer immunization days/campaigns in different locations, where people work and live; 7. Motivate local authorities and non-governmental organisations to cooperate on community-based interventions, particularly targeted to underserved groups; 8. Conduct thorough epidemiological analyses of the groups at risk for lower vaccination uptake; 9. Use mass media, e.g. insert measles-related messages in television soap operas, encourage wider collaboration between public health and film, TV industry; 10. Monitor the web to understand concerns on vaccination and provide answers based on trusted web sources. Underserved communities are diverse. To increase vaccination uptake, there is a need to understand the specificity of each community and design appropriate communication tools to address their special circumstances. Building and maintaining trust and confidence remain crucial to establish long-term good relationships between communities and health services.