Facing Measles Outbreak, Europe Could Benefit from Pitt Public Health Project

By: Allison Hydzik

As it wrestles with an ongoing measles outbreak, Europe may soon learn more about the impact of vaccination programs, thanks to a University of Pittsburgh Graduate School of Public Health project just getting underway.

This week, the World Health Organization issued a strong warning that measles continues to spread in Europe and has caused 35 deaths in the past year, the most recent in a 6-year-old boy in Italy. The Pitt Public Health project – based on a similar analysis of vaccine-preventable diseases in the U.S. that was published in the New England Journal of Medicine in 2013, called Project Tycho – could give European countries some much-needed evidence to promote the value of vaccination.

Project lead Dr. Wilbert van Panhuis, assistant professor of epidemiology and biomedical informatics at Pitt, explained that most of Europe actually has high vaccination rates, but there are still pockets where many people are not vaccinated. Those unvaccinated and tight-knit communities are providing fuel to the outbreaks.

“In Europe, the reasons people aren’t vaccinated are very diverse, and there isn’t any single policy to encourage vaccination, such as a vaccination mandate to attend school like we have in the U.S.,” said van Panhuis. “So the public health messaging to advocate for vaccination can be more difficult.”

For example, he said, Eastern Europe has migrant communities that may not have easy access to regular vaccination; in the United Kingdom, many people are worried about the debunked idea that vaccines cause autism; Germany, Switzerland and France all have alternative medicine communities that opt-out of vaccination; and a swath of the Netherlands is home to religious communities that say vaccination goes against their beliefs.

Facing Measles Outbreak, Europe Could Benefit from Pitt Public Health ProjectWhen someone with measles interacts with someone from those communities that have large numbers of unvaccinated people, the disease can spread rapidly. Measles is one of the most contagious diseases:  If one person has it, 90 percent of the people close to them who are not immune will likely get it, according to the U.S. Centers for Disease Control and Prevention.

Through Project Tycho, van Panhuis and his colleagues found that vaccines have prevented more than 100 million cases of serious childhood contagious diseases in the U.S. in the past 125 years. Pitt Public Health’s FRED Measles simulation, which shows how quickly measles can spread when vaccination rates dip too low, helped pass California’s childhood immunization mandate.

When people who could be immunized don’t get vaccinated and get sick, they increase the risk of the disease spreading to people who cannot be vaccinated, such as babies still too young for immunizations, children who had organ transplants and can’t be vaccinated because of immunosuppressant medications, and people with compromised immune systems.

“Every death or disability caused by this vaccine-preventable disease is an unacceptable tragedy,” Dr. Zsuzsanna Jakab, WHO Regional Director for Europe, said in a statement about the measles outbreak. “We are very concerned that although a safe, effective and affordable vaccine is available, measles remains a leading cause of death among children worldwide, and, unfortunately, Europe is not spared. Working closely with health authorities in all European affected countries is our priority to control the outbreaks and maintain high vaccination coverage for all sections of the population.”