EAP Webinar April 2025 | Resurgence of Measles and Pertussis | The Crucial Role of Vaccination in Prevention.
EAP Webinar Series 2025
Webinar 1: Focus on Vaccination
The inaugural webinar of the 2025 EAP Series addressed the alarming global and European resurgence of measles and pertussis (whooping cough), with a focus on the urgent need for enhanced vaccination strategies and public health action.
Webinar Takeaways
🦠Measles (Prof. Dornbusch)
- Historical perspective: Measles has killed an estimated 200 million people worldwide between 1855–2005.
- Resurgence: After declared elimination in the U.S. in 2000, outbreaks are again rising—10 million global cases and over 100,000 deaths in 2023.
- European burden: Over 127,000 cases in 2024, with Austria among the top five affected EU countries. Alarmingly, 20% of cases were in healthcare workers.
- High contagion: R₀ of 12–18; infection can occur from airborne particles in a room up to 2 hours after an infected person has left.
- Complications: Pneumonia, encephalitis, SSPE (subacute sclerosing panencephalitis), and immune amnesia lasting up to 3 years.
- Vaccine effectiveness: Two-dose MMR vaccine is ~99% protective. WHO recommends early vaccination (6 months) in outbreak situations, followed by regular schedule.
Myth busting: No scientific link between MMR vaccine and autism; the original claim has been thoroughly debunked and retracted.
🧫 Pertussis (Prof. Pana)
- Recent surge: A tenfold rise in pertussis cases across Europe post-COVID-19, with more than 32,000 cases in Q1 2024.
- Vulnerable groups: Infants under 6 months face the highest risk of fatal complications. Older children and the elderly are also increasingly affected.
- Disease features: Endemic; can last up to 3 months. Highly infectious, with up to 90% attack rate in unvaccinated household contacts.
- Vaccination coverage: Declining slightly across Europe (from 97% in 2012 to 94% in 2022 for DTP3).
- Maternal immunization: Strongly recommended during each pregnancy (weeks 27–36) to protect infants.
- Booster strategy: European schedules vary, but adult and adolescent boosters are critical for sustained protection.
- Vaccine limitations: Acellular vaccines (used in high-income countries) induce shorter-lasting immunity compared to whole-cell vaccines.
- Antimicrobial resistance: Macrolide-resistant strains emerging in Asia; global surveillance is key.
Research initiatives: Efforts like the PERISCOPE consortium are developing new vaccines, including promising intranasal candidates.
Call to action:
Q&A SummaryÂ
Can we give measles vaccine before the age of 6 months?
Yes, but only under specific circumstances. WHO recommends early measles vaccination (from 6 months) in outbreak or high-risk settings. However, maternal antibodies can neutralize the live vaccine in younger infants. Therefore, vaccination before 6 months is generally not effective unless the mother’s immune history indicates limited passive antibody protection. In specific high-risk scenarios, early immunisation may be life-saving, especially where maternal antibodies wane quickly. However, early vaccination should be carefully timed and followed by full immunisation according to national schedules. Clinical judgment and national guidelines should guide decisions.
Can we vaccinate a child that already has measles?
Answer (Prof. Dornbusch):
Once symptoms are present, it is too late for effective post-exposure prevention. However, post-exposure prophylaxis can be administered within 72 hours after contact with an infected individual. If appropriate (i.e., the child is not immunocompromised), vaccination during this window can still help prevent disease onset.
How can we treat children with pertussis having leukemoid reactions?
Such cases are very rare but serious. Hospitalization is essential, with supportive care including respiratory support, fluid balance, and nutrition. Leukemoid reactions may contribute to complications like pulmonary hypertension. Antibiotics (e.g. macrolides) should be started early to reduce symptoms and transmission. Prof. Dornbusch noted a fatal case in Austria, underlining the urgency of prevention and early intervention.
Is egg white allergy a contraindication for MMR vaccination?
Answer (Prof. Dornbusch):
No. Egg allergy is no longer considered a contraindication for the MMR vaccine.
This has been removed from official guidance. Only if the child experienced anaphylaxis after a previous MMR dose should re-vaccination be reconsidered, and even then, under specialist guidance.
Should women be vaccinated against pertussis before or during pregnancy?
Vaccination during pregnancy (between 27–36 weeks) is recommended, as this timing ensures maternal antibodies are passed to the baby via the placenta, providing protection until the child is eligible for direct immunisation.
Should children who already had measles or pertussis still receive the vaccines?
Answer (Prof. Pana & Prof. Dornbusch):
Yes. Even after natural infection, completing the recommended vaccination schedule is important due to waning immunity and the risk of reinfection or suboptimal protection over time.
After recovery, a yet unvaccinated measles patient should definitely be immunized against rubella and mumps by means of two doses of the MMR vaccine. However, an interval of at least three months should be left between the disease and the first vaccination to allow for recovery from the period of T-cellular immunosuppression.
About the Presenters
Hans Jürgen Dornbusch
Assoc. Prof
Associate Professor of Paediatrics and Adolescent Medicine, Medical University of Graz. Specialist in pediatric infectious diseases and vaccinology. Chair of the EAP Vaccination Strategic Advisory Group.
Zoi Dorothea Pana
Prof.
Professor of Paediatrics and Epidemiology, University of Nicosia. Expert in infection control and antimicrobial stewardship. Active member of EU-funded research and scientific committees in pediatric infectious diseases.
