https://doi.org/10.53453/ms.2025.1.5
Change in measles vaccination coverage and connections with
outbreaks in Lithuania, Europe and worldwide
Aušrinė Sasnauskaitė
1
, Ugnė Stimbirytė
1
, Jolanta Sauserienė
2
1
Lithuanian University of Health Science Faculty of Medicine, Medical academy, Kaunas, Lithuania
2
Lithuanian University of Health Sciences Kaunas Clinics, Department of Family Medicine, Kaunas, Lithuania
Abstract
Background. Measles is a dangerous viral disease.The number of outbreaks is increasing worldwide. Inadequate
vaccination is cited as the main reason for this.
Aim. To identify if there is a correlation between measles cases in Europe and globally in comparison with
vaccination coverage.
Materials and methods. A systematic analysis of the literature was carried out in May-June using the search
system Google Scholar, the scientific bases and journals, WHO’s official website and its database, for Lithuania
and its cases - National Center for Public Health and its database.
Results. In this study we found out there is a link between new measles cases, outbreaks, and vaccination rates.
As overall immunization rates fall below 95% or remain stagnant, the incidence of new outbreaks rises. While
Africa and the Eastern Mediterranean have the lowest vaccination rates and highest new cases from 2018 to 2021,
Europe and the Western Pacific are also seeing rising case trends. In Europe, cases have increased annually since
the COVID-19 pandemic, and overall vaccination rates remain inadequate. Lithuania is also experiencing
challenges with measles, with new cases reported in 2019, 2020, 2023, and 2024.
Conclusions. The top priority is to raise overall immunization coverage above 95%, alongside developing
effective healthcare systems and maintaining basic prevention measures. Additionally, innovative solutions like
UV-C lamps can help eliminate airborne pathogens like measles.
Keywords: measles, outbreaks of measles, vaccination, immunization
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
Medical Sciences 2025 Vol. 13 (1), p. 44-53, https://doi.org/10.53453/ms.2025.1.5
44
1. Introduction
Measles is a highly contagious viral disease
caused by the measles paramyxovirus, a
pathogen that affects humans and has no
environmental or animal reservoirs. The main
complications of measles include middle ear
infection, pneumonia and acute encephalitis.
Immunity acquired from infection or vaccination
provides long-term protection against severe
disease and prevents further transmission.
Before the introduction of the measles vaccine,
over 90% of children under 15 years were
infected, and the disease claimed millions of
lives annually. The implementation of
widespread vaccination has significantly
reduced the endemicity of measles. Globally,
immunization has led to a marked decrease in the
number of measles cases [1]. However,
outbreaks of measles indicate that measles
remains a threat even in those countries where
herd immunity has made the disease appear
eradicated.
2. Materials and methods
When preparing a literature review, we searched
for articles in both English and Lithuanian. The
key words were: measles, vaccination, outbreak
of measles. We searched for English articles in
specialised search system Google Scholar, also
in the scientific bases like Science Direct, NCBI,
scientific journals like The Journal of Infectious
Diseases, International Journal of Public
Health, Emerging Infectious Diseases. There
was also a lot of data from WHO’s official
website and its database. In Lithuanian, we
mostly checked the official website of the
National Center for Public Health and its
database. 29 articles were in English and 4 were
in Lithuanian. The articles release date was from
2020 to 2024. The review of scientific literature
was carried out in May-June. The number of
measles cases in Lithuania, various world
continents and the world as a whole was
searched, as well as the percentage of
vaccinations and the number of outbreaks.
3. Results
3.1. What is measles?
Measles is one of the most contagious viral
diseases globally, typically presenting with a
maculopapular rash. It is estimated that one
person can infect 12-18 healthy individuals,
compared to 1-2 people for influenza and an
average of 5-6 people for COVID-19 [2,3,4].
The disease usually begins with non-specific
symptoms resembling a cold: fever, cough,
runny nose, sore throat, or red eyes. The
incubation period is about 7-14 days [5].
Measles spreads through airborne droplets from
an infected person’s breathing, coughing or
sneezing. Initially affecting the respiratory tract,
the disease later spreads to multiple organ
systems. Major complications include difficulty
breathing, blindness, encephalitis, severe
diarrhea and associated dehydration, and ear
infections. Subacute sclerosing panencephalitis
is a slowly progressing fatal complication [2].
The most common cause of measles-related
death is pneumonia, accounting for 60% of
deaths [6]. Risk groups include pregnant women,
unvaccinated individuals and people with
immunodeficiency. The disease most frequently
affects children under 5 and adults over 30 years
old [7].
3.2. Relevance of the topic
Given that measles is a dangerous disease for all
age groups and its incidence has been rising
globally since 2022 with no specific treatment
available, vaccination remains the most effective
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
45
preventive measure [7]. Two doses of the
measles-containing vaccine (MCV) are 97%
effective in preventing measles, making it one of
the most effective vaccines ever developed. Mild
adverse reactions occur in less than 20% of
patients and severe reactions are very rare.
Before the creation of the vaccine, measles
infected the majority of children under 15 years
old and caused 135 million new cases and over 6
million deaths annually worldwide. The first
single-dose measles vaccine was licensed in
1963 for a public use and African countries
began national vaccination programs. By 1967,
Gambia became the first country to halt virus
transmission. In 1971, the combined MMR
(measles, mumps, and rubella) vaccine was
created, requiring a second dose, and in 2005, the
MMRV (measles, mumps, rubella and varicella)
vaccine was developed [8]. With the start of
massive measles immunization in the 1980s
globally, morbidity and mortality decreased
significantly. From 2000-2018, global annual
measles incidence per million people dropped by
66%, from 145 to 49 cases, annual reported cases
decreased by 59%, from 853,479 to 353,236
cases, and estimated annual deaths from measles
fell by 73%, from 535,600 to 142,300 cases.
Routine measles vaccination with mass
immunization campaigns are crucial. Achieving
herd immunity requires maintaining high
(≥95%) two-dose vaccination coverage,
essential for controlling the spread and aiming to
eliminate measles. Despite the ongoing global
WHO immunization campaign and the 2018-
2019 measles outbreak, vaccination response
and coverage remain inadequate [2]. The
growing problem is the increasing number of
measles cases and outbreaks, especially among
unvaccinated individuals - primarily school-
aged children and young adults [9]. Therefore, it
is crucial to identify the correlation between
measles cases in Europe and globally in
comparison with vaccination coverage, in order
to educate the public about the insufficient scale
of herd immunity and the resulting rise in new
cases and outbreaks, so it is the aim of our
research.
3.3. Situation of the measles
3.3.1. Situation in the world
Regarding the global measles situation over the
past six years, interesting trends can be observed,
with an uneven distribution of measles cases and
outbreaks across different world regions. There
is a fluctuating course of new measles cases. In
2018, 360 296 cases were recorded globally
(twice as many as the previous year). In 2019,
there was more than a twofold increase in new
cases from 2018, with 873 022 cases. In 2020, a
decrease in measles was observed, with 159 073
cases, and in 2021, there were 123 171 cases.
However, from 2022, the number of cases began
to rise again, with 205 173 cases, followed by
321 582 cases in 2023. According to WHO
(Geneva) data from April 2024, there have been
94 438 cases so far. The reasons for such an
interesting dynamic could be numerous,
including COVID-19 protection measures,
widespread quarantine, however the aspect of
vaccination remains significant [10]. Global
MCV vaccine coverage has stagnated since
2010, standing at 84-86% of the population. In
2019, there was the highest number of measles-
related deaths in nearly two decades, and
endemic spread resurged in several countries
that had previously achieved measles infection
control goals. As highlighted in the Democratic
Republic of the Congo, the most severe
outbreaks occur in resource-poor environments,
leading to serious consequences. Reduced
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
46
measles vaccination during the 2018-2020 Ebola
outbreak contributed to a measles outbreak,
resulting in approximately 7000 measles-related
deaths compared to 2243 Ebola deaths. The
COVID-19 pandemic further worsened the long-
term coverage of children's vaccinations. WHO
estimated that in 2020, 22.7 million children
missed their routine vaccination, which is 19.5%
more than in 2019. UNICEF reported that from
2019 to 2021, 67 million children were under-
vaccinated or entirely unvaccinated, and the
number of children receiving the first dose of
MCV (MCV1) decreased by 5%. In 2022,
Cardoso Pinto et al. published a systematic
review demonstrating that routine childhood
vaccinations decreased by an average of 10.8%
during the early COVID-19 pandemic [11].
Breaking cases down by region, in 2024, there
have been 11 145 measles cases in Africa, 120
cases in North and South America, 29 405 in the
Eastern Mediterranean region, 10 040 in the
South-East Asia region, and 961 cases in the
Western Pacific region, with Europe maintaining
the highest number of cases at 42 767. According
to data from 2018-2022, the African region had
the most cases, with the Eastern Mediterranean
region coming in second in 2021-2022 [12]. This
can be explained by low vaccination coverage:
in 2022, the African region had the lowest
immunization rates of all WHO regions, with
69% for the first dose and 45% for the second
dose, while the Eastern Mediterranean region
had 83% and 78%, respectively. Reasons for the
lower vaccination percentages in the African and
Eastern Mediterranean regions include a lower
number of literate and educated people,
misinformation, limited healthcare systems,
inaccessible services for those in need, staff
shortages, poor infrastructure, vaccine
unavailability, hard-to-reach living areas,
military conflicts and poorly functioning
vaccination campaigns [13,14].
Vaccination coverage is disproportionately
lower in low-income countries. The 2021 global
vaccination report estimated that out of 18.2
million unvaccinated children, 12.8 million
(70%) lived in middle-income countries, and 5
million (27%) lived in low-income countries
[15]. The highest vaccination percentages in
2022 were achieved by the European and
Western Pacific regions: the European region
had 93% immunization for the first dose and
91% for the second dose, and the Western
Pacific region had 92% and 91%, respectively
[16]. This correlates with fewer disease
outbreaks in these regions from 2018-2022
compared to other world regions. Despite this,
even these regions faced the threat of measles
outbreaks. A sharp increase in cases was
observed in the European region in 2022, 2023,
and 2024. In 2023, Kazakhstan was identified as
the country with the most cases globally, with
65% of cases among children under five and
70% among unvaccinated individuals. This
contributed to the overall and sudden increase in
cases in the European region in 2023-2024,
because Kazakhstan is part of the WHO
European region [17]. However, a concerning
trend is also observed in the Western Pacific
region, where measles cases increased by 255%
from 2022 to 2023. This surge is attributed to
discrepancies in vaccination coverage, gaps in
disease surveillance and travel by individuals
from outbreak-affected countries. The decline in
vaccination coverage in several Western Pacific
countries during the COVID-19 pandemic,
ongoing measles outbreaks in the Philippines
and persistent endemic measles spread in
Malaysia threaten a resurgence of measles in the
region in 2024-2025 [18]. Therefore, the most
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
47
problematic regions for immunization remain
Africa and the Eastern Mediterranean, which
recorded the highest number of cases from 2018-
2022. However, there is also a significant threat
to the European and Western Pacific regions,
where case numbers are rapidly increasing due
to insufficient overall immunization rates.
3.3.2. Situation in Europe According to WHO,
the European region is experiencing a dramatic
increase in measles cases. As of April 10, 2024,
there were 42 767 laboratory-confirmed cases in
the region, exceeding the total number reported
in 2023 [19]. In 2023, 40 out of 53 countries in
the region and at least 10 EU/EEA countries
reported an increase in measles cases. In 2023,
more than 42 200 cases were confirmed in 41
member countries, compared to 941 cases in
2022, representing a 44-fold increase [20]. As of
November 2023, there were about 21 000
hospitalizations and 5 measles-related deaths
[21]. In 2023, cases were distributed relatively
evenly across EU/EEA countries, except for
Romania, Austria and France. Romania declared
a measles epidemic in 2023, with 4679 cases
from January 1 to February 6, including 6 deaths.
In 2023, cases in EU/EEA countries were
reported in all age groups, with the highest
numbers among children aged 1-4 and 5-9 years
old [22]. Data from the past six years suggests
uneven growth in cases in the region: 89 148 in
2018, 106 130 in 2019, 10 945 in 2020, 99 in
2021, and 941 in 2022 [10]. This uneven trend
and the tenfold decrease in 2020 compared to
2019 and 2021 compared to 2020, similarly to
the situation in Lithuania, may be due to not
increased vaccination rates, however COVID-19
pandemic-related health measures such as
protective measures against COVID-19, which
also prevented measles and contact restrictions,
when schools were closed in all countries and
remote learning was introduced in at least 18
countries. It is difficult to discuss whether
remote doctor consultations during the pandemic
affected accurate measles diagnosis, especially
since it was much harder to assess measles
without seeing the patients' rash in person [23].
The biggest link to increased incidence in
specific age groups is inadequate vaccination. In
2023, 75.7% of reported measles cases in the
European region were unvaccinated patients.
The largest proportion of unvaccinated children
was among those under 1 year old (94.2%),
while among individuals aged 30 and older,
46.7% were unvaccinated, and 36.2% had
unknown vaccination status. In 2022, infants
under 1 year old were the most affected age
group (3.2 cases per 1 000 000 people), along
with children aged from 1 to 4 years old. Such
low vaccination rates among infected children
and the highest increase in new cases in 2023
among 1-4 and 5-9-year-olds raise significant
concerns about the increased risk of mortality
from measles complications [22]. Regarding
vaccination rates in the European region in 2023,
WHO has not released data. In 2018, there was
95% one-dose vaccine coverage, in 2019 - 96%,
2020-2021 - 94%, 2022 - 93%, so a decreasing
trend is observed. When it comes to the second
dose of the vaccine, only since 2018 a
vaccination rate higher than 90% has been
observed: 91% in 2018, 92% in 2019, 91% in
2020, 92% in 2021 and 91% in 2022. However,
this is still insufficient. The sudden outbreak of
cases in 2022 (941 cases compared to 99 cases in
2021) and the rapidly increasing number of new
cases in 2023 (42 200) are associated with the
continuously decreasing first-dose vaccination
rate and the fluctuating second-dose rate [24].
The national coverage for measles vaccines
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
48
decreased from 95% in 2019 to 92% in 2022.
The coverage for the first dose decreased most
sharply in Romania and Poland, and six
countries, including Cyprus, Estonia, Lithuania,
the Netherlands, Poland and Romania, reported
that the first-dose coverage was less than 90% in
2022 [25]. Romania's case can illustrate the
consequences of reduced vaccination coverage -
in 2023, there was a measles outbreak in
Romania, and in 2022 the first-dose vaccination
rate was only 83%, and the second-dose rate was
71% [23]. Only five EU/EEA countries achieved
more than 95% vaccination coverage with the
second dose in 2022 - Hungary, Norway, Poland,
Portugal and Slovakia. The connection with
vaccination is clear - Hungary, Portugal and
Slovakia did not record any measles cases in
2022 [11]. Thus, as vaccination coverage
decreases or remains unstable in the European
region, the number of sporadic outbreaks in
countries, especially those with lower
vaccination rates, increases. To eliminate
measles, countries must achieve and maintain
more than 95% coverage using two doses of the
measles vaccine. Therefore, achieving high
routine vaccination coverage must remain a top
priority for all countries [21].
3.3.3. Situation in Lithuania
In Lithuania, children are vaccinated twice
according to the national immunization
schedule: at 15 months and 6-7 years old. The
combined MMR (measles, mumps and rubella)
vaccine is used. The MMR vaccine was
introduced in 1946, and since 1988, two doses
have been administered [26]. In 2017, WHO's
European Regional Verification Commission for
Measles and Rubella Elimination (RVC)
declared Lithuania as one of 33 countries in the
European region to have eliminated measles
[27,28]. However, there was a measles outbreak
in Lithuania in 2019 resulting in 834 cases,
mostly in major cities: 425 in Kaunas and 314 in
Vilnius. In 2020, only 2 cases were reported in
the Kaunas district, indicating a significant
decrease. There were no cases in 2021 and 2022.
As of April 12, 2024, 19 cases have been
observed in 2024, showing an increase compared
to previous years (in 2023, there were 3 cases in
the Klaipėda district). Among adults, 68.4% of
those infected were unvaccinated, 10.5% had an
incomplete vaccination course, and 21.1% were
fully vaccinated [26]. It is believed that fewer
cases were observed during the COVID-19
pandemic due to reduced hospital and doctor
accessibility, milder disease forms or possibly
fewer cases due to COVID-19 control measures
like masks, respirators and quarantine, which
also had an impact on other airborne diseases
including measles. In Lithuania, the overall
vaccination rate is declining: from 94% in 2019
to 87% in 2022 [29]. In 2022, the MMR
vaccination rate among 2-year-olds was 86.46%,
and among 7-year-olds, 86.53%. In 2023,
87.08% of children under 2 years old and
85.72% of children under 7 years old were
vaccinated [30]. In 2021, fewer children were
vaccinated with the MMR vaccine in almost all
Lithuanian municipalities, with sufficient
coverage remaining only in Alytus County and
only in the 7-year-old age group. In Klaipėda,
MMR vaccination coverage for 2-year-olds
decreased to 80.70% in 2022 [29]. National
Center For Public Health (in Lithuanian -
NVSC) specialists emphasize that to control
measles, 95% of the population must be
vaccinated; otherwise, there is a real threat of
outbreaks not only among children but also
among adults [29]. Thus, observing the situation
in Lithuania, overall vaccination coverage is
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
49
insufficient (only a few municipalities ensure
adequate levels), increasing the likelihood of
new outbreaks.
3.4. Discussion and recommendations
In summary, new measles cases, outbreaks, and
vaccination rates are closely related. As the
overall immunization percentage decreases or
remains below 95%, the number of new
outbreaks increases. This problem is
encountered worldwide. Although Africa and
the Eastern Mediterranean were identified as
regions with the lowest vaccination rates and the
highest number of new cases an increasing trend
in cases has been observed in Europe and the
Western Pacific region [12]. The most
vulnerable groups are children aged 1-4 and 5-9
years old, with the primary cause of measles
being non-vaccination [22]. Lithuania is also
facing issues with measles, with new cases
observed in 2019, 2020, 2023 and 2024 [26].
WHO made several recommendations to reduce
the number of measles cases. The most
important aspect remains increasing the overall
immunization coverage to over 95%, which
requires the highest priority: investing more
funds, providing countries with necessary
vaccines, and giving evidence-based
information. It is also crucial to help develop
more effective healthcare systems in countries
experiencing war or famine conditions, to
increase education in communities that strictly
oppose vaccines, to identify the reasons behind
skepticism Another important recommendation
is to maintain simple prevention measures such
as hand hygiene, limiting contact with
symptomatic individuals and using protective
measures. The introduction of innovative
preventive measures is also beneficial, such as
using UV-C light lamps, which target airborne
pathogens and can destroy up to 98% of
pathogens in enclosed spaces.Additionally,
actively monitoring any increases in measles
cases in countries to detect them early is
essential [2,5,22,31,32].
4. Conclusions
Even though the rate of universal immunization
against measles is declining, the most effective
recommendations for reducing the number of
new cases remain: increasing the extent of
universal immunization to > 95%, developing
more efficient health protection systems in poor
countries, analysing reasons why such countries
refuse national vaccination, not forgetting basic
preventive measures (hand hygiene, protective
measures) and also by turning to innovative
preventive measures, such as UV-C lamps,
which effectively destroy the causative agents of
measles.
References
1. Xu J, Doyon-Plourde P, Tunis M,
Quach C. Effect of early measles vaccination on
long-term protection: A systematic review.
Vaccine. 2021 May;39(22):2929-37. Available
from:
https://www.sciencedirect.com/science/article/p
ii/S0264410X21004473
2. Gastañaduy PA, Goodson JL,
Panagiotakopoulos L, Rota PA, Orenstein WA,
Patel M. Measles in the 21st Century: Progress
Toward Achieving and Sustaining Elimination. J
Infect Dis. 2021 Oct 1;224(Suppl 4) –
S428. Available from:
https://academic.oup.com/jid/article/224/Supple
ment_4/S420/6378081
3. Cheung J, Tsang TK, Yen H, et al.
Determining Existing Human Population
Immunity as Part of Assessing Influenza
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
50
Pandemic Risk. Emerg Infect Dis.
2022;28(5):977-985. Available from:
https://wwwnc.cdc.gov/eid/article/28/5/21-
1965_article
4. Ramirez V. What Is R0? Gauging
Contagious Infections [Internet]. Healthline.
2020. Available from:
https://www.healthline.com/health/r-naught-
reproduction-number
5. Blakely K, Suttle R, Wood T,
Stallworth K, Baker N. Measles — What’s Old
Is New Again. Nurs Womens Health.
2020;24(1):45-51. Available from:
https://www.sciencedirect.com/science/article/a
bs/pii/S1751485119302314
6. World Health Organization. Measles.
Available from: https://www.who.int/news-
room/fact-sheets/detail/measles
7. European Centre For Disease
Prevention and Control. Factsheet about
measles. Available from:
https://www.ecdc.europa.eu/en/measles/facts
8. World Health Organization. History of
measles vaccination. 2023. Available from:
https://www.who.int/news-
room/spotlight/history-of-vaccination/history-
of-measles-vaccination
9. Nacionalinis visuomenės sveikatos
centras. Tymų statistiniai duomenys. Available
from: https://nvsc.lrv.lt/lt/uzkreciamuju-ligu-
valdymas/uzkreciamosios-ligos/tymai/tymu-
statistiniai-duomenys/
10. World Health Organization. Measles
reported cases and incidence. Available from:
https://immunizationdata.who.int/global/wiise-
detail-page/measles-reported-cases-and-
incidence?CODE=EUR&YEAR=
11. European Centre For Disease
Prevention and Control. Annual
Epidemiological Report for 2022. Available
from:
https://www.ecdc.europa.eu/sites/default/files/d
ocuments/Measles%20Annual%20Epidemiolog
ical%20Report%202022%20data.pdf
12. World Health Organization. Measles
vaccination coverage MCV1. Available from:
https://immunizationdata.who.int/global/wiise-
detail-page/measles-vaccination-
coverage?CODE=EMR+SEAR+AFR+EUR+W
PR+AMR&ANTIGEN=MCV1&YEAR=
13. Oduoye MO, Zuhair V, Marbell A,
Olatunji GD, Khan AA, Farooq A, et al. The
recent measles outbreak in South African Region
is due to low vaccination coverage. What should
we do to mitigate it? New Microbes New Infect
[Internet]. 2023 Sep 1;54:101164. Available
from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C10344677/
14. Musa N. Progress Toward Measles
Elimination — World Health Organization
Eastern Mediterranean Region, 2019–2022.
MMWR Morb Mortal Wkly Rep [Internet].
2024;73. Available from:
https://www.cdc.gov/mmwr/volumes/73/wr/m
m7307a1.htm
15. Packham A, Taylor AE, Karangwa M-
P, Sherry E, Muvunyi C, Green CA. Measles
Vaccine Coverage and Disease Outbreaks: A
Systematic Review of the Early Impact of
COVID-19 in Low and Lower-Middle Income
Countries. Int J Public Health.
2024;69:1606997. Available from:
https://www.ssph-
journal.org/journals/international-journal-of-
public-
health/articles/10.3389/ijph.2024.1606997/full
16. World Health Organization. Measles
vaccination coverage MCV1, MCV2. Available
from:
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
51
https://immunizationdata.who.int/global/wiise-
detail-page/measles-vaccination-coverage
17. University of Minnesota. Measles
activity expands rapidly in Europe, Kazakhstan
worst affected. Center for Infectious Disease
Research and Policy. Available from:
https://www.cidrap.umn.edu/measles/measles-
activity-expands-rapidly-europe-kazakhstan-
worst-affected
18. World Health Organization. Western
Pacific countries at risk of measles outbreaks due
to immunization and surveillance gaps.
Available from:
https://www.who.int/westernpacific/news/item/
01-03-2024-western-pacific-countries-at-risk-
of-measles-outbreaks-due-to-immunization-
and-surveillance-gaps
19. World Health Organization.
Provisional monthly measles and rubella data.
Available from:
https://www.who.int/teams/immunization-
vaccines-and-biologicals/immunization-
analysis-and-
insights/surveillance/monitoring/provisional-
monthly-measles-and-rubella-data
20. United Nations Regional Information
Centre. WHO: "Alarming" rise of measles cases
in Europe. Available from:
https://unric.org/en/who-alarming-rise-of-
measles-cases-in-europe/
21. World Health Organization. A 30-fold
rise of measles cases in 2023 in the WHO
European Region warrants urgent action.
Available from:
https://www.who.int/europe/news/item/14-12-
2023-a-30-fold-rise-of-measles-cases-in-2023-
in-the-who-european-region-warrants-urgent-
action
22. European Centre For Disease
Prevention and Control. Measles EU Threat
Assessment Brief February 2024. Available
from:
https://www.ecdc.europa.eu/sites/default/files/d
ocuments/measles-eu-threat-assessment-brief-
february-2024.pdf
23. Nicolay N, Mirinaviciute G, Mollet T,
Celentano LP, Bacci S. Epidemiology of
measles during the COVID-19 pandemic, a
description of the surveillance data, 29 EU/EEA
countries and the United Kingdom, January to
May 2020. Euro Surveill. 2020 Aug 6;25(31).
Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7459270/
24. World Health Organization. Measles
vaccination coverage. Available from:
https://immunizationdata.who.int/global/wiise-
detail-page/measles-vaccination-
coverage?CODE=EUR&ANTIGEN=MCV2&
YEAR=
25. Al-Tawfiq JA, Jain N, Tanasov A,
Schlagenhauf P. Measles Matter: Recent
Outbreaks Highlight the Need for Catch-up
Vaccination in Europe and Around the Globe.
New Microbes New Infect. 2024 Apr
1;58:101238–8. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C10973198/
26. Nacionalinis visuomenės sveikatos
centras. Tymai. Available from:
https://nvsc.lrv.lt/lt/uzkreciamuju-ligu-
valdymas/uzkreciamosios-ligos/ligu-aprasai-
pagal-abecele/t/tymai-2/
27. Swain C. Measles eliminated in 33
countries. Cambridge MedChem Consulting.
Available from:
https://www.cambridgemedchemconsulting.co
m/news/index_files/a146522aa2b7f4a12dabc0a
38cb9f587-294.html
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
52
28. World Health Organization Regional
Office for Europe. Measles and rubella
elimination country profile: Lithuania. Available
from: https://iris.who.int/handle/10665/346415
29. Nacionalinis visuomenės sveikatos
centras. Lietuvoje – pirmieji tymų atvejai,
raginame nepamiršti skiepų. Available from:
https://nvsc.lrv.lt/lt/naujienos/lietuvoje-
pirmieji-tymu-atvejai-raginame-nepamirsti-
skiepu/
30. Nacionalinis visuomenės sveikatos
centras. Skiepijimo situacija Lietuvoje per metus
reikšmingai nepagerėjo – dar reikia pasistengti.
Available from:
https://nvsc.lrv.lt/lt/naujienos/skiepijimo-
situacija-lietuvoje-per-metus-reiksmingai-
nepagerejo-dar-reikia-pasistengti/
31. Higuera V. Measles: Everything You
Need to Know. 2024. Available from:
https://www.healthline.com/health/measles#pre
vention
32. Columbia University Irving Medical
Center. New Type of Ultraviolet Light Makes
Indoor Air as Safe as Outdoors. 2022. Available
from:
https://www.cuimc.columbia.edu/news/new-
type-ultraviolet-light-makes-indoor-air-safe-
outdoors
Journal of Medical Sciences. 26 Jan, 2025 - Volume 13 | Issue 1. Electronic - ISSN: 2345-0592
53