The European Vaccination Challenge: Stemming the Resurgence of Vaccine-Preventable Diseases

Immunization ranks among the most effective public health achievements in history, having eradicated smallpox and nearly eliminated polio worldwide. This effort has significantly lowered the incidence and impact of numerous infectious diseases, establishing immunization as a cornerstone of child health and a critical safeguard for global public health security.1 The protective benefits of vaccines extend beyond the vaccinated individual, as they contribute to the essential phenomenon of herd immunity, in which a high proportion of immunized individuals indirectly protects those who cannot be vaccinated due to age, medical conditions, or compromised immune systems. This collective shield is essential for safeguarding the most vulnerable members of society.1,2 Despite these undisputable achievements, the WHO European Region is currently confronting a critical regression in its immunization efforts.3 Data from 2024 indicate that childhood vaccination coverage for critical diseases, such as measles, whooping cough, diphtheria, tetanus, and polio, has alarmingly failed to recover to prepandemic levels.3,4 This stagnation leaves an ever-increasing cohort of children vulnerable to diseases that are entirely preventable. This decline directly threatens decades of public health progress, setting a dangerous precedent and creating conditions ripe for widespread outbreaks of diseases once largely controlled or nearing elimination. The severity of the current situation demands immediate, decisive, and concerted action from all stakeholders. This commentary, authored by members of the working group on social pediatrics of the European Pediatric Association, Union of National European Pediatric Societies and Associations, in collaboration with the International Pediatric Association, aims to provide a brief overview of these alarming trends. It will summarize the multifaceted underlying drivers of declining coverage, with a particular focus on the insidious roles of vaccine complacency and hesitancy. Finally, this commentary will outline possible strategic pathways and interventions, which could be adopted urgently to reverse this dangerous trajectory and restore robust, equitable immunization coverage across Europe.