In 2023, Europe witnessed a resurgence of measles after several years, as reported by WHO until November 2023. Severe epidemics in 2018–2019 had a profound impact, with the introduction of infections to Iceland in 2019. While only one case led to spread locally, the total cases remained below ten. However, vaccination rates, persistently below the 95% target, contributed to the vulnerability. Measles is highly contagious and spreads easily, e.g. at airports. Achieving a 95% vaccination rate nationwide is pivotal in curbing its spread. In 2023, measles epidemiology resembled 2017, foreshadowing the major outbreaks of 2018–2019. With no effective treatments, measles can lead to serious complications (pneumonia, other infections), permanent damage (brain injury, blindness), or death in about one in a thousand cases. In 2023, the WHO's Europe Region reported five deaths, with final figures for the year to be released in 2024.

Status of Measles Vaccination in Iceland

During the COVID-19 years, measles vaccinations, especially the second dose in grade 7, were delayed in Iceland, with no full recovery yet. Similar situations occurred in many European countries, where pre-pandemic conditions were worse than in Iceland. The vaccination status of younger children has also declined, with less than 90% of the 2021 birth cohort registered for measles vaccination as of January 2024.

Measles Vaccination for Travel

In regions where outbreaks have already occurred, vaccination is crucial to prevent further spread and reduce illness severity. Travelers to European countries or those with layovers at major European airports must consider their and their children's vaccination status before embarking on their journey. Keflavík Airport's role should be noted for stopovers during transatlantic flights from Iceland.

Measles vaccination is safe and offers long-term protection. If necessary, the MMR vaccine, typically administered at the 18-month visit, can be given as early as 6 months. However, for children vaccinated before 12 months, long-term protection with this initial dose might not be sufficient, making a re-administration at the 18-month (and 12-year) visit advisable.

After vaccination, young children commonly experience fever (10-15%) one to two weeks later, with about half of them developing a rash that starts on the head and spreads down the body and limbs. These symptoms typically resolve within a few days. Localized rashes at the vaccine site are also common. In older children and adults receiving the MMR vaccine, fever is less frequent, but joint pain may occur about three weeks after vaccination if they haven't been vaccinated against rubella before (or had the disease). Importantly, additional doses of the MMR vaccine have not been linked to an increased incidence or severity of adverse reactions.

The Chief Epidemiologist