Measles killed 72 children and adults in Europe in 2018. According to the World Health Organisation, the total number of people infected with the virus in 2018 was the highest this decade: 3 times the total reported in 2017 and 15 times the record low number of people affected in 2016.

This has happened despite a higher average number of immunizations across Europe – with 90% of all children in the region, as shown in the figure below, receiving a second dose of measles-containing vaccines. So how is it possible that more immunization could still result in the rapid escalation of measles cases? The answer lies in the distribution of immunizations. Whereas there are many communities that immunize fully, several pockets of Europe don’t. It is in these small pockets that measles outbreaks occur. One of those is Italy, where anti-vaccine groups allied with populist politicians abolished a law that made vaccines compulsory last year, only for it to be repealed a short time later after measles cause soared.

The threat of measles is now so severe that the World Health Organization listed vaccine hesitancy, for the first time, as one of the top 10 global threats of 2019. One may wonder why it is possible for one of the richest regions of the world to still suffer the consequences of a disease that is entirely preventable. There are many reasons why anti-vaxxers, as they have come to be known, choose not to vaccinate their children. On the surface, it may seem like irrational support for pseudo-science, but ultimately the motives are political, economic or religious. But in poor societies, it is often simply a lack of information. And so an obvious question is what to do in a society where vaccination rates are low because people simply don’t know about the social benefits of immunization…

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