Measles – analysis of nationwide surveillance data, Czech Republic, 2018–2024

Abstract Background In response to the recent increase in measles cases and reported outbreaks across Europe, Czech surveillance data were analysed. The aim was also to evaluate the effect of vaccination on measles complications and hospitalisation. Methods The measles cases reported to the Czech national surveillance system between 2018-2024, based on the EU case definition (2018), were analysed using logistic regression with an odds ratio (OR) supplemented with the 95% confidence interval (95% CI) to measure the association between vaccination status and the occurrence of complications or hospitalisation. Results A total of 837 measles cases were reported, of which 94% were laboratory confirmed and 437 (52%) were male. The majority of cases (590; 71%) occurred in 2019. An epidemiological link was found in 407 cases. The median age of cases was 34 years (range: 0-75). In total, 111 (13%) measles cases were imported (62 from Ukraine, 5 from Vietnam and smaller numbers from 25 other countries; 59 of the imported cases were unvaccinated). Hospitalisation was required in 561 cases (67%). In total, 41% of all cases were known to have been vaccinated, of which 62% with two doses and 23% with one dose. Measles complications occurred in 11% of cases, most frequently pneumonia (3%). The highest proportion of complications occurred in infants (<1 year; 28%; cases who were too young to be vaccinated) and in adults aged 55-64 years (27%). Two doses of vaccine significantly reduced the risk of any complications compared to unvaccinated cases: OR 0.39 (95% CI: 0.21-0.72, p = 0.002) and the likelihood of hospitalisation: OR 0.50 (95% CI: 0.34-0.73, p < 0.001). Conclusions A protective effect of two-dose vaccination against measles complications and hospitalisation for measles was demonstrated. To prevent further cases, increased awareness and promotion of measles vaccination is recommended for all individuals, including travellers, as a substantial proportion of cases were unvaccinated. Key messages • Two-dose vaccination has a protective effect against measles complications and hospitalisation; increasing public awareness about the importance of measles vaccination and vaccine uptake is essential. • We recommend continuing routine childhood vaccination against measles and maintaining high vaccination coverage in order to prevent further cases and retaining measles elimination status in Czechia.