New preventive strategy to eliminate measles, mumps and rubella from Europe based on the serological assessment of herd immunity levels in the population

  • P. PlansEmail author


Herd immunity blocks the transmission of measles, mumps and rubella in a population group when the prevalence of positive serologic results (p) is higher than a critical value (p c), known as the herd immunity threshold. A new preventive strategy should be developed in order to achieve the elimination of measles, rubella and mumps in Europe based on the serological assessment of herd immunity levels in different population groups. This strategy could detect population groups without herd immunity (p < p c) and indicate the additional vaccination coverage required in these groups in order to establish herd immunity and prevent outbreaks. The serological assessment of herd immunity levels in Catalonia, Spain, showed that herd immunity had not been established for measles and mumps in schoolchildren (5–9 years of age) and youths/younger adults (15–29 years of age), and that the additional vaccination coverage required to establish herd immunity in these groups was 1–7 %. The new preventive strategy should be used to detect priority population groups for preventive and surveillance activities in European countries.


Measle Rubella Vaccination Coverage Mumps Herd Immunity 
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  1. 1.
    World Health Organization (WHO) (2003) Strategic plan for measles and congenital rubella infection in the European Region of WHO. WHO Regional Office for Europe, Copenhagen, Denmark. Available online at:
  2. 2.
    WHO Regional Office for Europe (1985) Targets for health for all. World Health Organization (WHO), CopenhagenGoogle Scholar
  3. 3.
    European Centre for Disease Prevention and Control (ECDC) (2011) Annual epidemiological report on communicable diseases in Europe 2011. ECDC, StockholmGoogle Scholar
  4. 4.
    World Health Organization (WHO) Centralized Information System for Infectious Diseases (CISID). Measles: number of cases, 2001–2011. Available online at:
  5. 5.
    Salleras L, Domínguez A, Torner N (2001) Confirmed interruption of indigenous measles transmission in Catalonia. Euro Surveill 6:113–117Google Scholar
  6. 6.
    Peña-Rey I, Castellanos T, Suárez B, Alcalde E, Martínez de Aragón MV (2006) Evaluación del plan de eliminación de sarampión en España. Año 2005. Bol Epidemiol Semanal 14:121–127Google Scholar
  7. 7.
    Domínguez A, Torner N, Barrabeig I, Rovira A, Rius C, Cayla J, Plasencia E, Minguell S, Sala MR, Martínez A, Costa J, Mosquera M, Cabezas C; Working Group for the Study of the Measles Outbreak in Catalonia (2008) Large outbreak of measles in a community with high vaccination coverage: implications for the vaccination schedule. Clin Infect Dis 47:1143–1149PubMedCrossRefGoogle Scholar
  8. 8.
    Departament de Salut (2010) Pla d’eliminació del xarampió a Catalunya. Informació sobre el brot de xarampió a Catalunya. Departament de Salut, BarcelonaGoogle Scholar
  9. 9.
    World Health Organization (WHO) (2003) WHO-recommended standards for surveillance of selected vaccine-preventable diseases. WHO, GenevaGoogle Scholar
  10. 10.
    Steffens I, Martin R, Lopalco PL (2010) Spotlight on measles 2010: measles elimination in Europe—a new commitment to meet the goal by 2015. Euro Surveill 15(50):pii=19749. Available online at:
  11. 11.
    Plans-Rubió P (2010) Prevalence of antibodies associated with herd immunity: a new indicator to evaluate the establishment of herd immunity and to decide immunization strategies. Med Decis Making 30:438–443CrossRefGoogle Scholar
  12. 12.
    Plans-Rubió P (2012) Evaluation of the establishment of herd immunity in the population by means of serological surveys and vaccination coverage. Hum Vaccin Immunother 8(2):184–188PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson RM, Hollingsworth TD, Nokes DJ (2009) Mathematical models of transmission and control. In: Detels R, Beaglehole R, Lansang MA, Gulliford M (eds) Oxford textbook of public health. Oxford University Press, New York, pp 715–744Google Scholar
  14. 14.
    Anderson RM (1992) The concept of herd immunity and the design of community-based immunization programmes. Vaccine 10:928–935PubMedCrossRefGoogle Scholar
  15. 15.
    Plans-Rubió P (2012) The vaccination coverage required to establish herd immunity against influenza viruses. Prev Med 55:72–77PubMedCrossRefGoogle Scholar
  16. 16.
    Domínguez A, Plans P, Costa J, Torner N, Cardeñosa N, Batalla J, Plasència A, Salleras L (2006) Seroprevalence of measles, rubella, and mumps antibodies in Catalonia, Spain: results of a cross-sectional study. Eur J Clin Microbiol Infect Dis 25:310–317PubMedCrossRefGoogle Scholar
  17. 17.
    Plans Rubió P (2012) Is the basic reproductive number (R0) for measles viruses observed in recent outbreaks lower than in the pre-vaccination era? Euro Surveill 17(31):pii=20233. Available online:
  18. 18.
    Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L (1998) Measles, mumps, and rubella—vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 47(RR-8):1–57PubMedGoogle Scholar
  19. 19.
    Hinman AR (1999) Eradication of vaccine-preventable diseases. Annu Rev Public Health 20:211–229PubMedCrossRefGoogle Scholar
  20. 20.
    Orenstein WA, Hinman AR, Strebel PM (2007) Eradicating measles: a feasible goal? Pediatr Health 1:183–190CrossRefGoogle Scholar
  21. 21.
    de Quadros CA, Izurieta H, Venczel L, Carrasco P (2004) Measles eradication in the Americas: progress to date. J Infect Dis 189(Suppl 1):S227–S235PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Health Department of CataloniaPublic Health Agency of CataloniaBarcelonaSpain
  2. 2.CIBER in Epidemiology and Public Health (CIBERESP)PamplonaSpain

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