Summary of routine immunization and vaccine-preventable diseases surveillance data 2019

1. www.euro.who.int
Routine immunization summary—
WHO European Region, 2019
Vaccine-preventable Diseases and Immunization programme
Division of country health programmes
Data as of 18 August 2020

2. Immunization system characteristics—WHO European Region,
2018–2019
2
AEFI: Adverse event following immunization
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
MCV1: measles-containing vaccine, first dose
MCV2: measles-containing vaccine, second dose
NITAG: National Immunization Technical Advisory Group
*The six WHO NITAG criteria are 1. legislative or administrative basis for the advisory group; 2. formal written
terms of reference; 3. at least five different areas of expertise represented among core members; 4. at least one
meeting per year; 5. circulation of the agenda and background documents at least one week prior to meetings; 6.
mandatory disclosure of any conflict of interest
Data source: 1 WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020; 2Polio Laboratory Network: www.euro.who.int/poliolabnetwork & personal communication based on annual accreditation
process of the European MR Laboratory Network; 3 WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
N (total # of country in the Region) = 53 All 53 countries submitted JRF in 2018 and 46 in 2019
Characteristic
2018
N(%)
2019
N(%)
Countries with ≥95% DTP3 coverage1
31(58) 32(60)
Countries with ≥95% MCV1 coverage1
29(55) 30(57)
Countries with ≥95% MCV2 coverage1
21(40) 23(43)
Countries with sustained DTP3 coverage ≥95% DTP3 in last 3 years1
26(49) 30(57)
Countries with sustained access to WHO accredited polio, measles, and rubella
laboratories2 53(100) 53(100)
Countries with NITAG in place that meets the six* WHO criteria3
35(66) 31(58)
Countries with national system to monitor AEFI3
52(98) 52(98)
Countries with communication plan to respond to vaccine safety-related events3
30(57) 32(60)
Countries with vaccine hesitancy assessment performed within last 5 years3
32(60) 32(60)
Countries with child’s vaccination status routinely checked at the time of
enrollment to or during childcare or school3 41(77) 43(81)

3. Regional immunization coverage estimates—WHO European
Region, 2015–2019
3Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
DTP1: diphtheria-tetanus-pertussis-containing vaccine, first dose
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
HepB3: hepatitis B vaccine, third dose
Hib3: Haemophilus influenzae type b vaccine, third dose
PCV3: pneumococcal conjugate vaccine, third dose
Pol3: polio-containing vaccine, third dose
MCV1: measles-containing vaccine, first dose
MCV2: measles-containing vaccine, second dose
Vaccine 2015 2016 2017 2018 2019
DTP1 96 95 96 97 97
DTP3 93 92 94 95 95
HepB3 82 82 84 84 92
Hib3 76 76 76 78 79
PCV3 48 62 73 78 80
Pol3 94 94 93 94 95
MCV1 94 93 95 95 96
MCV2 89 88 90 91 91

4. Diphtheria-tetanus-pertussis-containing
vaccine, third dose (DTP3)
4

5. Number of countries categorized by national DTP3 coverage
estimate—WHO European Region, 2015–2019
5Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
N (total # of countries in the Region) = 53
34
30
32
31
32
13
15
13
17
15
6
8
8
5
6
0 10 20 30 40 50
2015
2016
2017
2018
2019
Number of countries
Year
≥95% 90–94% <90%

6. Countries categorized by national DTP3 coverage estimate—
WHO European Region, 2019
6Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
Countries with <90%
DTP3 coverage estimate
Country % coverage
Romania 88
San Marino 88
Montenegro 86
Austria 85
Ukraine 80
Bosnia and Herzegovina 73
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
N (total # of countries in the Region) = 53

7. Number of countries with ≥90% DTP3 reported coverage in
≥90% of districts—WHO European Region, 2015–2019
7Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49
26 25 23
19
24
0
10
20
30
40
50
2015 2016 2017 2018 2019
Numberofcountries
Year
≥ 90% districts with ≥ 90% DTP3 reported coverage
Number of countries reporting district DTP3 coverage by category were 38 in 2015, 37 in 2016 and 2017, 40 in
2018 and 37 in 2019

8. Reported sub-national DTP3 coverage—WHO European
Region, 2019
8Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020 The second and third administrative level were used to map reported sub-national DTP3 coverage based on available data.
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49

9. Proportion of districts by different categories of DTP3 reported
coverage—WHO European Region, 2015–2019
9Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
DTP3: diphtheria-tetanus-pertussis-containing vaccine, third dose
N (total # of countries in the Region) = 53*
*Four countries have no subnational administrative level and are counted as 1 district
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2015 2016 2017 2018 2019
Proportionofdistricts
Year
≥95% 90-94% 80-89% 51-79% <50% Not reporting
Number of countries not reporting district DTP3 coverage by category were 10 in 2015, 11 in 2016 and
2017, 8 in 2018 and 11 in 2019

10. Number of children unvaccinated and under-vaccinated with
DTP-containing vaccine—WHO European Region, 2015–2019
10Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
DTP: diphtheria-tetanus-pertussis-containing vaccine
0
100
200
300
400
500
600
700
800
900
2015 2016 2017 2018 2019
Numberofchildren(inthousands)
Year
Unvaccinated (0 dose) Under-vaccinated (1 or 2 doses only)

11. Measles-containing vaccine, first dose (MCV1)
11

12. Number of countries categorized by national MCV1 coverage
estimate—WHO European Region, 2015–2019
12Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
MCV1: measles-containing vaccine, first dose
N (total # of countries in the Region) = 53
30
26
29
29
30
12
17
15
18
15
11
10
9
6
8
0 10 20 30 40 50
2015
2016
2017
2018
2019
Number of countries
Year
≥95% 90–94% <90%

13. Countries categorized by national MCV1 coverage estimate—
WHO European Region, 2019
13Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
Countries with <90%
MCV1 coverage estimate
Country % coverage
Estonia 88
Monaco 88
Serbia 87
Cyprus 86
San Marino 86
North Macedonia 75
Bosnia and Herzegovina 68
Montenegro 42
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
MCV1: measles-containing vaccine, first dose
N (total # of countries in the Region) = 53

14. Number of countries with ≥90% MCV1 reported coverage in
≥90% of districts—WHO European Region, 2015–2019
14
MCV1: measles-containing vaccine, first dose
Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49
22 21 21 19
22
0
10
20
30
40
50
2015 2016 2017 2018 2019
Numberofcountries
Year
≥ 90% districts with ≥ 90% MCV1 reported coverage
Number of countries reporting district MCV1 coverage by category were 38 in 2015, 37 in 2016, 38 in 2017, 39
in 2018 and 37 in 2019

15. Reported sub-national MCV1 coverage—WHO European
Region, 2019
15Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020 The second and third administrative level were used to map reported sub-national MCV1 coverage based on available data.
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
MCV1: measles-containing vaccine, first dose N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49

16. Proportion of districts by different categories of MCV1 reported
coverage—WHO European Region, 2015–2019
16Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
MCV1: measles-containing vaccine, first dose
N (total # of countries in the Region) = 53*
*Four countries have no subnational administrative level and are counted as 1 district
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2015 2016 2017 2018 2019
Proportionofdistricts
Year
≥95% 90-94% 80-89% 51-79% <50% Not reporting
Number of countries not reporting district MCV1 coverage by category were 10 in 2015, 11 in 2016,
10 in 2017, 9 in 2018 and 11 in 2019

17. Number of children unvaccinated with MCV1—WHO European
Region, 2015–2019
17Population source: United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2019 Revision.
Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
MCV1: measles-containing vaccine, first dose
0
100
200
300
400
500
600
700
800
900
2015 2016 2017 2018 2019
Numberofchildren(inthousands)
Year
Unvaccinated

18. Measles-containing vaccine, second dose (MCV2)
18

19. Number of countries categorized by national MCV2 coverage
estimate—WHO European Region, 2015–2019
19Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
MCV2: measles-containing vaccine, second dose
N (total # of countries in the Region) = 53
17
19
18
21
23
15
11
16
14
14
19
22
18
17
15
2
1
1
1
1
0 10 20 30 40 50
2015
2016
2017
2018
2019
Number of countries
Year
≥95% 90–94% <90% No data

20. Countries categorized by national MCV2 coverage estimate—
WHO European Region, 2019
20Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
Countries with <90%
MCV2 coverage estimate
Country % coverage
Cyprus 88
Italy 88
Turkey 88
Bulgaria 87
United Kingdom 87
Montenegro 86
Belgium 85
Austria 84
Czech Republic 84
France 83
Greece 83
Monaco 79
San Marino 79
Bosnia and Herzegovina 76
Romania 76
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
MCV2: measles-containing vaccine, second dose
N (total # of countries in the Region) = 53
No data (n=1)

21. Number of countries with ≥90% MCV2 reported coverage in
≥90% of districts—WHO European Region, 2015–2019
21
MCV2: measles-containing vaccine, second dose
Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49
16 14 15
19 19
0
10
20
30
40
50
2015 2016 2017 2018 2019
Numberofcountries
Year
≥ 90% districts with ≥ 90% MCV2 reported coverage
Number of countries reporting district MCV2 coverage by category were 33 in 2015 and 2016, 36 in 2017 and
2018 and 33 in 2019

22. Reported sub-national MCV2 coverage—WHO European
Region, 2019
22Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020 The second and third administrative level were used to map reported sub-national MCV2 coverage based on available data.
Disclaimer: The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or
area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2020. All rights reserved.
MCV2: measles-containing vaccine, second dose N (total # of countries in the Region) = 53
N (total # of countries in the Region with more than one administrative level) = 49

23. Proportion of districts by different categories of MCV2 reported
coverage—WHO European Region, 2015–2019
23Data source: WHO/UNICEF Joint Reporting Form on immunization (JRF) as of 18 August 2020
MCV2: measles-containing vaccine, second dose
N (total # of countries in the Region) = 53*
*Four countries have no subnational administrative level and are counted as 1 district
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2015 2016 2017 2018 2019
Proportionofdistricts
Year
≥95% 90-94% 80-89% 51-79% <50% Not reporting
Number of countries not reporting district MCV2 coverage by category were 15 in 2015 and 2016, 12 in
2017 and 2018, and 15 in 2019

24. Hepatitis-containing vaccine, birth and third dose
24

25. Number of countries categorized by national HepB-BD
coverage estimate—WHO European Region, 2015–2019
25Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
HepB-BD: hepatitis B vaccine, birth dose
N (total # of countries in the Region) = 53
18
16
16
18
16
3
5
3
1
4
1
1
2
2
1
30
30
31
31
31
1
1
1
1
1
0 10 20 30 40 50
2015
2016
2017
2018
2019
Number of countries
Year
≥95% 90–94% <90% No policy of universal vaccination of newborns No data

26. Number of countries categorized by national HepB3 coverage
estimate—WHO European Region, 2015–2019
26Data source: WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) as of 15 July 2020
HepB3: hepatitis B vaccine, third dose
N (total # of countries in the Region) = 53
22
23
20
23
24
15
14
17
15
16
8
8
9
8
8
8
8
7
7
5
0 10 20 30 40 50
2015
2016
2017
2018
2019
Number of countries
Year
≥95% 90–94% <90% No policy of universal vaccination of <1-year-olds

27. Links to routine immunization information
27
• WHO/UNICEF Estimates of National Immunization Coverage (WUENIC)
http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragebcg.html
• Polio laboratory network
www.euro.who.int/poliolabnetwork
© World Health Organization 2020
Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence
(CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).