Romania is grappling with the most severe measles crisis in the European Union, recording over 35,000 cases and at least 30 deaths between 2023 and 2025. The country accounted for 87% of all EU measles cases in 2024, with the next most affected nation, Italy, reporting just over 1,000 cases. Most fatalities were infants too young to be vaccinated, infected by older unvaccinated children.
The outbreak stems from a dramatic decline in vaccination coverage. The first dose of the MMR vaccine, recommended at 14-18 months, reaches only 81% by the later age, far below the 95% threshold for herd immunity. Uptake of the second dose at age five is just over 60% nationally, dropping to 20% in some communities, according to the National Institute of Public Health. Romania's MMR rate, which exceeded the European average of 93% in 2010, has been falling steadily, accelerating after the Covid-19 pandemic.
Structural issues compound the crisis. Since 2015, only general practitioners (GPs) are reimbursed for administering vaccines, increasing bureaucracy and straining an already overburdened system. School nurses, who previously provided a safety net for missed jabs, are no longer allowed to vaccinate. In Săcele, a town of over 30,000, just seven GPs serve the population. Dr Simona Codreanu, who sees over 50 patients daily, notes that many children receive only the birth vaccine and never return for the full schedule.
Poverty and access barriers also hinder vaccination. Casandra Stoica, a Roma mother of four living without running water or electricity, had to travel to a neighbouring county during the 2024 outbreak because local hospitals were full. Her two older daughters contracted measles, and she now wants to vaccinate all her children. 'The decision not to vaccinate doesn't always come from the parents,' says Gabriela Alexandrescu of Save the Children, citing medical deserts and GPs lacking time to counsel hesitant families.
Epidemiologists warn that without urgent action, another serious outbreak is imminent. Dr Aurora Stanescu calls the situation 'a national security issue' requiring firm political commitment. Dr Mirela Csabai, a GP in Săcele, describes the low vaccination rates as 'a powder keg'. 'Once an epidemic starts, it is already too late to vaccinate. We need to act now,' she says.
