This was pointed out during the XVI Immunization Conference of the AEP, where the recent resurgence of measles and whooping cough in Spain due to various outbreaks was addressed, as well as the problem that more than half of the autonomous communities do not exceed the 95 percent complete vaccination rate against them.
Measles, despite being officially eliminated since 2016, has accumulated 127 cases in the country so far this year, mostly imported, while in 2024 it recorded a total of 217 infections. Currently, the vaccine is administered in two doses within the infant vaccination schedule.
Data from the Ministry of Health show that although the vaccination rate is very high for the first dose, reaching 97.83 percent in 2023, it slightly decreases for the second dose, dropping to 94.42 percent, and only Castilla y León, Castilla-La Mancha, Madrid, Galicia, Navarra, and Andalucía exceeded the 95 percent recommended by experts.
According to specialists, the reasons that will continue to allow the virus to circulate, at least in the short term, are that measles can occur in children under 12 months who have not been vaccinated, as well as in children who have not reached maximum protection because they are under 3-4 years old and in adults born before 1981, the year the second dose of the vaccine began to be systematically administered.
All of this has led the CAV-AEP to modify its recommendations this year regarding vaccination, proposing to advance the administration of the second dose of the vaccine to 2 years, as opposed to the current 3-4 years, to ensure early protection. In this regard, Dr. Pineda pointed out that the second dose provides «truly effective» protection that will «last throughout life.»
CHANGES IN WHOOPING COUGH
In Spain, waves of whooping cough cases occur every 3-5 years, but they do not always follow the same pattern, requiring experts to be especially attentive to changes in the behavior of the causative pathogen in order to periodically review and adapt vaccination guidelines.
In the period from 2005 to 2023, the peak of highest incidence was reached in 2015, with 9,234 cases and an increase in deaths of young infants, after which the vaccination with Tdap (tetanus, diphtheria, and whooping cough) in pregnant women was introduced in 2016. «This measure quickly reduced mortality from this disease in infants under 3 months of age,» explained the co-director of the XVI Immunization Conference of the AEP, Antonio Iofrío.
The last epidemic wave that occurred over the past two years, which caused 2,754 cases in 2023 and 30,982 in 2024, was characterized by a significant impact among adolescents, with 71.5 percent of those infected being under 15 years old, and a change in the classic seasonal pattern of the disease, which is typical of warm months.
«In general, the reported cases of whooping cough were mild, with an estimated proportion of hospitalized cases of 2.9 percent,» Iofrío pointed out. Nevertheless, in this outbreak of 2023-2024, five deaths from whooping cough were reported: three infants whose mothers had not been vaccinated during pregnancy or had received the vaccine days before delivery, without enough time to pass antibodies to the fetus, and two other deaths of older adults with underlying diseases.
Health records show that, on average in 2023, a vaccination coverage rate of 90.45 percent was achieved against whooping cough, far from the recommended 95 percent, which was only surpassed by Madrid, Canarias, Cantabria, Galicia, and País Vasco. Therefore, Iofrío reiterated the importance of raising awareness about vaccination so that the pathogen cannot find «loopholes» to «sneak through.»
BOOSTER DOSES IN ADOLESCENTS
Therefore, the specialist has urged to ensure vaccination in pregnant women, infants, and children, avoiding delays in the doses indicated in the schedule, and has recommended vaccination in adolescents, between 10 and 12 years old, and in adult caregivers, where reinfections are common and act as transmitters in the community.
Regarding adolescents, the Vaccination and Immunization Calendar of the AEP has recommended a booster dose against whooping cough in this group since 2003. Currently, only Asturias, Andalucía, Cataluña, and Madrid include its administration.
In this regard, pediatricians have noted that in the European Union, all countries except six, including Spain, recommend a dose between 10 and 16 years old. In addition, 14 countries also suggest a dose in adults and in eight countries administer it every 10 years.