The World Health Organization (WHO) declared Estonia measles-free in 2017 after no local cases were reported from 2014–2016. Just a year later, the highly contagious disease was back.

This year alone, nine people in Estonia have contracted measles, according to Health Board figures. Some caught the virus abroad, but in other cases, the source of infection is unknown.

"Measles is extremely contagious and often comes with complications," said Juta Varjas, a service manager at the Health Board's Department of Communicable Diseases. Complications can include pneumonia, ear infections and encephalitis, or inflammation of the brain.

"It's severe for patients and demanding for medical staff as well," she added.

School nurses share the concern. Külli Reinsalu, chief nurse at the Tallinn Healthcare at School Foundation, said nearly two full large schools' worth of children in Tallinn went unvaccinated against measles last year.

"That worries us because vaccination is the only way to prevent measles," Reinsalu said. "Measles is no longer just a historical disease — it's back again."

School nurses sending reminders

Vaccination coverage in Estonia has dropped sharply in recent years. As of 2023, about 25,000 children under 16 were not vaccinated on schedule.

Varjas warned low vaccination coverage leaves the public vulnerable to preventable illness.

"The disease targets people who haven't had measles or aren't vaccinated," she said. "And then it spreads and, indeed, can trigger outbreaks."

Children go unvaccinated for various reasons, but lack of awareness or conflicting vaccine information is often to blame.

Reinsalu said parental inaction is increasingly common. School nurses request written, digitally signed consent for vaccinations, but often parents don't respond. Nurses will send multiple reminders, yet without consent, she added, kids unfortunately end up missing shots.

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