The global situation regarding measles vaccine uptake and outbreaks in 2024 and 2025 is concerning, with a significant increase in cases and declining vaccination rates

Background

Measles is a severe disease in children, with many complications (Table 1) and a death toll well above 1/1,000 in children.  As the disease is highly contagious (reproductive rate Ro = 15-17) each person will become infected sooner or later if not vaccinated. Vaccine uptake with 2 doses must be >95% to eliminate the disease locally or eradicate it globally – which is a goal of WHO.

Table 1:Measles comlications

It is important to note that these percentages can vary depending on factors such as age, vaccination status, and overall health of the affected children. Additionally, some complications may be more common in certain populations or outbreaks.

Vaccine Uptake

Global measles vaccine coverage has declined since the COVID-19 pandemic. In 2023, 83% of children received their first dose of measles vaccine, down from 86% in 2019. Only 74% of children globally received the recommended second dose. More than 22 million children missed their first dose of measles vaccine in 2023.

Outbreaks and Cases

An estimated 10.3 million people were infected with measles in 2023, a 20% increase from 2022. In 2023, 57 countries experienced large or disruptive measles outbreaks, up from 36 countries in 2022. Major outbreaks occurred in various regions, including Africa, the Middle East, and Asia. The largest outbreak in 2023 was in the Democratic Republic of the Congo, with 311,500 cases.

Regional Highlights

The Americas region regained its status as free of endemic measles in 2024, with Brazil re-verified as having eliminated the disease. Europe saw a surge in cases, with Britain reporting 2,911 confirmed measles cases in 2024, the highest since 2012. In the U.S., measles cases in 2024 were nearly double the total for 2023, with cases confirmed in at least 18 states.

Deaths and Severity

An estimated 107,500 people died from measles in 2023, mostly unvaccinated children under 5 years old. The U.S. registered its first measles death since 2015 in early 2025.

Vaccination Challenges

Coverage of 95% or greater with two doses of measles vaccine is needed to prevent outbreaks. Low-income countries had 64% coverage for the first dose in 2023, compared to 94% in high-income countries.

The situation underscores the urgent need for increased vaccination efforts and public health measures to prevent further outbreaks and protect vulnerable populations.

Author: Prof. Joe Schmitt—Global Health Press
Translator: MSc, MD. Le Minh Dat

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References

1.      World Health Organization. Measles cases and deaths surge worldwide as vaccine coverage drops. WHO Newsroom. November 16, 2023.

2.      Centers for Disease Control and Prevention. Measles Cases and Outbreaks. CDC Measles (Rubeola). Updated February 5, 2024.

3.      Pan American Health Organization. The Americas region regains status as free of endemic measles. PAHO News. March 8, 2024.

4.      UK Health Security Agency. Measles cases in England surge to highest levels in over a decade. GOV.UK Press release. January 19, 2024.

5.      World Health Organization. Measles and Rubella Surveillance Data. WHO Immunization, Vaccines and Biologicals. Updated December 15, 2023.