Measles cases are rising – here’s what can be done

This article was first published in February 2024 and most recently updated in November 2024.

There were an estimated 10.3 million cases of measles worldwide in 2023 – a 20% increase on 2022 figures, according to the World Health Organization (WHO).

This follows the WHO's announcement earlier in 2024 that there had been a 30-fold increase in measles cases between 2022 and 2023 across 41 countries in Europe and parts of central Asia.

So why are we in the middle of this "alarming rise" in measles cases – and what is being done about it?

Measles is caused by a highly contagious virus that infects the respiratory tract and spreads throughout the body, causing fever and a rash.

At its most severe, it can lead to complications including blindness, pneumonia and encephalitis, or swelling of the brain, which can kill.

The latest data from the WHO shows that over 100,000 people died from measles in 2023, the majority being children.

Young children under five, pregnant women, adults over 20 and those with compromised immune systems are most at risk of measles complications.

While measles is still common in Africa and parts of the Middle East and Asia, countries in Europe and the US had been declared measles-free in recent years – and these are now seeing a worrying resurgence.

Kazakhstan, one of 53 countries included in the WHO European Region, has seen the highest number of measles cases, with 13,677 recorded in 2023, 65% of which were in children under five.

In western Europe, the UK is one of the worst affected countries. On 19 January, the UK’s Health Security Agency (HSA) declared a “national incident”, reports the Financial Times (FT), after seeing suspected cases more than quadruple in England and Wales – from 360 in 2021 to 1,603 in 2023. And on 25 June, the UK's vaccine committee head told the BBC the country was "at a tipping point, where there's a real risk for more children getting seriously ill or [dying] from diseases we can prevent".

This is in stark contrast to 2017, when the UK received “measles-free status” from the WHO as a result of having just 284 cases. The city of Birmingham alone registered 250 cases in the four months from October 2023 to January 2024, according to the FT.

As the Chief Executive of the HSA Professor Dame Jenny Harries warned, children who get measles can be “very poorly, and some will suffer life-changing complications”.

The US Centers for Disease Control and Prevention (CDC), which is monitoring outbreaks, warned healthcare providers to be on the alert for patients with symptoms of measles, as 23 cases were reported since early December 2023.

To keep progressing in the fight against measles, countries are expected to achieve a rate of 95% coverage with 2 doses of measles-containing vaccine.

In the two decades between 2000 and 2020, second-dose vaccine coverage rose in all regions, albeit unevenly, as seen in the chart using WHO and CDC data below. This saved an estimated 57 million lives.

But these rates of vaccination coverage have since been dropping.

In the WHO European Region alone, over 1.8 million infants missed their measles vaccination between 2020 and 2022, at least partly caused by the COVID-19 pandemic.

While in the UK, more than 3.4 million children under 16 are either completely unprotected or only partially protected against measles, says NHS England.

Globally, the spread of misinformation about vaccine safety has contributed to the largest sustained drop in the uptake of childhood vaccinations in 30 years, in what UNICEF Executive Director Catherine Russell warned in 2022 was a “red alert” for child health.

“We need immunization catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems,” she said.

As the figures show, there’s urgent work needed to get immunization programmes back on track and to rebuild trust in vaccine safety to reach the 95% coverage threshold.

“Vaccination is the only way to protect children from this potentially dangerous disease,” the WHO’s Regional Director for Europe, Dr Hans Kluge said.

Countries also need to detect and respond quickly to measles outbreaks to limit further transmission.

Kluge praised Kazakhstan for taking decisive action to tackle measles, with measures including isolating patients and observing people they have been in contact with; catch-up immunizations for all children under 18 who missed routine vaccination; and a public education campaign.

In the UK, vaccine confidence has dropped since the pandemic, but access is a major factor in vaccine uptake, according to Helen Bedford, professor of children’s health at University College London.

She told the FT: “We need to be thinking more about taking vaccination to the people, rather than expecting them always to come to us.”

Building up regional vaccine manufacturing capacity can help to make access to vaccines more equitable. To this end, the World Economic Forum has been working with its healthcare partners including the Coalition of Epidemic Preparedness Innovations and the US National Academy of Medicine on the Regionalized Vaccine Manufacturing Collaborative.

In January, we published A Framework for Enhancing Vaccine Access Through Regionalized Manufacturing Ecosystems – to serve as a roadmap for regions to grow production and distribution capabilities sustainably and establish local capacities to respond at scale in epidemics.