Global measles cases increase by 20%, driven by ‘stalled’ vaccine coverage
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Key takeaways:
- Measles cases increased globally by 20% last year, and by 37% in Africa.
- More than 22 million children globally missed their first dose of the measles vaccine.
Measles cases increased globally by 20% in 2023, and roughly 22 million children missed their first measles vaccine dose, according to the CDC and WHO’s annual global measles report.
The report also showed an 8% decrease in measles deaths from the year before. Officials said during a media telebriefing that the surge in cases is being driven by “stalled” vaccine coverage.
“For more than 50 years, the measles vaccine has continued to be one of our most effective vaccines, and since 2000 alone, the vaccine has saved more than 60 million lives,” Natasha S. Crowcroft, MD, senior technical advisor for measles and rubella in WHO’s Department of Immunization, Vaccines and Biologicals, said during the briefing.
“Despite the effectiveness of this vaccine, we’re continuing to see another year of stalled measles vaccine coverage, and countries and communities that need to reach 95% of children with two doses are not reaching that level — and that’s what’s needed to protect communities from outbreaks.”
The new data, published in MMWR, showed that global first-dose measles vaccine coverage held steady in 2023 at 83% and that second-dose coverage increased to 74% in 2023 from 73% the year before, although both remain well below the 95% threshold widely considered necessary to prevent outbreaks.
Overall, the report estimated that 22.2 million children did not receive a first dose of measles vaccine, a 2% increase from 2022 but still 9% lower than in in 2021.
According to the report, 57 countries experienced large or disruptive measles outbreaks last year — a 60% increase over 2022 — with nearly half of all the large or disruptive outbreaks occurring in Africa.
Globally, 82 countries have eliminated endemic measles, including the United States. Brazil was recertified this week as having eliminated the disease — returning the Americas to being free of locally acquired infections. Aside from Africa, every other WHO region has at least on country that has eliminated measles, but “we still have a long way to go before we’ve protected everyone from measles,” Crowcroft said.
In 2023, there were an estimated 10.341 million cases of measles globally, a 20% increase from the 8.645 million estimated for 2022. Crowcroft said that roughly half — about 4.8 million cases, a 37% increase from 2022 — were in Africa. Europe saw a roughly 200% increase. Most cases worldwide occurred in children aged 5 years or younger, Crowcroft said.
Although CDC and WHO officials noted that vaccine levels have improved in some ways in the last year, they warned the increase in outbreaks and cases is concerning.
In the U.S., vaccination coverage among kindergarteners — including with the MMR vaccine — has dipped below 93% amid an increase in vaccine exemption rates, including nonmedical exemption rates. In April, the CDC said a rise in cases could threaten the country’s elimination status.
“We have talked a lot about hesitancy and resistance to vaccines during COVID-19, but we have to look at all of the other causes that can be a reason why a child doesn’t have access to a vaccine,” Christine Dubray, MD, MSc, measles elimination team lead in the CDC’s Global Immunization Division, said during the briefing.
“It can be hesitancy, but it can also be access — the mother doesn’t have money to go take the bus, for example. So, we need to really look at all causes to better understand for each community why children don’t have access to these vaccines.”
References:
- Minta AA, et al. MMWR Morb Mortal Wkly Rep. 2024;doi:10.15585/mmwr.mm7345a4.
- Measles cases surge worldwide, infection 10.3 million people in 2023. https://www.cdc.gov/media/releases/2024/p1114-measles-cases.html. Published Nov. 14, 2024. Accessed Nov. 14, 2024.
- PAHO re-verifies Brazil as a measles-free country. https://www.paho.org/en/news/12-11-2024-paho-re-verifies-brazil-measles-free-country. Published Nov. 12, 2024. Accessed Nov. 15, 2024.
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