Measles Resurgence Sparks Global Alarm Amid Declining Vaccination Coverage

A major review published in The New England Journal of Medicine warns of a worsening global measles crisis, highlighting a sharp increase in cases and deaths due to declining vaccination coverage, rising vaccine hesitancy, and post-pandemic disruptions in immunization programs. The review calls for urgent measures to bridge immunity gaps and reinforce public health defenses.1

Globally, over 395,000 lab-confirmed measles cases were reported in 2024, and more than 16,000 in just the first two months of 2025. Alarmingly, more than half of these cases required hospitalization. Young children, immunocompromised individuals, and pregnant women remain the most vulnerable. Complications such as pneumonia, diarrhea, otitis media, and encephalitis are reported in nearly one-third of all measles cases. In malnourished children, measles-related mortality is particularly high, with blindness and severe immune suppression posing long-term risks.

Of critical concern is the observed decline in maternal antibodies among infants, leaving many unprotected in the first six months of life. Despite the widespread availability of safe and effective measles vaccines, global coverage remains well below the 95% threshold required for herd immunity. The COVID-19 pandemic compounded this issue, severely disrupting immunization programs, especially in low- and middle-income countries.

The review also revisits the role of vitamin A supplementation, which has been shown to reduce measles-related mortality, especially in vitamin A-deficient populations, significantly. However, in developed countries, vitamin A use remains inconsistent and often misunderstood due to misinformation.

Among the key recommendations, the authors emphasize timely vaccination—including the potential need for an earlier dose in infants during outbreaks—use of post-exposure prophylaxis, and integration of novel tools like microneedle patches to boost vaccine accessibility. They caution against complacency, warning that the U.S. could lose its measles elimination status if current trends continue.

As the world faces the threat of measles re-establishing itself in regions where it was once eliminated, the article underscores the critical need to rebuild trust in vaccines, close immunity gaps, and invest in public health infrastructure to prevent avoidable deaths from a vaccine-preventable disease. 

Source: Do LAH, Mulholland K. Measles 2025. N Engl J Med. 2025 Jun 25.