16 November 2023 – More children died from measles in 2022 than 2021, according to a new report released today by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). The data serve as an urgent call to action—placing renewed attention on the importance of life-saving vaccines.

Last year, 136,200 people—most of them children—died from measles. That is why it’s imperative that children everywhere get the necessary two doses of the measles vaccines, which are 97% effective at preventing measles infections for life.

Measles cases are also on the rise; the data show a jump in the number of people with measles, surging from 7 million in 2021 to 9 million in 2022. The increases in both number of deaths and cases reflect the severity of the disruption of routine health services caused by the COVID-19 pandemic.

Since 2001, the Measles & Rubella Partnership (M&RP) has worked with countries to vaccinate millions of children, helping to prevent an estimated 57 million deaths. Despite global measles vaccination coverage reaching 83% for the first dose in 2022, progress has not been equitable and the risk of dying from measles is highest in low-income countries where vaccination coverage was only 66% last year. We can and must do more to ensure every child is protected, no matter where they live.

Measles cases anywhere in the world pose a risk to all countries and communities where immunization coverage is below 95%. In 2022, 37 countries were affected by large or disruptive measles outbreaks, nearly double the number of countries in 2021. Because measles outbreaks most often occur in un- or under-vaccinated communities, outbreaks point to weaknesses and inequities in immunization programs and other essential health services. Understanding where and why outbreaks happen can help public health officials deliver tailored solutions to ensure measles and other vaccinations are available to and accessed by all.

The M&RP allies with countries in protecting every child by supporting efforts to reach the 95% coverage goal for first- and second-dose measles vaccinations. This includes accelerated actions to reach unprotected children by conducting preventive vaccination campaigns prior to the start of countries’ high transmission periods and recognizing and addressing immunization gaps resulting from inequity, climate-related crises, migration, and conflict.

“To reverse the worrying increasing trend in measles cases and deaths, countries at high risk need to urgently implement vaccination campaigns while working to strengthen health systems and be ready for rapid outbreak response,” said Dr. Mary Agocs, M&RP co-chair, and director of the Measles & Rubella Partnership at the American Red Cross. “The M&RP stands ready to support countries, working in collaboration to ensure every child receives life-saving vaccines.”

The increase in measles cases and deaths, concentrated in certain countries and regions, underscores the global inequity of access to reliable health care and routine services including immunizations. The M&RP and the countries we work with share a common goal to eliminate measles not just as a target, but as a promise to future generations. By intensifying our focus, working together, and using measles as a tracer for inequity, we can make a significant step towards a world where every child has the chance to survive and thrive, free from the threat of measles and all vaccine-preventable diseases.

Quotes from M&RP members:

Gavi, the Vaccine Alliance

“The concerning surge in measles outbreaks and mortality is a stark reminder of the importance of sustained attention on recovering from the pandemic and ensuring health systems are equipped to reach even the hardest to reach communities. Gavi, the Vaccine Alliance, has played a foundational role in supporting lower-income countries’ measles vaccination efforts since 2000 and we will double down on this commitment in 2024: reinforcing our support to countries for their routine measles and rubella programmes, helping countries launch an unprecedented number of campaigns, supporting outbreak response, and focusing on achieving high coverage rates by reaching zero-dose children and missed communities with the lifesaving power of vaccines.” – Aurélia Nguyen, Chief Programme Officer at Gavi, the Vaccine Alliance

American Red Cross

“Red Cross volunteers live and work in the same vulnerable communities where children are becoming ill and dying from measles. Many of these volunteers have seen firsthand just how devastating this disease can be”, says Marian Spivey-Estrada, Principal Deputy and Vice President of International Services at the American Red Cross. “It is our duty as humanitarians to protect these communities and ensure that all children everywhere have a chance to live long healthy lives free of this vaccine preventable disease.”

UNICEF

“A 43 per cent increase in measles deaths, mostly among children, is a devastating reminder of what is at stake when we don’t vaccinate communities against deadly diseases. But it is not too late to stop these numbers from climbing and save lives. We know what it will take to fill the immunity gap and recover from the decline in immunization coverage, and we know what it will cost. The next step is to act.” – Dr. Ephrem Lemango, UNICEF Chief of Immunization

United Nations Foundation

"Before a measles vaccine was available globally, 2.6 million people, mostly children, were dying every year from this deadly disease. We’ve made immense progress since then, and we cannot let it stop now. It is time for public health leaders and communities to recommit to protecting all children from measles." – Lori Sloate, Senior Director of Global Health for the United Nations Foundation

U.S. Centers for Disease Control and Prevention

“The increase in measles outbreaks and deaths is staggering, but unfortunately, not unexpected given the declining vaccination rates we’ve seen in the past few years,” said John Vertefeuille, director of CDC’s Global Immunization Division. “Measles cases anywhere pose a risk to all countries and communities where people are under-vaccinated. Urgent, targeted efforts are critical to prevent measles disease and deaths.” 

World Health Organization

“The lack of recovery in measles vaccine coverage in low-income countries following the pandemic is an alarm bell for action. Measles is called the inequity virus for good reason. It is the disease that will find and attack those who aren’t protected,” said Kate O’Brien, WHO Director for Immunization, Vaccines and Biologicals. “Children everywhere have the right to be protected by the lifesaving measles vaccine, no matter where they live.”

GAVI FACTSHEET: STATE OF MEASLES IMMUNISATION IN LOWER-INCOME COUNTRIES

How does vaccination against measles work in lower-income countries?

• One of the top vaccine-preventable killers of children, measles is highly contagious and requires at least 95% vaccine coverage through routine vaccination and highly effective supplementary campaigns. This presents a significant challenge to countries, particularly lower-income countries, that continue to struggle to close immunity gaps.
• The measles-containing vaccine is safe, effective and inexpensive. Children should receive two doses of the vaccine through a combination of routine and supplementary activities to ensure they are immune: the first dose at 9 months and the second dose at 15–18 months of age.
• Measles vaccination also represents an important opportunity to strengthen health systems. Measles is a tracer, and when an unimmunised child is identified and reached through a measles or measles-rubella (MR) vaccination campaign, it serves as a critical entry point for both routine immunisation and other essential services.
• Routine immunisation: Gavi supports lower-income countries to introduce two doses of measles-containing vaccine (MCV1 and MCV2) into routine programmes.
• Preventive catch-up and follow-up vaccination campaigns: In addition, the Vaccine Alliance supports the planning, application, implementation and evaluation of regular preventive measles/measles-rubella (M/MR) follow-up and catch-up vaccination campaigns that supplement routine immunisation activities, with the specific aim to identify and reach missed communities with un- or under-immunised children, and thus reduce immunity gaps wherever possible.
• Outbreak response: Gavi is the primary funder of immunisation activities in response to measles outbreaks in lower-income countries, through contributions to the Measles & Rubella Partnership (M&RP)’s Outbreak Response Fund.

2023: Recovery from the COVID-19 pandemic

• Preventive vaccination campaigns: So far in 2023, nine lower-income countries have planned and rolled out follow-up vaccination campaigns in an accelerated effort with Gavi support: Democratic Republic of the Congo (DRC), South Sudan, Cameroon, Malawi, Mozambique, Papua New Guinea, Yemen, Syria and Nigeria. Two of these countries (DRC and Nigeria) are among the top ten countries with unvaccinated or “zero-dose” children. An additional three countries are scheduled to roll out campaigns before the end of the year: Chad, Central African Republic and Sudan.
• Routine immunisation: In 2023, Mauritania introduced a second dose of measles-containing vaccine into its routine immunisation programme.
• Outbreak response: In 2023, Gavi dedicated more than US$ 12 million to the Measles & Rubella Partnership (M&RP)’s Outbreak Response Fund to support outbreak response in six lower-income countries.
• The Big Catch-up: In April 2023, Gavi joined global and national health partners for “The Big Catch-up”, a targeted global effort to boost vaccination among children following declines driven by the COVID-19 pandemic. This effort aims to reverse the declines in childhood vaccination recorded in over 100 countries since the pandemic.

2024: Doubling down on measles immunisation

• In 2024, Gavi plans to support at least 15 lower-income countries to roll out measles and rubella catch-up and follow-up vaccination campaigns aiming to reach about 38.5 million children – an unprecedented number of campaigns. These 15 countries – Burkina Faso, Cambodia, Chad, Côte d'Ivoire, Eritrea, Ghana, Lao PDR, Liberia, Madagascar, Mali (rubella catch-up), Mauritania, Nepal, Rwanda, Sierra Leone and Tanzania – represent those with approved plans to-date.
• In parallel, Alliance partners are continuing to work with other priority and at-risk countries. In November 2023, Gavi’s Independent Review Committee (IRC) of experts will review plans for measles vaccination in an additional five countries, to be implemented in 2024: Guinea-Bissau (MR introduction with catch-up campaign), and Guinea, Kyrgyzstan, Mozambique and Zambia (supplementary follow-up campaigns). The IRC is composed of a range of technical experts from across the world who meet regularly to review applications for support from Gavi-eligible countries and to advise on roll-out plans.

Gavi support: 2000–2022

• From 2000–2022, Gavi has supported lower-income countries to reach more than 863 million children through measles-rubella campaigns; more than 366 million through measles follow-up campaigns; and more than 172 million through routine immunisation. For more information, visit Gavi’s 2022 Annual Progress Report.
• Working through the Measles & Rubella Partnership’s Outbreak Response Fund, Gavi has also been the main funder of measles outbreak response activities in lower-income countries – providing nearly US$ 100 million to cover the 68 country applications for outbreak response support received since 2013.

Global immunisation coverage: 2000–2022

• During 2000–2022, estimated measles vaccination prevented approximately 57 million deaths worldwide/globally.
• Coverage with first and second doses of measles-containing vaccine increased in 2022 but still falls short of the required 95% threshold as demonstrated by significant increase in disruptive outbreaks (37 in 2022, compared to 22 in 2021).

MEDIA CONTACTS

Meg Sharafudeen
+41 79 711 55 54
msharafudeen@gavi.org

Collins Weru Mwai
+25 078 783 66 38
cmwai@gavi.org

Cirũ Kariũki
+41 79 913 94 41
ckariuki@gavi.org

Laura Shevlin
+ 41 79 529 92 87
lshevlin@gavi.org

Matthew Grek
+44 77 38 46 64 53
mgrek@gavi.org

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