A comprehensive report published in The New England Journal of Medicine has raised a red flag about the global resurgence of measles, a disease once thought to be under control in many parts of the world. In their June 2025 review, Drs. Jennifer B. Nuzzo and Saad B. Omer provide a stark overview of how declining vaccination rates, misinformation, and systemic weaknesses are fuelling a dangerous public health crisis.
Measles, one of the most contagious viruses known to science, requires near-universal immunisation to keep outbreaks at bay. Yet, according to the report, global coverage with the first dose of measles-containing vaccine has stagnated at around 83% since 2009, falling well below the 95% threshold required for herd immunity. The COVID-19 pandemic only worsened the situation. In 2021 and 2022, more than 60 million doses were delayed or missed.
The authors note: “The effects of these setbacks are already evident. In 2022, there were more than 9 million measles cases and 136,000 deaths globally — increases of 18% and 43%, respectively, over 2021.” And in 2023, outbreaks were reported in 51 of the 53 countries in the WHO European Region alone.
Fuelled by fear and disinformation
The resurgence is not simply due to access problems. In high-income countries like the United States, vaccine refusal and delay — often driven by misinformation — are becoming increasingly common. “In 2023, there were 58 measles outbreaks in the United States, accounting for 338 cases across 20 states,” the report reveals, adding that “misinformation about vaccine safety and underestimation of disease risks have eroded public confidence.”
This trend has prompted public health experts to warn of a creeping erosion of trust in medical institutions. The report points out that social media has accelerated the spread of anti-vaccine narratives, undermining decades of progress.
Vulnerable populations bear the brunt
While high-profile outbreaks in wealthy nations often make headlines, the greatest burden falls on lower-income countries. Children under the age of five account for the vast majority of measles deaths. “As many as 83% of the 56 million children worldwide who did not receive a single routine vaccine dose in 2021 were concentrated in low- and middle-income countries,” the authors write.
Measles not only causes death and disability in the short term, but it also weakens the immune system for months, leaving children susceptible to other infections. This “immune amnesia” adds further urgency to the call for widespread vaccination.
The path forward
In response to the crisis, the authors urge robust action at every level of society. National governments must invest in routine immunisation programmes and restore trust in vaccines through community engagement. International organisations, meanwhile, must help fund vaccination campaigns and address misinformation.
The authors also advocate for stronger mandates: “Vaccination mandates for school entry have proved effective in maintaining high coverage rates,” the report notes, especially when combined with limited exemptions.
Ultimately, the measles resurgence is a litmus test for public health systems in the post-COVID era. As the authors conclude, “Failure to respond decisively to this crisis risks reversing decades of progress in disease prevention.”
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Photo credit: CDC, Unsplash