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Measles was long considered conquered in many developed countries thanks to vaccination programmes. But last week the World Health Organization warned of an “alarming rise” in the virus across its 53-country European region. Cases leapt to 42,207 in January-November 2023, against 942 in all of 2022. Russia and Kazakhstan reported more than 10,000 cases each. Among west European countries, the UK had the highest confirmed cases, with 183 — and after a recent surge in parts of England millions of parents are being contacted to urge them to catch up with their children’s missed immunisations. The resurgence of measles is an alarm call for public health authorities to look at why vaccination rates have dropped — and how to rebuild them.
One result of vaccines’ success is that most people have forgotten how nasty measles is. Up to the 1960s, the virus killed about 2.6mn a year worldwide, mostly under-5s. In most cases, it causes a high fever, cough, conjunctivitis and a horrible rash. Some people develop serious complications including pneumonia, seizures, meningitis and blindness. In the UK, about one in five children with measles are hospitalised; about one in 5,000 die. It is also hugely contagious. If Covid-19’s reproduction or R number — the expected number of people one infected person will infect in a susceptible population — is 1-2, for measles it is 12-18.
“Vaccine hesitancy” today and in the past is a factor in the measles rebound. The claim by a British doctor, Andrew Wakefield, in 1998 that the two-part, pre-school vaccine against measles, mumps and rubella was linked to autism — later comprehensively debunked — led jabs to fall for a while in the UK and elsewhere. MMR vaccine coverage among older teens and the early 20s today is lower in some places than it should be.
The Covid pandemic brought a new surge of misinformation from “anti-vaxxers”, fanned by social media and some populist politicians. This exacerbated vaccine hesitancy, which had been ticking up and causing measles flare-ups in various countries, even pre-pandemic.
Perhaps a bigger factor, health experts say, is that coping with the pandemic and administering Covid jabs caused disruptions to other routine vaccination programmes, with families visiting doctors less often. In England, NHS figures suggest more than 3.4mn under-16s are not fully protected against MMR. In some countries other factors are at play. Russia’s president Vladimir Putin last month blamed reports of regional vaccine shortages in part on foreign companies leaving the market and domestic manufacturers’ failure to step up quickly enough.
Increasing awareness and access are key to rebuilding vaccine coverage. UK polling in 2022 found more than 90 per cent of parents of young children believed vaccines worked and were safe. Health experts say most parents will get children inoculated if they are prompted, and can do so at times and locations convenient for working families. Mobile vaccination centres and offering them out-of-hours and in pharmacies can improve uptake.
Information campaigns are also needed to remind people of the risks of illnesses, to highlight vaccines’ effectiveness, and to combat myths. They should utilise social media and involve outreach by trusted figures whose words may carry more weight in some communities than national politicians or health leaders. It would make sense for schools to check routinely whether pre-school jabs have been given, while stopping short of compulsion.
Science, through inoculations, has tamed many diseases that once killed or damaged millions. But we cannot afford to forget why action was taken against them in the first place — and so allow them to gain a foothold once more.
