Childhood measles cases have risen sharply worldwide following disruptions to vaccination programs during the COVID-19 pandemic, reversing decades of progress against the highly contagious disease, according to a new international study.
Researchers at the University of Queensland examined measles infections, deaths and vaccination coverage among children under five across 204 countries and territories between 1990 and 2023.
The study, published October 21 in Nature Medicine, estimates that measles cases increased 40%, from 11.1 million in 2019 to 15.6 million in 2023. Approximately 118,000 children died from the disease in 2023.
“This has contributed to a global resurgence of measles in young children,” said Associate Professor Benn Sartorius, noting that worldwide infections had declined nearly 80% between 1990 and 2019.
US Vaccine Policy Under Scrutiny
The findings come amid changes to American childhood vaccination policy under the Trump administration.
In August, the White House directed the Department of Health and Human Services to reassess childhood vaccination recommendations, including examining whether the combined measles, mumps and rubella vaccine could be offered as separate injections.
The administration’s order maintained the availability of combination vaccines while calling for further evaluation of vaccination schedules.
The Centers for Disease Control and Prevention continues to recommend two MMR doses, at ages 12–15 months and 4–6 years. Two doses provide approximately 97% protection against measles.
Meanwhile, MMR vaccination coverage among American kindergarten students has declined from approximately 95% to 92%, increasing concerns about outbreaks in undervaccinated communities.
Globally, an estimated 23.7 million infants missed their first measles vaccine dose in 2023, with sub-Saharan Africa accounting for half of those children.
Brooklyn’s Orthodox Jewish Communities Faced Major Outbreak
New York City previously experienced a major measles outbreak concentrated in predominantly Orthodox Jewish neighborhoods of Brooklyn.
Between September 2018 and July 2019, health authorities confirmed 649 cases, with most infections occurring in Williamsburg and Borough Park. Approximately 93% of patients belonged to Orthodox Jewish communities, while more than 85% of patients with known vaccination histories were unvaccinated.
The outbreak led to 49 hospitalizations and prompted city authorities to declare a public health emergency, requiring vaccinations in designated Williamsburg neighborhoods.
New York State subsequently eliminated religious exemptions from school vaccination requirements in June 2019.
Researchers emphasize that restoring routine immunization programs and reaching undervaccinated populations remain essential to preventing further outbreaks, particularly as international travel and declining immunity leave communities vulnerable to renewed transmission.
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