The United States is facing a resurgence of measles, with over 4,500 cases reported this year—twice the number from 2022. Experts warn that if vaccination rates do not improve, the country risks losing its measles-free status and could see the virus become endemic once again. A recent forecast published in JAMA estimates that without improved vaccination efforts, there could be 851,300 cases, more than 170,000 hospitalizations, and 2,550 deaths from measles over the next 25 years.
Kitty Mohan, vice-president of the Standing Committee of European Doctors (CPME), expressed concerns about the implications for European communities, which also face challenges with vaccination coverage. “Due to international travel routes and the ease and speed at which people move across borders, combined with the infectiousness of measles before the rash starts, the disease can spread rapidly,” Mohan said. She highlighted that a mere 15 minutes of face-to-face contact with an infectious person could likely result in transmission.
Currently, some of the largest measles outbreaks are occurring in Bangladesh, Indonesia, and Guatemala, with cases reported at 65,430, 46,578, and 31,222 respectively. The European Centre for Disease Prevention and Control (ECDC) noted that whether an imported case leads to further transmission in Europe depends on local immunity levels and if the virus reaches groups with low vaccination coverage.
European vaccination data shows that coverage is at 92% for the first dose and 88% for the second. While these rates are considered to provide “strong population protection,” they fall short of the 95% two-dose coverage threshold needed to prevent sustained transmission of the virus. Lower rates in specific communities can pose a significant risk, particularly to those who are unvaccinated.
The ECDC emphasized that most measles cases occur in unvaccinated individuals and urged countries to close immunity gaps and ensure timely vaccinations. This is particularly vital for protecting infants too young to be vaccinated and individuals unable to receive the vaccine due to medical reasons.
Pockets of Low Coverage
The issue of vaccination gaps is not restricted to countries with low overall rates. Clusters of unvaccinated individuals within otherwise immunized populations can create conditions for outbreaks. Factors contributing to low coverage include access to vaccination services and varying levels of community awareness and acceptance of vaccines.
The ECDC continues to monitor the situation, recently indicating that the overall risk of measles for certain vulnerable groups in Europe is moderate. Surveillance data indicate a reduction in reported cases for 2026 compared to 2025, although these numbers remain preliminary. Measles continues to be endemic in twelve European countries, with Romania reporting the highest incidence in recent years.
