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vaccination

Measles was, for a period, treated by public health authorities in many high-income countries as a largely solved problem — a disease that persisted in pockets of the world with weaker health infrastructure, but that had been effectively eliminated elsewhere through sustained vaccination programmes. That framing no longer holds. Outbreaks have been reported in numerous countries that had previously achieved or come close to elimination status, and the underlying pattern behind them is consistent: falling childhood vaccination coverage rather than any change in the virus itself.

• The MMR vaccine (measles, mumps and rubella) has an extremely strong safety record, established over decades of use and large-scale post-marketing surveillance.
• Vaccination coverage in numerous countries dipped during the disruption to routine healthcare services around the pandemic years and has not fully recovered in several.
• Coverage gaps are frequently concentrated in specific communities or regions rather than spread evenly, which matters enormously for a disease that relies on sustained chains of transmission.