Progress Toward Regional Measles Elimination — Worldwide, 2000–2021

Abbreviations: MCV1 = first dose of measles-containing vaccine; MCV2 = second dose of measles-containing vaccine; WHO = World Health Organization.
*https://immunizationdata.who.int/pages/coverage/mcv.html (Accessed September 29, 2022).
^†Denominator is the number of WHO member states.
^§https://immunizationdata.who.int/pages/incidence/measles.html (Accessed September 29, 2022).
^¶Population data from United Nations Department of Economic and Social Affairs, Population Division, 2022. Any country not reporting measles cases for that year was removed from both the numerator and denominator in calculating incidence.
**Cases per 1 million population.

Abbreviations: NA = not applicable; WHO = World Health Organization.
*The measles mortality model used to generate estimated measles cases and deaths is rerun each year using the new and revised annual WHO-UNICEF estimates of national immunization coverage data as well as updated surveillance data. In 2021, data on case fatality from an updated systematic review and a suite of covariates with known relationships to case fatality were used in a Bayesian meta-regression modeling framework to produce estimates of measles case fatality ratios; therefore, the estimated number of cases and mortality estimates for 2000–2020 in this report differs from previous reports.
^†Estimated measles mortality was too low to allow reliable measurement of mortality reduction.

Authors and Disclosures

Anna A. Minta, MD¹, Matt Ferrari, PhD², Sebastien Antoni, MPH¹, Allison Portnoy, ScD³, Alyssa Sbarra, MPH⁴, Brian Lambert², Sarah Hauryski², Cynthia Hatcher, MPH⁵, Yoann Nedelec, MPH¹, Deblina Datta, MD⁵, Lee Lee Ho, MPH¹, Claudia Steulet, MPH¹, Marta Gacic-Dobo, MSc¹, Paul A. Rota, PhD⁶, Mick N. Mulders, PhD¹, Anindya S. Bose, MD¹, William A. Perea¹ and Patrick O'Connor, MD<sup>1

1</sup>Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland; ²Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, Pennsylvania; ³Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts; ⁴Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom; ⁵Global Immunization Division, Center for Global Health, CDC; ⁶Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC.

Corresponding author
Anna A. Minta, mintaa@who.int.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Matt Ferrari reports grants from the Bill and Melinda Gates Foundation, the World Health Organization (WHO), and Gavi, The Vaccine Alliance to develop measles models. Allison Portnoy reports grant support from the Bill and Melinda Gates Foundation to develop models. Lee Lee Ho reports support as a consultant for WHO. No other potential conflicts of interest were disclosed.

Sidebar

Summary

What is already known about this topic?

Progress toward measles elimination experienced setbacks in 2020 during the COVID-19 pandemic.

What is added by this report?

During 2000–2021, measles vaccination prevented an estimated 56 million deaths worldwide. In 2021, only 81% of children received their first dose of measles containing vaccine (MCV), the lowest coverage reported since 2008, leaving 25 million children vulnerable to measles. Measles surveillance continues to be suboptimal, and large and disruptive outbreaks were reported in 22 countries.

What are the implications for public health practice?

Reaching all children with 2 doses of MCV and strengthening measles surveillance is critical to close immunity gaps, prevent outbreaks, and recover progress lost during the pandemic.