photo credit: © UNICEF/U.S. CDC/UN0669697/Owoicho

 

Immunization coverage for measles improved slightly from the previous year, with 84% of children receiving the first dose and 76% receiving the second in 2024, according to new national immunization coverage data released July 15 by the World Health Organization (WHO) and UNICEF. However, this coverage remains below the 90% global target to achieve by 2030.

The slight global increase doesn’t tell the whole story—significant inequities in vaccine access persist between high- and low-income countries across regions. First-dose coverage in low-income countries was only 66%. The percentage of children receiving both measles doses was 52%. Further, children who are malnourished—many of whom live in low-income countries—are especially at risk of severe complications and death given a malnourished body’s weakened ability to fight disease.

The growing number of outbreaks globally highlights the risk of immunity gaps—or concentrated populations of un- and under-immunized people. Despite an estimated two million more children being reached with measles vaccination last year compared to 2023, more than 30 million children remain under-protected, and coverage levels are well below the 95% threshold needed to prevent outbreaks. As a result, the number of countries experiencing outbreaks is expanding. In 2024, the number of countries experiencing large or disruptive measles outbreaks rose sharply to 60, nearly doubling from 33 in 2022.

“Because measles is so easily transmitted between unvaccinated people, outbreaks can serve as an indicator of health inequities—a proverbial canary in a coal mine,” said WHO Technical Officer and Measles & Rubella Co-Chair Santosh Gurung. “The growing number of measles outbreaks signals broader weaknesses in immunization programs and primary health care systems that must be urgently addressed. Outbreaks anywhere are a risk to unprotected children everywhere.”

Children in fragile, conflict-affected, and vulnerable countries are particularly at risk. While only 24% of infants live in these countries, they make up 54% of infants without any protection against measles. Further, the risk of outbreaks increases in these countries, in part because coverage rates are lower—64% for the first dose and only 49% for both doses. In 2024, 56% of fragile, conflict-affected, and vulnerable countries experienced a large or disruptive outbreak, while only 24% of countries without these challenges did.

To protect children around the world, the global community must support countries to strengthen routine immunization efforts, identify and scale alternative vaccine delivery strategies to close immunity gaps, and provide reliable support for timely and high-quality immunization campaigns. Furthermore, effective outbreak response is critical. The capabilities needed for response include sensitive surveillance systems and the ability to quickly initiate funding and technical support when outbreaks are identified.

Amidst stagnating immunization coverage, misinformation, and shrinking health budgets, now is the time to push forward, not pull back. “Since 2000, measles vaccinations have saved more than 60 million lives—mostly children,” said UNICEF Senior Health Advisor and Measles & Rubella Partnership Co-Chair Ahmadu Yakubu. “Unless we act now, we risk unraveling decades of hard-earned progress—setting us back and making it even harder to keep children everywhere safe.”