Measles Is Making a Comeback — Here's Why

Once thought to be largely under control, measles is again making headlines around the world. Despite the availability of a safe and highly effective vaccine, cases are rising in countries that had previously eliminated the disease including Canada, the United States, and across Europe.

This resurgence raises critical questions: Why is a vaccine-preventable disease returning? And what can be done to stop its spread?

Understanding Measles

Measles, also known as rubeola or red measles, is one of the most infectious diseases in humans. In a community with no immunity, a single infected person can spread the virus to 12 to 18 others. Before vaccination became widespread, measles infected around 30 million people each year and caused more than 2 million deaths globally.

Canada eliminated measles in 1998, meaning that there was no sustained, ongoing transmission of the disease within the country for at least 12 months. However, elimination doesn’t mean eradication. When vaccination rates drop, even temporarily, the virus can quickly return.

A Brief History of Measles Vaccination

Efforts to control measles have evolved over centuries, but meaningful progress began in the 20th century. The first measles vaccine was licensed in 1963, followed by the introduction of the MMR vaccine, measles, mumps, and rubella in 1971. In 2005, the varicella (chickenpox) vaccine was added to create the MMRV combination.

Administered in two doses, the measles vaccine provides strong protection: one dose offers about 93% effectiveness, and two doses exceeds 99%. Between 2000 and 2023, measles vaccination efforts are estimated to have saved more than 60 million lives globally.

Herd Immunity and the Importance of High Coverage

Because measles spreads so efficiently, controlling it requires a high level of community immunity. Public health experts estimate that around 92–95% of the population must be immune through vaccination or past infection, to achieve herd immunity and prevent outbreaks. When immunization rates fall below this threshold, the virus can spread rapidly, even in countries where it had been previously eliminated.

Why Are Vaccination Rates Falling?

Misinformation and Vaccine Hesitancy

One of the most damaging setbacks in public health in recent decades stemmed from a fraudulent claim linking the MMR vaccine to autism. The now-retracted study, published in The Lancet in 1998, was later exposed as scientific fraud. Yet the fear it created had global consequences.

Parents in the UK, the United States, and Canada delayed or declined vaccination out of fear, resulting in a resurgence of measles outbreaks in 2008 and 2009. In the years since, misinformation has continued to spread amplified by social media and anti-vaccine groups further eroding public trust in vaccines and public health institutions.

COVID-19 Disruptions and Global Gaps

The COVID-19 pandemic disrupted routine healthcare systems worldwide. In 2021, nearly 40 million children missed a scheduled measles vaccine dose, leading to sharp increases in both cases and deaths. In Ontario, childhood vaccination coverage dropped significantly during the early months of the pandemic and only partially recovered by the end of 2020.

By 2023, more than 22 million children globally had missed their first measles dose. That same year, global measles cases increased by 20%.

Vulnerable Communities and Limited Access

Certain communities are more vulnerable to outbreaks due to low vaccination rates or barriers to healthcare access. In Texas, for example, un-vaccinated Mennonite communities contributed to large outbreaks. In one county, nearly 14% of children were unvaccinated due to exemptions.

Rural and remote communities often face logistical challenges in accessing healthcare services, including routine vaccinations, making them particularly susceptible to vaccine-preventable diseases.

A Global Surge

In 2025, the United States reported its highest number of measles cases in over 30 years—surpassing previous peaks like the 2014 Disneyland outbreak and the 2019 outbreaks in Orthodox Jewish communities in New York. By mid-April 2025, over 800 cases had already been recorded, with three deaths and numerous hospitalizations.

This surge is not unique to the United States. Across Europe, measles cases in 2024 exceeded 35,000 a tenfold increase from the 3,973 cases reported in 2023. Romania and Kazakhstan have been among the hardest hit. In Africa, the situation is even more serious: no country in the region has yet achieved measles elimination, and outbreaks are continuing to grow.

Although local circumstances vary, the common denominator is clear: declining vaccination coverage, often driven by misinformation and weakened healthcare systems.

COVID-19’s Lingering Impact

In addition to service disruptions, the pandemic has had a lasting effect on public trust. Mixed messages, politicization of health measures, and conflicting policies during COVID-19 have deepened public skepticism toward all vaccines including those for diseases like measles. This erosion of trust continues to undermine immunization efforts, making the task of rebuilding confidence more urgent than ever.

Recommendations for Moving Forward

Tackling the measles resurgence requires both immediate action and long-term strategies:

• Expand catch-up vaccination campaigns in communities where immunity gaps exist.

• Partner with local and cultural leaders to promote vaccine confidence through trusted voices.

• Improve access by offering mobile vaccination clinics, extending clinic hours, and reducing barriers in rural and underserved areas.

• Counter misinformation with proactive, transparent, and evidence-based communication strategies.

• Rebuild public trust through consistent policies, clear messaging, and community engagement.

  
  

Conclusion

Measles is a disease we have the tools to eliminate but complacency, misinformation, and global disruptions have allowed it to return. The resurgence we are seeing today is not due to a failure of science, but a failure of systems, communication, and trust. Vaccines remain one of the most effective tools in modern medicine. They save lives not just of those who receive them, but also of the vulnerable individuals who rely on herd immunity for protection.

There is no one-size-fits-all solution. Every country, every community, and every household needs tailored approaches that consider cultural context, build relationships, and make vaccines accessible. Because when vaccines are embraced, they save lives everywhere.

References

• Government of Alberta. Measles: Learn about measles and how to protect yourself and your family. 2025. Available at: https://www.alberta.ca/measles

• Hewitt GL, Obeid A, Fischer PR. Measles outbreaks in the United States in 2025: Practice, policy, and the canary in the coalmine. New Microbes New Infect. 2025;65:101591. Published 2025 May 5. doi:10.1016/j.nmni.2025.101591

• Ji C, Piché-Renaud PP, Apajee J, et al. Impact of the COVID-19 pandemic on routine immunization coverage in children under 2 years old in Ontario, Canada: A retrospective cohort study. Vaccine. 2022;40(12):1790-1798. doi:10.1016/j.vaccine.2022.02.008

• Osman S, Crowcroft N, McLachlan E, et al. Population immunity to measles in Canada using Canadian Health Measures survey data - A Canadian Immunization Research Network (CIRN) study. Vaccine. 2022;40(23):3228-3235. doi:10.1016/j.vaccine.2022.04.011

• Rao TS, Andrade C. The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian J Psychiatry. 2011;53(2):95-96. doi:10.4103/0019-5545.82529

• World Health Organization. History of measles vaccination: One of the most contagious diseases. 2025. Available at: https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-measles-vaccination

Assessed and Endorsed by the MedReport Medical Review Board