Measles was once close to being wiped out in many countries. But now it is spreading again—mainly because the COVID-19 pandemic disrupted vaccination programs and more people are refusing vaccines. In their recent New England Journal of Medicine review, Dr. Do and Dr. Mulholland report that in 2024 alone, nearly 400,000 measles cases were confirmed worldwide. The real number is probably even higher. Early data from 2025 shows the problem is getting worse fast, making it urgent to boost vaccination rates again.

Measles spreads extremely easily—each infected person can pass it to up to 18 others. The illness can be very serious. It causes complications like pneumonia, ear infections, eye problems, and diarrhoea. In rare cases, it can lead to severe brain diseases like encephalitis or subacute sclerosing panencephalitis, which are often fatal. Children who are undernourished or have weak immune systems are at highest risk. Even after recovering, they can remain vulnerable to other infections because measles weakens their immune memory.

Outbreaks are happening in places where too few people are vaccinated—such as refugee camps or communities where false information spreads. In some parts of the United States, vaccination rates have fallen below 75%, and babies under 12 months (too young for their first vaccine) are being hit the hardest.

The global response is also weakening. United States funding cuts to international organizations like World Health Organization (WHO) and Global Alliance for Vaccines and Immunization (GAVI), The Vaccine Alliance have slowed vaccine efforts in lowest income countries. At the same time, misinformation and myths—like the false idea that vaccines cause autism or that vitamin A can prevent measles—are still common and harmful.

But there is hope. Studies show that earlier measles vaccination can protect young babies. Vitamin A can lower the risk of complications, and giving vaccines or immune globulin after exposure can help stop the spread. New tools like microneedle patches could make vaccines easier to deliver in hard-to-reach areas. Most importantly, we need to rebuild trust in vaccines and fight misinformation.

This review is a must-read for physicians, public health workers, and decision-makers. Measles reminds us that if we let our guard down, even well-controlled diseases can return—and undo years of progress in just a short time.

Reference

Do LAH, Mulholland K. Measles 2025. N Engl J Med. 2025. doi: 10.1056/NEJMra2504516. Epub ahead of print.