Measles Elimination, 2000–2023: 60.3 Million Deaths Averted, but Coverage Has Stalled

Measles is highly contagious and can cause severe complications and death; stopping it takes high population immunity. Vaccination works: over the past 50 years, measles vaccine has saved an estimated 94 million lives. All countries in the six World Health Organization (WHO) regions have committed to eliminating measles — yet no region had achieved and sustained elimination by the end of 2023. The Immunization Agenda 2030 makes elimination a core measure, calling for strong surveillance and equitable 95% coverage with two timely doses.

Headline numbers

From 2000 to 2023, vaccination averted an estimated 60.3 million measles deaths; estimated cases fell 72% and deaths 87%.

Image from the Centers for Disease Control and Prevention

Vaccination has stalled

• MCV1 rose from 71% to 86% between 2000 and 2019, dropped to 81% in 2021 during COVID-19 — the lowest since 2008 — and has been stuck at 83% since 2022. No region has regained its 2019 level; only the African, Americas and European regions improved in 2022–2023.
• 22.2 million children missed their first dose in 2023 — 472,000 more than in 2022. Ten countries — four in the African region, four in the Eastern Mediterranean, two in South-East Asia — held 57% of them.
• MCV2 reached 74%; the number of countries offering a second dose doubled, from 95 in 2000 to 190 in 2023.
• About 112 million people were vaccinated in campaigns in 37 countries in 2023, and 9.4 million more in outbreak responses in 14 countries.

The gaps are unequal:

Countries hit by at least one large outbreak in 2019–2023 had 80% coverage, against 91% elsewhere.

Surveillance and outbreaks

• 86 (58%) of 149 reporting countries met the surveillance sensitivity target in 2023, up from 74 (51%) in 2022; labs in the Global Measles and Rubella Laboratory Network — 762 of them — received 436,421 specimens, up from 274,270.
• Reported incidence rose from 28 to 91 per million.
• Large or disruptive outbreaks hit 57 countries in five regions: 27 in Africa, 13 in the Eastern Mediterranean, 10 in Europe, 4 in South-East Asia and 3 in the Western Pacific.
• Deaths fell despite more cases because more outbreaks struck countries where children are less likely to die of measles than in the African region.
• Only two genotypes — D8 (74% of 2023 sequences) and B3 (26%) — have been reported since 2021, down from nine in 2013.

Elimination status

By the end of 2023, 82 countries (42%) had been verified as having eliminated measles, but no African country had. The Americas achieved elimination in 2016, then lost it when endemic spread returned in Brazil and Venezuela; Venezuela was reverified in 2023, and in November 2024 Brazil was too — so the Americas are once again free of endemic measles.

What's needed

The Measles and Rubella Strategic Framework sets out how to strengthen surveillance, reach 95% coverage with two doses, and prepare for outbreaks; the Big Catch-Up and follow-up campaigns aim to close gaps opened during the pandemic. Vaccination has done more to cut deaths than any other health measure in the past 50 years, with measles vaccine contributing most — yet an estimated 107,500 people still died of measles in 2023.

Limitations: coverage and case data vary in quality; campaign and outbreak-response data are incomplete, so doses may be undercounted; and model estimates are revised each year.

Sources

Based on "Progress Toward Measles Elimination — Worldwide, 2000–2023," by Anna A. Minta, Matt Ferrari, Sebastien Antoni and colleagues, Morbidity and Mortality Weekly Report 73(45), Centers for Disease Control and Prevention; a work of the United States government in the public domain.