In a shocking turn of events, the European Region has reported the highest number of measles cases in over 25 years, according to the latest joint analysis by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). A staggering 127,350 measles cases were recorded in 2024, doubling the 2023 figures and marking the most significant surge since 1997, when approximately 216,000 cases were reported.

The outbreak has raised serious concerns among health experts and policymakers alike. Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, sounded a stern warning: “Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security. As we shape our new regional health strategy for Europe and central Asia, we cannot afford to lose ground. Every country must step up efforts to reach under-vaccinated communities.”

Children under the age of five are particularly vulnerable, accounting for more than 40% of reported cases in Europe and Central Asia. Worryingly, over half of these cases required hospitalization, and preliminary data as of 6 March 2025 indicates that 38 people have lost their lives to the disease. These numbers expose significant gaps in vaccination coverage, especially among young children.

The resurgence of measles is particularly alarming given the consistent decline in cases since the late 1990s. In 2016, cases had dropped to just 4,440, but that progress has been reversed, first with a spike in 2018 and 2019, and now with the recent surge in 2024. This backslide is largely attributed to reduced immunization coverage during the COVID-19 pandemic. Vaccination rates have not yet rebounded to pre-pandemic levels, leaving many communities exposed to the virus.

The consequences of this trend are not confined to Europe. In 2024, Europe accounted for a third of the global measles burden, with 359,521 cases reported worldwide. The risk of transmission across borders remains high as the virus targets pockets of unvaccinated or under-vaccinated populations. Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia, stressed the urgency of action: “Measles cases across Europe and Central Asia have soared over the past two years – pointing to gaps in immunization coverage. To protect children from this deadly and debilitating disease, we need urgent government action including sustained investment in healthcare workers.”

Some countries have become hotspots due to consistently low vaccination coverage. In Bosnia and Herzegovina, Montenegro, North Macedonia, and Romania, MCV1 coverage remained below 80% in 2023, far from the 95% threshold needed to maintain herd immunity. In Bosnia and Herzegovina, coverage rates have remained below 70% for over five years, while in Montenegro, they have lingered at an alarming 50%. Romania, bearing the brunt of the outbreak, recorded 30,692 cases in 2024, followed closely by Kazakhstan with 28,147 cases.

The impact of measles is not limited to short-term health risks. It is one of the most contagious viruses, capable of causing severe complications like pneumonia, encephalitis, diarrhea, and long-term effects such as blindness. More concerning is its ability to compromise the immune system by erasing the memory of how to fight infections, rendering survivors vulnerable to other diseases.

The resurgence of measles in Europe is not merely a public health crisis; it is a stark reminder of the consequences of vaccine complacency. The COVID-19 pandemic disrupted routine immunization efforts, but the responsibility to protect public health does not wane with a global crisis. Vaccination is not just a personal choice – it is a collective responsibility that ensures community safety.

Governments must act decisively to restore and enhance vaccination programs, particularly in under-vaccinated regions. Investing in healthcare workers, strengthening public awareness campaigns, and rebuilding trust in vaccines are essential steps to halt the march of measles. Failure to act now could reverse decades of progress and leave future generations vulnerable to entirely preventable diseases. The time to act is now – before complacency costs more lives.