Top 5 Takeaways

1. Global Measles Incidence Trends: Measles incidence decreased globally from 2000 to 2016, increased from 2017 to 2019, and then decreased again in 2020.
2. Impact of Measles Vaccination: Measles vaccination has prevented an estimated 31.7 million deaths worldwide since 2000.
3. Surveillance Challenges: Measles surveillance worsened in 2020, with fewer specimens submitted for testing and fewer countries meeting surveillance sensitivity indicators.
4. Immunization Coverage Decline: Global coverage for the first dose of measles-containing vaccine (MCV1) declined to 84% in 2020, with significant regional variations.
5. Need for Enhanced Efforts: To achieve regional measles elimination, enhanced efforts are needed to ensure all children receive two doses of MCV, implement robust surveillance, and close immunity gaps.

Original Article Author and Citation

Corresponding Author

Meredith G. Dixon, mgdixon@cdc.gov

Suggested Citation

Dixon MG, Ferrari M, Antoni S, et al. Progress Toward Regional Measles Elimination — Worldwide, 2000–2020. MMWR Morb Mortal Wkly Rep 2021;70:1563–1569. DOI: http://dx.doi.org/10.15585/mmwr.mm7045a1

Summary

This report outlines the progress and challenges in achieving regional measles elimination from 2000 to 2020. While significant reductions in measles incidence and mortality were achieved, the resurgence of cases from 2017 to 2019 and the impact of the COVID-19 pandemic in 2020 have posed significant challenges. Measles vaccination has been instrumental in preventing millions of deaths, but global immunization coverage and surveillance need substantial improvement to meet elimination targets.

Methods

The study utilized data from WHO and UNICEF on immunization coverage, measles case reports, and surveillance performance. Estimates of measles cases and deaths were derived using a model that incorporates vaccination coverage data, case data, and population estimates. The model was updated to reflect new assumptions and case-fatality ratios.

Discussion

The report highlights the decline in measles incidence and mortality from 2000 to 2016, followed by a resurgence and then a decline in 2020. The COVID-19 pandemic significantly impacted immunization activities and surveillance, leading to increased susceptibility among children. The report emphasizes the need for robust surveillance systems, targeted immunization efforts, and tailored strategies to close immunity gaps.

Conclusion

To achieve regional measles elimination, it is crucial to enhance immunization coverage, particularly for the second dose of the measles-containing vaccine, and to strengthen surveillance systems. Addressing immunity gaps and improving outbreak response will be vital in sustaining progress toward measles elimination.

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