28th August 2026
There was a time when measles was becoming something most parents in Britain barely had to think about.
Vaccination had changed the picture so dramatically that measles seemed to belong to another generation. It was still possible to catch it, but sustained transmission had been brought under control and the UK achieved WHO measles elimination status in 2016.
Now that achievement has been lost.
And the story is not simply about a disease returning. It is about how quickly something that appears to have been defeated can come back when vaccination levels fall.
The issue has been highlighted by a recent article in The Conversation, which warns that millions of people around the world could contract measles during 2026 as vaccination coverage falls and outbreaks spread.
The latest UK figures make that warning particularly relevant.
Britain no longer has measles elimination status
In January this year, the World Health Organization's European Regional Verification Commission confirmed that the UK had lost its measles elimination status, based on surveillance data for 2024.
It wasn't the first time.
Britain achieved elimination in 2016, lost it in 2018 after measles transmission became re-established, and then regained the status after the dramatic reduction in transmission during the Covid pandemic.
But that pandemic-era improvement was not a permanent victory.
The UK has now lost elimination status again.
That distinction matters.
"Losing elimination status" does not mean that everyone in Britain is suddenly at risk of catching measles, or that measles is widespread everywhere.
It is a technical public-health classification meaning that sustained endemic transmission has been re-established.
But it is an important warning that the population is no longer sufficiently protected to prevent the virus from gaining a foothold.
The numbers tell the story
The WHO target is generally around 95% coverage with two doses of a measles-containing vaccine if transmission is to be reliably interrupted.
The UK is nowhere near that level nationally.
In the data used to determine the UK's status, only 83.7% of five-year-olds had received two MMR doses.
England recorded 2,911 laboratory-confirmed measles cases during 2024 — the highest annual total for decades.
And the problem has not disappeared during 2026.
By 17 August 2026, England had recorded 970 laboratory-confirmed measles cases, already exceeding the 959 recorded during the whole of 2025.
Two children in England have also died from measles during 2026.
These are not statistics from some distant part of the world.
They are happening in Britain.
Scotland is in a better position — but shouldn't be complacent
This is where the Scottish picture becomes particularly interesting.
Scotland's vaccination rates are considerably better than the UK figure that led to the loss of elimination status.
Public Health Scotland's latest figures show that 91.7% of children had received their first MMR dose by 24 months in the quarter ending March 2026.
By age five, 95.4% had received the first dose.
But the crucial second dose was lower: 89.6% by age five, increasing to 90.6% by age six.
So Scotland is doing better than some parts of the UK, but even here the second-dose figure is below the 95% level generally needed to maintain population protection.
And national averages can conceal local differences.
Public Health Scotland reports significant differences in vaccination uptake according to deprivation and other factors.
That means a national figure can give a reassuring impression while particular communities remain much more vulnerable.
And measles is already here
It is not simply a theoretical risk from people arriving from overseas.
Public Health Scotland says there had been 13 laboratory-confirmed measles cases in Scotland during 2026 by 22 July.
There were 28 cases during 2025 and 24 in 2024.
Many Scottish cases in recent years have involved imported infection followed by transmission among people who were not vaccinated or were not fully vaccinated.
That is precisely why elimination is so difficult.
The virus doesn't need to live permanently in Scotland to cause trouble.
Someone can acquire measles abroad, return to Scotland and come into contact with people who aren't adequately protected.
Most people may never know that has happened.
But if the virus encounters enough susceptible people, an outbreak can begin.
Why measles is different
There is an important reason health authorities become so concerned about measles when vaccination levels fall.
It is exceptionally infectious.
A person doesn't have to spend hours sitting beside someone with measles. Brief exposure can be enough.
That means vaccination isn't simply about protecting the individual who receives it.
High coverage also protects babies who are too young to have completed their vaccinations and people who cannot be vaccinated for medical reasons.
Public Health Scotland describes infants under one, pregnant women and immunocompromised people as being at increased risk of complications and death.
That is why the 95% figure matters.
It isn't an arbitrary target designed to make vaccination programmes look successful.
It is about creating enough population immunity to stop the virus finding a continuous chain of susceptible people.
The world is becoming a more difficult place for elimination
Britain is not alone.
Canada lost its measles elimination status in November 2025 after sustained transmission lasting more than a year.
Across the Americas, measles has also surged.
By the end of June 2026, the Pan American Health Organization reported almost 23,000 confirmed measles cases across the region during the first 25 weeks of the year, with Mexico, Guatemala, the United States and Canada accounting for most cases. Thirty-nine deaths had been reported.
Meanwhile, WHO data cited by UKHSA recorded 64,542 laboratory-confirmed measles cases worldwide during the first half of 2026.
So Britain is operating in an environment where the virus is circulating extensively.
That makes maintaining high vaccination coverage even more important.
Scotland's new vaccination schedule could help
There is some good news.
From January 2026, the UK introduced a change to the childhood vaccination programme.
The combined measles, mumps, rubella and varicella vaccine — MMRV — is now offered at 12 months, with the second dose at 18 months.
The idea is to get children fully protected earlier rather than waiting until the traditional later appointment.
Older children and adults who missed vaccination can also catch up with MMR through the NHS.
Scotland is implementing these changes alongside the rest of the UK.
That could help.
But changing the timetable only works if people actually attend the appointments.
The worrying lesson from measles
Perhaps the most important part of this story is psychological rather than medical.
When vaccination works, it can make the disease itself almost invisible.
Parents who have never seen a child seriously ill with measles may understandably wonder why vaccination is so important.
The success of vaccination can therefore create the conditions for complacency.
As fewer people see the consequences of the disease, vaccination can start to appear less urgent.
And then coverage falls.
Eventually the disease returns.
That appears to be part of what we are now seeing with measles.
The UK didn't lose elimination status because the science stopped working.
It lost it because the population stopped being sufficiently protected to prevent transmission.
The vaccine remains highly effective.
The problem is getting enough people vaccinated.
What does this mean for people in Caithness?
It would be easy to look at figures from London, Birmingham or international outbreaks and conclude that this has little to do with life in the far north.
But geography doesn't create an immunity bubble.
People travel.
Children travel.
Families visit relatives.
Visitors come to the Highlands.
And measles can travel with them.
The sensible response isn't alarm.
It is awareness.
For anyone unsure whether they or their children have received both doses of MMR, the NHS provides a way to check vaccination records and catch up if necessary.
And perhaps that is the real message from the global measles resurgence.
Elimination is not the same thing as eradication.
We didn't destroy measles.
We created a level of population immunity that made it extremely difficult for measles to sustain itself.
That achievement can be lost.
Britain has now demonstrated that twice.
Scotland currently has a stronger position than some parts of the UK, but its second-dose coverage is still below the level that provides the greatest protection.
The challenge now is not to frighten people back into vaccination.
It is to remind people why vaccination became so successful in the first place.
Because when a disease becomes rare, it is very easy to forget what "rare" was protecting us from.
And measles is providing Britain with a rather uncomfortable reminder.
The Convrsation article 21 August 2026
Why millions of people around the world will contract measles in 2026
The World Health Organization estimates that in 2026 nearly 11 million people will contract the virus that causes measles. Most of these cases will occur in Africa and Asia, but many countries in the Americas and Europe are reporting outbreaks affecting hundreds or thousands of people.
There is no treatment for measles, but vaccines have been proven to be safe and effective at preventing the disease. Unvaccinated people who get sick with measles are at risk of serious complications that can lead to deafness, blindness and death. The risk of a bad outcome is higher for people who are undernourished and unable to access supportive medical care.
As an infectious disease epidemiologist, I study the reasons for changes in population health risks around the world. The specific factors leading to measles epidemics vary by country, but the underlying cause everywhere is decreased vaccination rates.
Zero-dose children in low-income countries
The vast majority of parents around the world want to protect their children from preventable infectious diseases through vaccination. In many lower-income countries, the supply of vaccines remains insufficient to meet the demand for them.
Because measles is highly contagious, the vaccination rate needs to be above 95% to protect a community from outbreaks, creating what is known as “herd immunity.” One dose of measles vaccine protects most people from the disease, but two doses are recommended to improve effectiveness.
Most high-income countries have measles vaccine rates near the 95% target. In Europe, the average one-dose vaccination rate is about 94%, and the two-dose rate is about 88%. In the U.S., more than 90% of 2-year-olds have received at least one dose of measles vaccine and more than 92% of kindergartners have received two doses. The vaccine coverage rate is above 95% in many communities, though it is much lower in some school districts.
In contrast, only about 80% of young children in low- and middle-income countries have received at least one dose of measles vaccine, and only about 70% have received two doses.
Almost every country had reduced access to vaccines during the early months of the COVID-19 pandemic, when supply chains and clinic access were severely disrupted. Most young children in high-income countries were able to catch up on missed doses before they reached school age. But in lower-income countries, millions of kids who missed routine vaccinations during the pandemic are still classified as “zero-dose children” who have not received any of the vaccines their countries recommend.
Only a tiny fraction of the cases of measles diagnosed in lower-income countries are confirmed with laboratory tests and reported to public health authorities, so it’s impossible to get an exact case count. But healthcare workers have reported observing higher than typical numbers of cases in many countries during the past year.
In 2026, measles epidemics have been reported in countries experiencing armed conflict or housing refugees displaced by war, such as Burundi, Democratic Republic of Congo, Somalia, Sudan and Yemen.
Outbreaks have also been reported in peaceful countries, including Maldives and Zambia, and cases are surging in India. Dozens of other countries are also experiencing epidemics. All of these situations are linked to undervaccination.
Vaccine shortages in Bangladesh
Bangladesh has reported more measles cases this year than any other country, and more than 900 people have died from the infection.
While Bangladesh faces many of the same challenges as other low- and middle-income countries, the past few years have presented some unique difficulties.
In 2024, the country’s longtime government collapsed and an interim government was installed. During this time of political instability the government ordered too few vaccine doses.
In 2025 vaccine shortages worsened when the interim government decided to stop procuring its vaccines through UNICEF and instead tried to purchase them through a competitive bidding process before new supply chains had been established.
Bangladesh has now resumed working with UNICEF to acquire vaccines. Unfortunately, it has returned to UNICEF at a time when its partner organization Gavi, the Vaccine Alliance, is facing funding cuts.
Under Gavi’s cofinancing model, low- and middle-income countries’ initial vaccine purchases are subsidized by contributions from high-income countries and other investors. Over time, countries pay an increasing portion of their own vaccine costs.
Because Gavi pools orders from all over the world, it is able to shape markets and negotiate with vaccine manufacturers for lower costs per dose. The major limitation of this system is that reduced funding for global health shrinks the budget for subsidizing vaccine purchases.
But since 2025, France, Germany, the U.K., the U.S. and several other high-income countries have significantly reduced their budgets for development assistance, leaving Gavi with a substantial budget shortfall.
As Bangladesh has grown its economy, it is paying a greater share of the costs of the vaccines it purchases through Gavi. However, it does not yet have the means to fully self-finance its vaccine program. For now, if Gavi’s budget is not fully replenished, countries like Bangladesh will not have enough money to buy all of the vaccines they need.
Even though a mass vaccination campaign in early 2026 saw more than 1 million Bangladeshi children vaccinated against measles, the percentage of children who have been vaccinated remains far below the 95% threshold required to prevent widespread epidemics.
Vaccine hesitancy in faith communities in the Americas
Two years ago the entire region of the Americas – North, Central, and South America and the Caribbean – was classified as a measles-free zone.
Canada officially lost its measles elimination status in November 2025 after more than a year of sustained transmission. Mexico and the U.S. have met the criteria to lose their measles-free status when the Pan American Health Organization’s measles elimination committee meets again in November 2026.
The country reporting the largest number of measles cases in the Americas in 2026 is Guatemala, which has already logged more than 30,000 confirmed cases. The Guatemalan epidemic has been traced back to a gathering in Santiago Atitlán in December 2025 that was organized by a Christian megachurch whose leaders have been vocal about their anti-vaccine views.
Measles began circulating in late 2024 and early 2025 in Canada, Mexico and the U.S. among rural, conservative Mennonite communities where leaving children unvaccinated has become the cultural norm.
In South Carolina and Utah, recent outbreaks have been linked to low vaccination rates among conservative religious groups that are not connected with Mennonite churches. More cases of measles have already been diagnosed in the U.S. in 2026 than in any year since 1991.
The measles virus has moved from religious communities into other undervaccinated population groups. The epidemic that started in Mennonite villages in Mexico spread into neighboring Indigenous communities. An outbreak that started among German-speaking Mennonites in Bolivia crossed the border into Peru and was then amplified by visitors to large cultural festivals who brought the virus home with them.
Stopping the spread
The total number of measles cases per year decreased from an estimated 38 million in 2000 to about 10 million in 2019. That trend has reversed since the COVID-19 pandemic. The number of measles cases and the number of countries experiencing measles epidemics has gone up as the vaccination rate in some populations has gone down.
Getting back on track toward eliminating measles as a global public health problem will look different depending on the circumstances in each country. For low- and middle-income countries, ending measles epidemics will require increasing funding for Gavi and other international partnerships so that the vaccine supply can grow to meet the demand.
The need is different in countries where vaccination rates are falling even though measles vaccines are readily available. Stopping the spread of measles in undervaccinated communities will depend on the challenging task of building vaccine confidence among parents of young children.
Note
To read the article from The Convesration with links to more information go HERE