Global measles cases rose by 40 per cent between 2019 and 2023, prompting a warning that falling vaccination rates in Queensland could leave more children vulnerable to the highly infectious disease.
Researchers at the University of Queensland examined measles cases, deaths and vaccine gaps among children under five across more than 200 countries and territories. They found that infections increased from 11.1 million to 15.6 million during the period after the Covid-19 pandemic.
Sub-Saharan Africa and South Asia recorded the highest mortality rates, with disruptions to immunisation programmes, health systems and funding contributing to continuing outbreaks.
Associate Professor Benn Sartorius, from UQ’s Frazer Institute, said the resurgence had reversed decades of progress against measles, following an almost 80 per cent worldwide reduction in cases between 1990 and 2019.
“The resurgence coincides with COVID-19 related disruptions to immunisation programs, health systems, and funding – reflecting both the fragility of measles control and vulnerability of children in lower-resourced areas,” he said.
Australasia still had among the highest measles vaccination coverage rates globally, with an estimated 96 per cent of children under five receiving their second vaccine dose in 2023. But more recent Australian Immunisation Register figures show coverage declining in nearly every state and territory over the past three years.
Queensland recorded the lowest vaccination rates in Australia, according to the data, raising concerns among infectious disease specialists about the risk of further cases and more serious illness.
Professor Paul Griffin, director of infectious diseases at Mater Health, said hospitals were seeing more measles presentations, mainly involving children who had not been vaccinated.
“By now, measles is something I hoped I’d be having to know about from a historic point of view,” Professor Griffin said.
“People underestimate measles and think of it as something that’s a fairly benign rash in kids. Unfortunately, it’s far from that; it’s quite a severe respiratory virus.”
Measles can spread rapidly where immunity is low, with a single case capable of generating up to 18 secondary infections. Complications include pneumonia and encephalitis, or swelling of the brain, while unvaccinated young children and people with weakened immune systems face a greater risk of severe illness and death.
Australia eradicated endemic measles in 2014, and severe infections have become rare because vaccination has kept case numbers relatively low. Professor Griffin warned that continued increases could lead to deaths and serious complications returning, as has happened in other countries including the United States.
