US measles surge reminds of Europe’s vaccination gaps
The US risks losing its measles elimination status as under-vaccinated communities across Europe remain vulnerable to imported cases.
Giedre Peseckyte
Thu, October 29, 2026
The United States is at risk of losing its measles-free status as cases surge, raising fresh concerns about the vulnerability of European communities where vaccination coverage remains below the level needed to prevent sustained transmission.
More than 4,500 cases have been reported in the US this year — roughly twice the total reported last year. A forecast published in JAMA suggests that measles could become endemic again in the US if vaccination rates fail to improve, potentially resulting in 851,300 cases, more than 170,000 hospitalisations and 2,550 deaths over 25 years.
The outbreak across the Atlantic could also signal a wider risk, Kitty Mohan, vice-president of the Standing Committee of European Doctors (CPME) and its rapporteur on vaccination, told Euronews.
"Due to international travel routes and the ease and speed at which people move across borders, combined the infectiousness of measles before the rash starts, people can travel quite far whilst infectious and so the disease can spread rapidly," Mohan said.
Measles is among the most contagious infectious diseases. People can transmit the virus for around four days before the characteristic rash appears, meaning they may travel across borders before realising they are ill.
"15 mins face to face with someone who is infectious will mean you are likely to get measles," Mohan said.
The US is not the only country where measles continues to circulate. The biggest outbreaks currently are in Bangladesh, with cases surpassing 65,430, Indonesia with 46,578 and Guatemala with 31,222 cases.
"Whether an imported case leads to further transmission in Europe depends primarily on immunity levels in the affected community in Europe and whether the virus reaches groups with low vaccination coverage," the European Centre for Disease Prevention and Control (ECDC) told Euronews.
Vaccination coverage was 92% for the first dose and 88% for the second dose — a "strong population protection," ECDC said.
But that remains below the recommended 95% two-dose coverage needed at national and local levels to prevent sustained transmission and achieve measles elimination. National averages can also conceal areas or communities with lower vaccination coverage.
"Most measles cases occur in unvaccinated people," the ECDC said, recommending that countries close immunity gaps, ensure both vaccine doses are administered on time, offer catch-up vaccination to eligible adolescents and adults, and maintain strong surveillance and outbreak-response systems.
The consequences extend beyond those who can choose to get vaccinated. Infants who are too young to receive the vaccine, as well as people who cannot be vaccinated for medical reasons or whose immune systems cannot mount an adequate response, depend on high levels of immunity in the wider population.
"Herd immunity or maintaining vaccination rates above a threshold would protect these groups - so lower rates make them more susceptible to disease," Mohan said.
The problem is not confined to countries with low national vaccination rates. Clusters of unvaccinated or under-vaccinated people can emerge within otherwise well-protected populations, creating local conditions in which outbreaks can take hold.
Coverage gaps can reflect a range of factors, including difficulties accessing vaccination services, limited information or awareness, and concerns about vaccines.
"There are traditional risk groups - such as traveller communities and some religious groups who historically have been reluctant to vaccinate," said Mohan.
However, ECDC underlined that "the presence of a group of unvaccinated people does not automatically mean that a large outbreak will spread across the wider population," using the Urkult festival in northern Sweden as an example. The outbreak at the festival occurred between 30 July and 2 August this year, mainly affecting unvaccinated children and adolescents. It involved 28 cases, including 12 secondary cases, but did not lead to sustained transmission in the wider population.
"The fact that there were relatively few secondary cases among those exposed at the festival is due to the high level of immunity within the population, a result of strong participation in the childhood vaccination program," said Johanna Rubin, Acting Head of the Vaccination Unit at Sweden's public health agency.
"This once again highlights the importance of high community-level protection," ECDC said.
For now, the risk for Europeans remains the same, ECDC said, as per its latest assessment, with the overall risk set as moderate for infants under 12 months, children aged one to five and immunocompromised people. For older unvaccinated children and adults, the risk is estimated to range from low to moderate. People with immunity from vaccination or previous infection are considered to have a low risk of measles.
ECDC surveillance data indicate fewer reported measles cases in 2026 than in 2025, although 2026 figures remain preliminary and should be interpreted with caution.
Measles is endemic in twelve European countries: Bosnia and Herzegovina, France, Georgia, Germany, Italy, Kazakhstan, Kyrgyzstan, Poland, Romania, Russia, Türkiye, and Ukraine.
Romania reported most of the cases, with numbers reaching 30,692 in 2024, up from 3,371 in 2023.
Six European countries: Armenia, Austria, Azerbaijan, Spain, the United Kingdom, and Uzbekistan have re-established endemic measles transmission based on the number of cases in 2024 earlier this year.
The US risks losing its measles elimination status as under-vaccinated communities across Europe remain vulnerable to imported cases.
Giedre Peseckyte
Thu, October 29, 2026
The United States is at risk of losing its measles-free status as cases surge, raising fresh concerns about the vulnerability of European communities where vaccination coverage remains below the level needed to prevent sustained transmission.
More than 4,500 cases have been reported in the US this year — roughly twice the total reported last year. A forecast published in JAMA suggests that measles could become endemic again in the US if vaccination rates fail to improve, potentially resulting in 851,300 cases, more than 170,000 hospitalisations and 2,550 deaths over 25 years.
The outbreak across the Atlantic could also signal a wider risk, Kitty Mohan, vice-president of the Standing Committee of European Doctors (CPME) and its rapporteur on vaccination, told Euronews.
"Due to international travel routes and the ease and speed at which people move across borders, combined the infectiousness of measles before the rash starts, people can travel quite far whilst infectious and so the disease can spread rapidly," Mohan said.
Measles is among the most contagious infectious diseases. People can transmit the virus for around four days before the characteristic rash appears, meaning they may travel across borders before realising they are ill.
"15 mins face to face with someone who is infectious will mean you are likely to get measles," Mohan said.
The US is not the only country where measles continues to circulate. The biggest outbreaks currently are in Bangladesh, with cases surpassing 65,430, Indonesia with 46,578 and Guatemala with 31,222 cases.
"Whether an imported case leads to further transmission in Europe depends primarily on immunity levels in the affected community in Europe and whether the virus reaches groups with low vaccination coverage," the European Centre for Disease Prevention and Control (ECDC) told Euronews.
Vaccination coverage was 92% for the first dose and 88% for the second dose — a "strong population protection," ECDC said.
But that remains below the recommended 95% two-dose coverage needed at national and local levels to prevent sustained transmission and achieve measles elimination. National averages can also conceal areas or communities with lower vaccination coverage.
"Most measles cases occur in unvaccinated people," the ECDC said, recommending that countries close immunity gaps, ensure both vaccine doses are administered on time, offer catch-up vaccination to eligible adolescents and adults, and maintain strong surveillance and outbreak-response systems.
The consequences extend beyond those who can choose to get vaccinated. Infants who are too young to receive the vaccine, as well as people who cannot be vaccinated for medical reasons or whose immune systems cannot mount an adequate response, depend on high levels of immunity in the wider population.
"Herd immunity or maintaining vaccination rates above a threshold would protect these groups - so lower rates make them more susceptible to disease," Mohan said.
The problem is not confined to countries with low national vaccination rates. Clusters of unvaccinated or under-vaccinated people can emerge within otherwise well-protected populations, creating local conditions in which outbreaks can take hold.
Coverage gaps can reflect a range of factors, including difficulties accessing vaccination services, limited information or awareness, and concerns about vaccines.
"There are traditional risk groups - such as traveller communities and some religious groups who historically have been reluctant to vaccinate," said Mohan.
However, ECDC underlined that "the presence of a group of unvaccinated people does not automatically mean that a large outbreak will spread across the wider population," using the Urkult festival in northern Sweden as an example. The outbreak at the festival occurred between 30 July and 2 August this year, mainly affecting unvaccinated children and adolescents. It involved 28 cases, including 12 secondary cases, but did not lead to sustained transmission in the wider population.
"The fact that there were relatively few secondary cases among those exposed at the festival is due to the high level of immunity within the population, a result of strong participation in the childhood vaccination program," said Johanna Rubin, Acting Head of the Vaccination Unit at Sweden's public health agency.
"This once again highlights the importance of high community-level protection," ECDC said.
For now, the risk for Europeans remains the same, ECDC said, as per its latest assessment, with the overall risk set as moderate for infants under 12 months, children aged one to five and immunocompromised people. For older unvaccinated children and adults, the risk is estimated to range from low to moderate. People with immunity from vaccination or previous infection are considered to have a low risk of measles.
ECDC surveillance data indicate fewer reported measles cases in 2026 than in 2025, although 2026 figures remain preliminary and should be interpreted with caution.
Measles is endemic in twelve European countries: Bosnia and Herzegovina, France, Georgia, Germany, Italy, Kazakhstan, Kyrgyzstan, Poland, Romania, Russia, Türkiye, and Ukraine.
Romania reported most of the cases, with numbers reaching 30,692 in 2024, up from 3,371 in 2023.
Six European countries: Armenia, Austria, Azerbaijan, Spain, the United Kingdom, and Uzbekistan have re-established endemic measles transmission based on the number of cases in 2024 earlier this year.
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