Europe has had the highest number of measles cases since 1997, according to a new report from the World Health Organization (WHO). There were 127,350 cases in 2024 – about double the number from 2023.

“Measles is back, and it’s a wake-up call,” says Dr Hans Henri P. Kluge, WHO regional director for Europe. “Without high vaccination rates, there is no health security.” Last year, there were 38 deaths from measles.

Transmission is similar to COVID, with respiratory droplets and aerosols (airborne transmission) spreading the virus between people. The infection produces a rash and fever in mild cases, and encephalitis (brain swelling), pneumonia and blindness in severe cases.

Hospitalisation and deaths are overwhelmingly in unvaccinated people, with mortality rates in developed countries around one in 1,000 to one in 5,000 measles cases.

Each person infected with measles will, on average, spread the virus to between 12 and 18 other people. This is more infectious than COVID. For example, someone with the omicron variant would spread the virus to around eight others.

In 2022 the WHO had described measles as an “imminent threat in every region of the world”. The widespread impact of COVID made it harder for people to access healthcare, reducing the ability of regular health services, like vaccinations, to function properly.

These new stark figures from WHO Europe are an inevitable consequence of lower vaccination rates. Measles is almost entirely vaccine-preventable, with two doses providing greater than 99% protection against infection. The vaccine has an excellent safety record, with severe harm being extremely rare.

The proportion of the population that needs to be vaccinated to keep local transmission low and prevent outbreaks (so-called “herd immunity”) is around 95%.

WHO Europe highlighted some examples of where there are clear gaps in vaccine coverage. In Bosnia and Herzegovina, Montenegro, North Macedonia and Romania, fewer than 80% of eligible children were vaccinated in 2023, with rates below 50% for the past five or more years. Romania had the highest number of measles cases in Europe in 2024 – an estimated 30,692 cases.

Misinformation is the driver

Misinformation is an important factor that reduces vaccine uptake. For example, in the UK, former physician Andrew Wakefield presented falsified data in 2002 claiming the MMR (measles, mumps and rubella) vaccine caused autism. He somehow got these claims published in The Lancet – although the paper was later retracted.

This fake scare received sustained media coverage, which resulted in lower uptake in young children at the time and was then a key factor a large measles outbreak among teenagers in England in 2012.

The claims have spread internationally. In 2020, a US population survey found that “18% of our respondents mistakenly state that it is very or somewhat accurate to say that vaccines cause autism”.

Sadly, misinformation about health can even be found at the highest levels of government. US President Donald Trump repeatedly made false claims during the COVID pandemic, including the suggestion that injecting disinfectant might cure COVID. In 2025, he appointed Robert F. Kennedy as the Secretary of Health and Human Services. Kennedy has long espoused anti-vaccine viewpoints, including being required to apologise in 2015 for comparing vaccination programmes to the Holocaust.

RFK Jr. was made to apologise for comparing vaccination programmes with the Holocaust. Maxim Elramsisy/Shutterstock

In a recent interview with Fox’s Sean Hannity, Kennedy said of the MMR vaccine: “It does cause deaths every year. It causes — it causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera.”

This is untrue. The Infectious Disease Society of America points out that there have been “no deaths related to the measles, mumps and rubella vaccine in healthy individuals”. This is amid two measles deaths in unvaccinated people in the US, the first such deaths since 2003. There are estimates that the measles vaccine prevented 94 million deaths globally between 1974 to 2024.

The US National Institute for Health, one of the world’s biggest funders of health research, announced on March 10 2025 that it was axing research that aimed to understand and address vaccine hesitancy.

This goes alongside the US Centers for Disease Control and Prevention (CDC) apparently planning a large study into potential associations between vaccines and autism, despite dozens of studies indicating there being no such link.

This volatility coming from the US and elsewhere matters for Europe. Trump and the US have political supporters in Europe, so their messaging carries weight and could do harm. Anti-vaccine sentiment promoted on Facebook from within the US resulted in comments on the posts from multiple countries. The use of social media has been observed to spread misinformation internationally, for example, within Europe. Russian trolls are also involved in creating arguments about vaccines.

There is an urgent need for outbreaks to be brought back under control and for accurate information about vaccines to be the key message in public discussions. As Dr Kluge highlights: “The measles virus never rests – and neither can we.”

Michael Head, Senior Research Fellow in Global Health, University of Southampton

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