Progress Toward Measles Elimination - World Health Organization Eastern Mediterranean Region, 2019-2022

Abstract

In 2015, all 22 World Health Organization Eastern Mediterranean Region (EMR) countries and areas (countries) pledged to achieve measles elimination by 2020. Despite success in several countries, most countries in the region still have not eliminated measles. This report updates a previous report and describes progress toward measles elimination in EMR during 2019-2022. During that period, estimated regional coverage with the first and second doses of a measles-containing vaccine (MCV) was 82%-83% and 76%-78%, respectively. During 2019-2022, approximately 160 million children were vaccinated during national or subnational supplementary immunization activities. Reported confirmed regional measles incidence decreased from 29.8 cases per 1 million population in 2019 to 7.4 in 2020, but then increased 68%, to 50.0 in 2022 because of challenges providing immunization services and conducting surveillance during the COVID-19 pandemic. Surveillance indicators deteriorated in 11 (50%) of the 22 EMR countries. During 2019-2022, four countries in the region were verified as having achieved measles elimination, but other countries reported immunity gaps and increased measles incidence in 2022. To achieve measles elimination in EMR, national immunization programs, especially in those countries with high measles incidence, will need to continue to recover from the COVID-19 pandemic, increase overall vaccination coverage to close immunity gaps, and maintain high-quality disease surveillance.

FIGURE

Confirmed measles cases, by month and year of rash onset — World Health Organization Eastern Mediterranean Region, 2019–2022 Abbreviation: WHO = World Health Organization. * Confirmed and clinically compatible measles cases reported to WHO by countries and areas. A case of measles was laboratory-confirmed when measles-specific immunoglobulin M antibodies were detected in serum, or measles-specific RNA was detected by polymerase chain reaction testing in a person who was not vaccinated during the 30 days before rash onset. A case of measles lacked serologic confirmation but was confirmed by epidemiologic linkage when linked in time and place to a case of laboratory-confirmed measles. During 2013–2019, a case of measles meeting the WHO case definition but without a specimen collected could be reported as clinically compatible.