Summary
A Global Burden of Disease Study estimates that measles cases among children under 5 rose to 15.6 million worldwide in 2023, with 118,000 deaths. The rebound followed years of falling disease burden and coincided with a slight decline in first-dose vaccine coverage.
A Global Burden of Disease (GBD) study published in Nature Medicine estimates that measles caused 15.6 million cases and 118,000 deaths among children under 5 worldwide in 2023. The estimates mark a sharp rebound after decades of declining burden: between 1990 and 2019, global measles incidence fell by about 80% and mortality by about 90%.
The analysis covers 204 countries and territories from 1990 through 2023. It also finds that first-dose measles-containing vaccine coverage, which had risen for decades, slipped from 83.6% in 2019 to 81.0% in 2023. Second-dose coverage continued to rise, reaching 71.4% in 2023.
Disease burden rose as first-dose coverage stalled
The study estimates that measles cases increased by 40% between 2019 and 2023, while deaths rose by 12%. Sub-Saharan Africa and South Asia continued to carry the highest burden among the regions assessed.
The vaccination measures are MCV1, the first dose of a measles-containing vaccine, and MCV2, the second. Globally, MCV1 coverage increased from 67.2% in 1990 to 83.6% in 2019, then eased to 81.0% by 2023. MCV2 coverage grew from 14.4% in 1990 to 68.4% in 2019 and 71.4% in 2023.
The contrasting recent trends matter for routine immunisation: MCV2 coverage rose, but MCV1 coverage fell slightly, while estimated cases and deaths climbed. The study reports that several regions remained below the Immunization Agenda 2030 target of 90% coverage. These patterns point to gaps in protection and support the authors’ call to restore routine vaccination and strengthen outbreak preparedness; they do not, by themselves, identify a single cause for the resurgence.
What the estimates show
The researchers used GBD 2023 to assess measles incidence, mortality, disability-adjusted life years (DALYs) and vaccine coverage in children under 5. DALYs combine years of life lost to premature death with years lived with disability, providing a measure of overall health loss. The published abstract gives no DALY totals, so the central finding here is the change in estimated cases, deaths and coverage.
These are GBD burden estimates across countries and years, rather than a simple tally of reported cases. The study makes its burden and vaccine-coverage estimates publicly available through the IHME GBD Results Tool and the GHDx vaccination-coverage record. Its broad time span places the recent rebound against the long-term gains, while the coverage figures highlight the continuing challenge of keeping children protected through routine vaccination.