Bangladesh is grappling with the world’s most severe measles outbreak this year, a crisis driven by declining vaccination coverage, insufficient outreach, and gaps in data quality that have challenged containment efforts. Since mid-March, the country has reported approximately 202,000 suspected measles cases, including 22,000 that have been laboratory-confirmed, according to the World Health Organization (WHO). The outbreak has resulted in at least 1,147 deaths, predominantly among children under five.
The resurgence follows setbacks in Bangladesh’s immunization program in 2025. Coverage for the measles vaccine declined from around 96% for the first dose in 2024 to roughly 90% the following year, falling below the 95% threshold the WHO considers necessary to maintain herd immunity and prevent outbreaks. Political instability, health worker strikes, and disruptions in vaccine supply during a period of national unrest contributed to the decline, officials and experts say.
Efforts to contain the outbreak initially appeared effective after a government emergency campaign in April and May vaccinated nearly 20 million children aged six months to five years. However, the program ultimately missed millions of children. Internal government documents and health worker testimonies indicate that the rapid rollout—compressed into four weeks instead of the usual months-long planning cycle—limited the scope of preparedness checks and outreach. An example emerged when a subsequent health initiative targeted four million more children in the same age group, highlighting the shortfall in the vaccination campaign.
The shortfall has had devastating consequences in regions such as Sylhet in northeast Bangladesh, one of the hardest-hit areas. Families have reported receiving no visits from health workers prior to the deaths of their children. Parents like Amin Mia recall health officials arriving only after his two-year-old son Arman died from measles. Similar stories were shared across the region, underscoring how poor coverage disproportionately affects the poorest and most remote communities.
Despite a government assertion in May by Health Minister Sardar Md Sakawat Husain that the outbreak was "under control," new daily case counts in September averaged nearly 1,200, the highest since May. Challenges remain in accurately tracking vaccination coverage amid data inconsistencies, with official records sometimes reflecting vaccination numbers exceeding 100% of target populations, raising concerns about reporting quality.
Health experts emphasize that vaccine hesitancy and lack of awareness are significant barriers. Although vaccine hesitancy has gained attention globally, especially in wealthier countries influenced by public figures skeptical of vaccines, Bangladesh faces greater challenges related to access and the availability of health services. Furthermore, the government faces difficulty reaching an estimated 40% of children who remain unregistered and coping with a shortage of health workers, with a third of relevant positions unfilled.
Recognizing ongoing gaps, the government launched a new campaign at the end of September targeting 3.4 million children previously missed. Authorities have pledged widespread village-level involvement to ensure no child is left unvaccinated, while experts call for expanding vaccination efforts to include children older than five, a demographic that accounts for about a third of current measles cases.
Complicating the public health situation is the concurrent dengue epidemic, placing additional strain on healthcare facilities. Hospitals in Sylhet are overwhelmed, with the region’s main pediatric facility operating beyond capacity as it treats hundreds of measles patients.
WHO officials underscore the importance of strengthening routine immunization systems to prevent future outbreaks and stress that vaccinating children remains the most effective and cost-efficient strategy. The Bangladeshi experience serves as a cautionary example of the risks that arise when immunization programs falter, particularly in resource-limited settings.