Amid vaccine procurement delays and misinformation, measles makes a deadly comeback
To achieve herd immunity, about 95% of a population needs to be vaccinated with two doses of the measles-containing vaccine. Anything less, and the virus finds room to spread
In a recent post on the Facebook profile of one Noyon Chatterjee 9, the author claims that measles was already declining before vaccines existed.
"It causes a mild infection with a death rate of just 0.1%," the author argued, claiming that global concerns are exaggerated, and pharmaceutical companies are exploiting fear to push mass immunisation.
Another Facebook profile, Ariyan Rasid, wrote that vaccines are a Western tool to kill babies. The real story, according to him, is not public health but profit. He frames vaccines as a business and fear, its marketing tool.
It is against the backdrop of this sort of misinformation by anti-vaxxers, coupled with the delay in securing measles vaccines during the terms of the previous administrations, the country now finds itself facing a measles outbreak.
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The outbreak has claimed the lives of at least 47 children so far in 2026. Health officials report a 75-fold increase in cases compared to the same period last year, with 676 confirmed cases recorded in the first three months of 2026 alone.
A global comeback
Data from the World Health Organization and UNICEF show that worldwide measles cases surged sharply in 2024 and 2025, as millions of children missed routine immunisation. Europe recorded its highest number of cases in over two decades, while the US saw its worst outbreak in more than 30 years, according to the Centers for Disease Control and Prevention.
This resurgence is not happening in isolation. It is unfolding in the aftermath of the Covid-19 pandemic, which disrupted immunisation campaigns worldwide but also triggered a parallel "infodemic" of mistrust.
The immunity gap
Measles is one of the most contagious viruses known to science. Epidemiologists often cite its basic reproduction number (R₀) as between 12 and 18, meaning one infected person can spread it to up to 18 others in an unprotected population.
This is why vaccination thresholds matter so much. To achieve herd immunity, about 95% of a population needs to be vaccinated with two doses of the measles-containing vaccine.
Anything less, and the virus finds room to spread.
Dr Ahmed Mushtaque Raza Chowdhury, convener of Bangladesh Health Watch, says, "A large portion of children have remained outside that immunity. If they can be covered, the situation will definitely improve — dramatically improve. As for why it seems higher this year, it was not sudden. Cases have been increasing since last year, and now it has become more visible."
Globally, WHO estimates that nearly 40 million children missed at least one measles vaccine dose during the pandemic years. Even in countries where overall coverage appears high, pockets of under-vaccinated communities — often shaped by misinformation — have created fertile ground for outbreaks.
Bangladesh, despite a relatively strong routine immunisation infrastructure, is not immune to this trend.
The misinformation ecosystem
The anti-vaccine argument rarely presents itself as outright rejection. Instead, it borrows selectively from science, mixes facts with falsehoods, and frames itself as sceptical.
A typical narrative runs like this: measles deaths were already declining before vaccines; natural infection builds immunity; vaccines carry risks; pharmaceutical companies profit from fear.
Each claim contains a fragment of truth but is stripped of context.
Yes, measles mortality declined in many countries before the vaccine era due to improved nutrition and healthcare. But incidence remained high. The introduction of vaccines in the 1960s led to a dramatic and sustained drop in both cases and deaths.
The fundamental issue is that Bangladesh currently lacks the specialised administrative personnel to manage this. There is a palpable expertise gap. Furthermore, our system frequently places clinical doctors into these high-level administrative roles through political appointments… While these individuals are medically qualified, they often lack the specific background or technical training required for international procurement.
Yes, natural infection confers immunity — but at the cost of disease, complications, and, in some cases, death. Vaccines provide immunity without those risks.
And yes, vaccines, like all medical interventions, can have side effects — but serious adverse events are exceedingly rare compared to the risks posed by the diseases they prevent.
What misinformation does is flatten these nuances into a single, misleading conclusion: that vaccines are optional, unnecessary, or even harmful. This is where misinformation becomes decisive. Anti-vaccine narratives do not need to convince a majority. They only need to influence a critical minority — enough to push coverage below herd immunity thresholds.
Syed Abdul Hamid, professor at the Institute of Health Economics at Dhaka University, points to the post-pandemic surge in such narratives, "There has also been a rise in anti-vaccine propaganda, especially after Covid-19. When vaccination is voluntary, not all guardians are aware. Not all parents take their children to paediatricians."
So how can this be countered?
He replied, "The government has the responsibility to prevent and punish such misinformation. There is no continuous research into where we are lacking or how to respond to misinformation."
The cost of complacency
One of the most persistent claims in anti-vaccine discourse is that measles is "mild" — a childhood illness that most people recover from. This is dangerously misleading.
While many cases are uncomplicated, measles can lead to severe complications, including pneumonia, encephalitis (brain inflammation), blindness, and long-term immune suppression. In low-resource settings, where malnutrition is common and access to critical care is limited, the risks are significantly higher.
Globally, measles still kills tens of thousands of children each year, despite the availability of a safe and effective vaccine.
Dr Raiiq Ridwan of Cambridge University Hospitals highlights how outcomes vary sharply depending on health system capacity, "While so many people are getting measles globally, the death rate in Bangladesh is very high. This is because we do not have sufficient ICU capacity, emergency treatment facilities, or the ability to quickly support critically ill patients. There is also no proper system for rapid transfer when needed. Around 50 people have died, many of which could have been preventable."
Why is there a shortage of vaccines?
Another problem occurs when the administration finds itself lacking sufficient vaccines.
Measles vaccines are primarily supplied to Bangladesh through Gavi, the Vaccine Alliance, with the funding for these essential doses provided by international donor agencies. The distribution of these vaccines follows two distinct pathways.
First, vaccines are administered through approximately 120,000 centres nationwide. In rural areas, this is managed by field-level health workers, while urban distribution is handled by city corporation vaccinators and various NGOs. Under this routine schedule, children receive their first dose at nine months and a second at 15 months.
Second, every few years, nationwide campaigns are launched to provide rapid coverage for all children aged between nine months and 10 years. The most recent large-scale campaign of this nature took place in December 2020.
Historically, Bangladesh's immunisation efforts have been integrated into the Health, Population, and Nutrition Sector Programme (HPNSP), commonly referred to as the "Sector Programme." Within this framework, the Expanded Programme on Immunisation (EPI) operated under the Maternal and Child Health Operational Plan.
While discussions regarding moving away from Gavi in favour of direct procurement began as early as 2017, the situation reached a turning point in June 2024, when the fourth phase of the Sector Programme concluded without being renewed.
In 2025, the interim government's decision to abolish the sectoral programme entirely triggered a series of procurement complications. An initiative to bypass UNICEF and move to a direct-purchase model was met with objections from the Ministry of Finance, alongside hurdles related to approval protocols and financial auditing. These administrative bottlenecks led to several policy reversals, resulting in the loss of critical time.
After all this, the vaccines are now being procured through Gavi. While Gavi has already provided two crore measles vaccines for the campaign, other necessities like syringes have yet to be procured.
But this period of protracted indecision and administrative delay has caused a significant disruption in the vaccine supply chain, leaving a several-month gap in availability.
Public health expert Dr Taufique Joarder, associate professor at the National University of Singapore (NUS), said, "The fundamental issue is that Bangladesh currently lacks the specialised administrative personnel to manage this. There is a palpable expertise gap. Furthermore, our system frequently places clinical doctors into these high-level administrative roles through political appointments — whether in the EPI (Expanded Programme on Immunisation) or MNCH (Maternal, Neonatal, and Child Health) departments.
"While these individuals are medically qualified, they often lack the specific background or technical training required for international procurement. This is not a failure unique to any one administration — whether the current government or its predecessors — but a chronic institutional malaise," he added.
"We are placing untrained personnel into roles that require years of technical experience. In the field of immunisation, where demand is immediate and constant, we simply do not have the luxury of waiting for directors to find their footing," he pointed out.
Professor Hamid pointed out the need for a systemic response, "Parents must be made aware, educated, and guided in parenting. They must be informed about inoculating their children. There is a lack of awareness overall. That is why the situation requires both state initiatives and a broader social movement."
