Bangladesh is confronting a significant measles outbreak that has resulted in more than 1,000 deaths beginning in March, even as health authorities have administered approximately 20 million vaccine doses through an emergency vaccination campaign that commenced in April. By early September, official records documented 1,009 deaths, comprising 100 laboratory-confirmed measles fatalities and 909 classified as suspected measles deaths. The epidemic represents a dramatic reversal from the previous year, when Bangladesh recorded only 132 measles cases with zero deaths.
Public health experts attribute the outbreak’s persistence to multiple systemic vulnerabilities in Bangladesh’s immunization infrastructure. Vaccination coverage rates had declined significantly in preceding years, with first-dose measles-rubella coverage falling from 88.6 percent in 2019 to 86 percent by 2023, while second-dose coverage decreased from 89 percent to 80.7 percent. The country had not conducted a nationwide supplementary measles-rubella campaign since late 2020 and early 2021. Additionally, routine immunization was disrupted during the COVID-19 pandemic, and misinformation and vaccine hesitancy further reduced vaccination uptake. Political instability following an uprising in July 2024 that resulted in a change of government led to delays in vaccine procurement and subsequent shortages in 2024 and 2025.
Even the reported success of the emergency vaccination campaign obscures underlying challenges. Authorities initially set a vaccination target of approximately 18 million children aged six months to under five years when launching the nationwide campaign on April 20. However, a subsequent government initiative to administer Vitamin A supplements to roughly 24 million children in the same age group suggested the original target had significantly underestimated the eligible population. Epidemiologists emphasize that national coverage statistics can mask critical immunity gaps in specific communities, particularly among hard-to-reach and mobile populations. Measles transmission requires only small concentrations of unprotected individuals to persist, meaning even high national average coverage rates may conceal dangerous gaps.
Mortality data reveals the outbreak’s particular severity among very young children. Of the 57 confirmed or suspected measles deaths recorded at Dhaka’s Infectious Diseases Hospital through late August, approximately 86 percent were infants younger than 15 months, with 31 deaths occurring in children under nine months—the age when routine measles vaccination typically begins. Approximately 83 percent of those who died had received no measles vaccine. Pneumonia emerged as the leading complication in documented deaths. Medical professionals expressed particular concern regarding infections among infants who had not yet reached vaccination age, highlighting the vulnerability of the youngest populations during disease outbreaks.
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