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Eliminating Measles: Factors That Contribute to Re-Establishing Transmission.

Emily Gibson1, David N Durrheim2, Patrick O'Connor3

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|November 26, 2025
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Summary

Maintaining measles elimination is challenging. Low vaccination coverage, lower-middle income status, and neighboring endemic countries increase the risk of measles re-establishment in previously eliminated regions.

Keywords:
eliminationepidemiologyeradicationmeaslessurveillancevaccination coverage

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Area of Science:

  • Public Health
  • Epidemiology
  • Vaccinology

Background:

  • Measles elimination status has been lost by 14 countries since 2016.
  • Re-establishment of endemic measles transmission poses a global health concern.

Purpose of the Study:

  • To identify risk factors associated with the loss of measles elimination status.
  • To explore factors contributing to the re-establishment of endemic measles transmission.

Main Methods:

  • Narrative literature review.
  • Utilized World Health Organization (WHO), World Bank, and United Nations data.
  • Employed descriptive epidemiology and regression modeling.

Main Results:

  • Vaccination coverage is the primary factor influencing measles elimination.
  • Lower-middle income status and proximity to endemic countries elevate re-establishment risk.
  • Quality of vaccination coverage data requires careful consideration.

Conclusions:

  • Sustaining measles elimination requires robust vaccination programs and global coordination.
  • Addressing socioeconomic factors and regional endemicity is crucial.
  • Coordinated global efforts are essential for eventual measles eradication.