A VACCINATION DRIVE TOO LATE FOR THOUSANDS: BANGLADESH’S MEASLES CRISIS EXPOSES FATAL GAPS IN CHILDHOOD IMMUNISATION

October 17, 2026

DHAKA, OCTOBER 17, 2026: Bangladesh is struggling to contain one of the world’s deadliest measles outbreaks, with 1,147 reported deaths and more than 202,000 suspected cases since the outbreak began in mid-March. The crisis has exposed serious weaknesses in routine immunisation, public-health data collection and emergency vaccination efforts, with children under five accounting for 94 per cent of reported deaths.

According to the World Health Organization (WHO), approximately 22,000 of the suspected cases had been laboratory-confirmed by October 9. The scale of the outbreak has raised alarm among public-health experts, who warn that falling vaccination coverage and inadequate outreach can allow a highly contagious disease to spread rapidly, particularly among children in poorer and remote communities.

Bangladesh had previously made considerable progress in childhood immunisation. WHO and UNICEF estimates showed that the country achieved 96 per cent coverage for the first measles vaccine dose and 93 per cent for the second in 2024. However, vaccination coverage declined in 2025, when first-dose coverage fell to 90 per cent and second-dose coverage to 86 per cent—below the approximately 95 per cent coverage generally required to prevent sustained measles outbreaks.

The deterioration followed major political upheaval in 2024, when protests ended the 15-year rule of former Prime Minister Sheikh Hasina. In the subsequent disruption, health workers went on strike, vaccine orders were delayed and follow-up vaccinations associated with routine programmes were interrupted.

The consequences became particularly severe in the northeastern Sylhet region, one of the worst-affected areas. Families described losing unvaccinated children after they developed measles, while alleging that health workers had failed to reach their villages in time.

Amin Mia, a 26-year-old father from Sylhet, said his two-year-old son, Arman Hossain, died in July, approximately 24 hours after being admitted to hospital. The family had sold its three-wheeled auto-rickshaw to pay for treatment. Arman’s unvaccinated four-year-old sister survived.

Mia said health workers had not visited their remote village to offer vaccinations before the tragedy. “They came only after I buried my son,” he said.

Another family suffered a similar loss in June, when nine-month-old Labiba Akter died of measles. Her father, Humayun Rashid, said his daughter could have received a vaccination during an emergency campaign that had lowered the eligible age from nine months to six months. However, he said no health worker had informed the family about the opportunity.

These accounts highlight a central weakness in the response: making vaccines available does not guarantee that children receive them. In remote communities, inadequate communication, incomplete records and the absence of health workers can leave families unaware of vaccination opportunities until an outbreak has already reached them.

Bangladesh launched an emergency vaccination campaign in April, and nearly 20 million children reportedly received vaccines in April and May. The government initially suggested that the programme was bringing the outbreak under control. However, the number of cases rose again, and September recorded an average of 1,198 new cases a day, the highest daily average since May.

Subsequent reviews raised questions about whether the campaign had reached all eligible children. A separate routine health intervention in June had a target list containing four million more children in the same age group than the measles campaign. This discrepancy suggested that the emergency programme had missed a substantial number of children.

Meeting records reviewed during the investigation also indicated that the government had conducted only one round of preparedness checks before launching the April campaign, rather than the four rounds typically undertaken. Such checks assess vaccine storage, equipment, staffing and the number of children requiring immunisation. The abbreviated preparation reflected the urgency of the response but may have left gaps in the campaign’s implementation.

By August, the proportion of children with confirmed measles who had not been vaccinated had remained high, increasing from 82 per cent before the campaign to 85 per cent afterwards. Public-health experts said the figures underscored persistent failures to reach children who were most vulnerable.

The quality of vaccination data has emerged as another concern. WHO and UNICEF have questioned official figures for measles and other immunisation programmes between 2023 and 2025. In some preliminary records, the number of children reportedly vaccinated exceeded 100 per cent of the target population, suggesting errors in counting either doses administered or the number of children eligible.

Such weaknesses can undermine public-health planning. Without reliable records identifying which children have received their vaccines, authorities cannot accurately estimate immunity levels, locate missed communities or deploy emergency teams where they are most urgently needed.

The government launched another campaign at the end of September, targeting 3.4 million children who had previously been missed. Health officials have pledged to involve communities across villages to improve coverage and ensure that children are not excluded from immunisation.

Nevertheless, significant structural obstacles remain. UNICEF and the Bangladesh Bureau of Statistics estimate that as many as 40 per cent of children are not registered, while government figures indicate that approximately one-third of health-worker positions remain vacant. Experts have also urged the authorities to extend vaccination efforts to children older than five, who account for roughly one-third of measles cases.

The pressure on medical facilities has compounded the emergency. Bangladesh is also confronting a dengue epidemic, stretching healthcare capacity at a time when hospitals are treating growing numbers of measles patients. In September, a 100-bed hospital in Sylhet reportedly had 178 patients admitted on the day it was visited by investigators.

The WHO has stressed that preventing an outbreak through routine vaccination is easier, safer and less expensive than responding after transmission has accelerated. Mark Jit, a WHO vaccine adviser and professor at New York University, described Bangladesh’s experience as a warning to every country about the consequences of falling immunisation rates.

Bangladesh’s measles emergency demonstrates how political disruption, weak public-health infrastructure, unreliable data and missed vaccination opportunities can combine to produce a devastating outcome. The immediate priority is to reach unvaccinated children, strengthen emergency treatment and stop further transmission. The longer-term challenge is to rebuild a resilient immunisation system capable of protecting every child before a preventable disease becomes a national catastrophe.