What CDC is Doing About Global Measles and Rubella

Overall Focus

CDC works with partners worldwide to eliminate measles and rubella, protecting people, especially children, from these deadly and disabling diseases.

CDC invests globally in reducing the burden of vaccine-preventable diseases because it is a best buy for public health and strengthens U.S. national and global health security. Vaccines save millions of lives, reduce healthcare costs and minimize economic impacts on families and societies.

Rubella Goals

Eliminate rubella in every region of the world.

CDC works toward elimination goals for rubella established in 5 of the 6 regions of the world.

Rubella infection during pregnancy can lead to serious complications, including miscarriage, stillbirth or lifelong disabilities known as congenital rubella syndrome (CRS). CDC invests in surveillance, early detection, and laboratory confirmation of the circulation of rubella virus. This investment strengthens immunization systems, including in the remaining countries where rubella vaccine is not yet delivered through their national immunization programs. A single dose of rubella vaccine offers protection against the virus for life, helps stop transmission, and saves lives.

Today, rubella vaccine is administered through the national immunization programs in 175 countries. This progress represents protection from rubella infection in . In 2015, the Region of the Americas was declared rubella free, and the remaining five World Health Organization (WHO) regions are making progress toward elimination.

More Babies Protected from Rubella Than Ever Before

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Percentage of countries that have introduced rubella-containing vaccine in the routine schedule, by World Bank income group and year – worldwide, 2000-2020.

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The percentage of countries that have introduced rubella-containing vaccine from 2000-2020 has held steady at 100% for high-income countries, trended upward and leveled out at around 90% for upper-middle income countries and lower-middle income countries, and trended upward to just under 50% for low-income countries. [Gross National Income per capita in USD in 2020: high income >$12,695; upper-middle income: $4,096–$12,695; lower-middle income: $1,046–$4,095; low income: ≤$1,045. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. In 2020, there were 59 high income, 54 upper middle-income, 54 lower middle-income, and 27 low-income countries.]

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Rubella is being eliminated country by country with more babies protected in lower- to middle-income countries than ever before. Because of vaccination activities, 70% of all infants worldwide have access to rubella vaccine, and 50% of countries have stopped local rubella transmission, ending fetal death and birth defects due to CRS in those countries.

Measles Goals

Achieve High Vaccination Coverage to Prevent and Stop the Spread; Reach Measles Elimination in Every Region of the World

CDC is focused on eliminating measles in every region of the world. By improving vaccination coverage worldwide and strengthening national immunization service delivery to reach every child with lifesaving vaccines, a world free from measles deaths and disease is attainable. Today, every region in the world has a measles elimination goal, yet no region has achieved and sustained elimination.

From 2000 to 2021, CDC supported worldwide vaccination efforts against measles that helped save over 56 million lives. Because measles is so contagious and can easily spread to unvaccinated or under-vaccinated populations, CDC works with countries to achieve and maintain a ≥95% coverage rate with two doses of measles vaccine to prevent measles infections and outbreaks.

Vaccinate Every Child On Time to Regain Progress Towards Measles Elimination

In recent years, progress toward measles elimination targets has stalled, caused by a failure to vaccinate every child on time. Causes for failure to vaccinate must be addressed and include:

• Ongoing disruptions of vaccination activities during the COVID-19 pandemic.
• Weak and strained health systems leading to many children not receiving immunization services.
• Insufficient focus on equity with some children being left out and never reached by any vaccines.
• Poor quality data leading to an inability to correctly identify who needs to be vaccinated.
• Lack of investments in measles outbreak response capacity to be able to quickly contain outbreaks and limit the spread of measles outside of geographic pockets and across borders.
• No implementation of effective communications strategies to counter the misinformation and disinformation leading to erosion of trust in vaccines.

CDC is a member of the Measles & Rubella Partnership (MR&P), previously known as the Measles & Rubella Initiative, which includes American Red Cross, the Bill & Melinda Gates Foundation, Gavi, the Vaccine Alliance, the United Nations Foundation, UNICEF and WHO. On January 1, 2023, M&RP aligned with Immunization Agenda 2030, with the target of saving 50 million lives through access to essential vaccines by the end of 2023.

All partners adopted the Measles & Rubella Strategic Framework, an ambitious global strategy to maximize the lifesaving impact of measles and rubella vaccines.

Detect, Mitigate and Quickly Respond to Measles Outbreaks to Limit Loss of Life

A worldwide response plan, the Global Strategic Measles Outbreak Response Plan for 2021 – 2023, focuses on strategies and tools needed to detect and respond to measles outbreaks quickly to minimize loss of life quickly and effectively.

One example of CDC’s work: from June to July 2020a CDC-supported mass measles vaccination campaign in Ethiopia’s Oromia Region protected 14.5 million children from measles while mitigating the risk of COVID-19.

Learn more about why CDC is working to eliminate global measles and rubella, and how those efforts save lives and contribute to strengthening U.S. national and global health security.