During the COVID-19 crisis, tens of millions of children worldwide missed life-saving measles vaccines in both wealthy and developing nations. Restrictions on access to clinics, shortages of protective gear for health workers, and fear of infection disrupted vaccination campaigns. In November 2022 the World Health Organization warned that measles was an imminent threat in every region of the world.
Measles is often underestimated in Russia, with a mistaken belief that it is not as serious as other diseases. In truth, measles never fully disappeared. In laboratory terms, the virus remains remarkably stable and unchanging from the pre-vaccine era. It is among the most contagious diseases on the planet, able to linger in the air for up to two hours and to spread from an infected person up to four days before and after a rash appears. The stability of the virus helps explain why the measles vaccine is so effective. Unlike some viruses that mutate rapidly, the measles virus exists as a single strain. Although Russia eliminated the disease during the Soviet period, there is no guarantee this status will hold forever.
Measles remains a serious threat and could reemerge for a long period. Its appearance in Russia this year seems linked to migrant workers from Central Asia, where the disease is more common. This suggests a broader challenge: unvaccinated Russians face higher infection risks due to declining vaccination rates in neighboring countries. Even within Russia, vaccination coverage has dropped compared with past levels.
Why do more parents refuse vaccination, fueling a return of a disease that has caused hundreds of deaths in recent years? A key factor is a troubling loss of historical memory. Many parents today have no recollection of living with measles and may not remember how vaccines eliminated diseases like smallpox and polio. The decline in vaccination rates reflects not only memory gaps but also overconfidence in unverified personal knowledge. Some anti-vaccine advocates label themselves as researchers, equating casual online searches with the rigorous work published in peer-reviewed journals.
Measles is not a minor concern. It ranks as one of the most severe childhood infections, highly contagious and difficult to detect early on before the rash appears.
Even in uncomplicated cases, measles causes substantial distress for a sick child and their family for seven to ten days. There are no proven antiviral treatments for measles or its complications. The illness begins in the airways with a runny nose, sore throat, red eyes and a worsening cough. Unlike many colds, measles worsens over several days, bringing high fevers up to around 40 degrees Celsius and often forcing children to rest in bed with nausea, vomiting, chills and headaches. This pre-rash stage lasts roughly four days, during which a large amount of virus is released into the environment, explaining the high contagiousness. Measles spreads beyond the respiratory tract to the skin and other organs through the bloodstream, and the rash appears as the immune system responds to the infection. Delays in immune activation can prolong illness and increase tissue damage. Hospitalization rates for measles are highest among children under five, ranging from nine to twenty-five percent in high-income regions. Complications occur in about one in three cases, including middle ear infections in fourteen percent, diarrhea with dehydration risk in eight percent, and pneumonia in nine percent. Encephalitis, an inflammation of the brain, with convulsions or coma is the most dangerous complication, occurring in about one in a thousand cases, and recoveries among survivors often involve lasting brain changes.
Measles is not inconsequential. At best it brings trouble; at worst it can threaten life. Parents should take this risk seriously. Given the strong safety record of the measles vaccine, ensuring full vaccination remains a reasonable strategy to protect children. When vaccination rates rise, the most vulnerable children also gain protection. The goal is to eradicate this ancient disease with a highly effective and safe vaccine that has stood the test of time.
The writer’s personal view is presented here and may not reflect a formal editorial stance.