What’s going on with Measles in England?

An explanation of where we are, how we got here and what we can do

There have been various headlines this week warning of a significant measles outbreak in England. Overall, the UK Health Security Agency (UKHSA) has reported 96 confirmed measles cases since 1 January 2026, concentrated in London (64% of cases) and the West Midlands (26% of cases). But what does this all mean? Is 96 a lot? Why is it happening? And what can we do about it?

In short, this isn’t as big an outbreak as some we’ve seen in last few years, but it is happening in the context of fewer children being vaccinated. London in particular is far below the required vaccination rate (95%) to keep Measles at bay. Measles is one of the most infectious diseases known in non-immune populations. This means that this outbreak has the potential to keep growing in areas where fewer people are vaccinated. The good news is that we do have free, very safe and very effective vaccines for Measles (non-pork gelatine versions (Priorix Tetra) are available). Over the last 25 years, vaccination was most commonly offered as MMR (to protect against Measles, Mumps and Rubella) and from January 2026 is now offered as MMRV to additionally protect against Chicken Pox.

A quick history of Measles in England

The below chart shows notifications of Measles in England since we started collecting them in 1940.

Before a vaccine was available, there were hundreds of thousands cases reported every year with large epidemics every two years or so. The first Measles vaccine was introduced in 1968 after which cases started to fall rapidly, but nonetheless tens of thousands of children were still infected each year, mainly because it took several years for the percentage of children vaccinated to increase from 50% to over 80%. In the late 1980s, the combined MMR vaccine was introduced, making it easier for children to be vaccinated (because it required fewer jabs and doctor visits) and it came with a campaign to encourage vaccination. By the late 1990s, when a second dose of MMR was introduced, well over 90% of children were getting vaccinated. Two doses of MMR offer 99% protection against becoming infected with Measles if exposed, and the World Health Organization (WHO) recommends that if a country can vaccinate over 95% of its population (normally during early childhood) then this is enough to stop Measles from spreading (the herd immunity threshold).

But then in the early 2000s, Andrew Wakefield (a now struck-off ex-doctor) published bogus claims about the vaccine (and stood to personally profit if he could undermine confidence in MMR). You can read all about it in this amazing graphic explanation by Darryl Cunningham. This led to a sharp drop in the number of children being vaccinated over the following years and is likely to have contributed to a significant 2012 outbreak in England where a lot of 5-15 year olds were infected. Vaccination rates recovered but have been declining again slowly since 2014 or so. Confidence in vaccines was further damaged by the Covid pandemic for a variety of reasons, including misinformation about Covid vaccines.

The amazing, incredible consequence of years of high rates of Measles vaccination was that for 20 or so years in England, Measles essentially disappeared. In 2016, almost fifteen years after Wakefield, The World Health Organization declared Measles eliminated (no or very little local transmission) in England. We’d gone from hundreds of thousands of cases, and hundreds of deaths a year before vaccination to basically none. But nationally, by 2025 only 84% of 5-year olds had had 2 doses of MMR, a long way off the 95% threshold required to keep Measles eliminated.

There is also stark regional variation, with London having by far the lowest vaccine uptake in the country (70%) and the West Midlands the next lowest (84%), while the South West and the North East both have 90% uptake. This means that we would expect Measles to be able to spread most easily in those regions, especially London where there has been relatively low coverage for over 10 years, meaning there are far too many susceptible children who will be vulnerable if exposed.

So is 96 cases so far in 2026 a lot?

Compared to the 20th Century, no of course it isn’t. But it is an unwelcome sign that we could be returning to the early vaccine era when lower coverage meant significant annual outbreaks. Below is a plot of confirmed measles cases in England per year since 2013. Annual cases were increasing again before the pandemic, and in 2018 England lost its elimination status. The public health measures we had to institute for Covid were enough to eliminate Measles again, but in the face of continued falls in MMR vaccine coverage, we couldn’t keep it and saw a really significant number of cases in 2024. Because of this, we officially lost our elimination status again at the beginning of this year. The issue isn’t just the number of cases, but the fact that they came from sustained local transmission.

Local transmission can be sustained longest in areas with the lowest population immunity. So, unsurprisingly, cases over the last few years have been concentrated in the two least vaccinated regions, London and the West Midlands.

So while 96 cases in the first few weeks of 2026 may not be a huge number, it is worrying because the susceptible population is growing not shrinking and providing more room for local epidemics to grow. Measles is a serious illness and the more it spreads, the more likely people will develop complications or even die. In 2024, 5 people died from Measles (including 1 child), and last year saw 2 Measles deaths (including 1 child) (UKHSA data).

And when it comes down to it, 96 cases in just a few weeks is huge when we know it can be zero or close to zero. There mustn’t be any shrugging of shoulders, or acceptance of these outbreaks. We know that they are avoidable because we did avoid them – for years, and not long ago.

We have the vaccine, we have the means to distribute it. What we need is to redouble efforts to tackle the slow loss of confidence in vaccines. There is no quick way to do this but we do have the tools – it requires effort, outreach, listening to people’s concerns, answering their questions, and working within communities.