Hundreds of people could die in measles outbreaks in the next 20 years unless vaccination rates are dramatically improved, a top disease expert has warned.
Unvaccinated babies aged under 12 months would make up a significant proportion of 480 avoidable deaths over the next two decades, according to modelling by Imperial College London.
Katharina Hauck, a professor in health economics and deputy director of the university’s Jameel Institute, which led the research, suggested there could be two major outbreaks resulting in an additional 390,000 cases, based on a vaccination rate of around 90 per cent.
Current vaccination rates for the two doses required to provide protection against the highly contagious disease are around 85 per cent.
The warning comes after a child died and several others were left “seriously ill” at Liverpool’s Alder Hey Children’s Hospital after contracting measles, just days after health officials warned about an increase in cases due to people not being vaccinated.
The Royal College of Paediatrics and Child Health said the decline in UK vaccination rates is “extremely concerning” and urged governments across the UK to “act urgently” to reverse the trend.
The researchers estimated that the costs of hospitalisation combined with productivity loss because people are unable to work due to measles could amount to £290m over 20 years.
The modelling is a worst-case scenario as it assumes no increased uptake in vaccinations and that health authorities take no action to improve rates in the event of an outbreak. It also assumes that 3 per cent of those who are unvaccinated are against vaccination in principle. However, several officials told The Independent that reasons for not being vaccinated vary, and a significant proportion of children who have not received the vaccine will have missed out because their parents either didn’t have access to it or haven’t prioritised it.
Since 1989, fewer than five people have died each year from measles, but experts warn that cases will rise if uptake doesn’t improve.
Professor Steve Turner, of the Royal College of Paediatrics and Child Health, said more must be done to improve vaccination rates. He said: “[Measles] poses a significant risk to everyone, putting immense strain on already struggling health services and also our economy. Paediatricians are particularly concerned about current measles outbreaks in the UK. Measles can be safely prevented by vaccination.”
Uptake for the first dose of the measles, mumps and rubella (MMR) vaccine in children aged 2 years in England is 85.6 per cent, and uptake of the second dose at age 5 years is 85.5 per cent. This is below the 95 per cent target the World Health Organisation (WHO) says is necessary to achieve and maintain elimination of the virus.
The UK Health Security Agency (UKHSA), whose remit is to prevent and respond to disease, warned in 2023 that cases in London could result in an outbreak affecting between 40,000 and 160,000 people if vaccination rates, which were at 74 per cent for both doses, did not improve.
The latest vaccination rates from January 2025 to March 2025 show that the figure has fallen further in the capital to just 70 per cent.
In 2023-24, NHS England implemented a nationwide catch-up campaign for MMR vaccinations for those who had missed out, which delivered an extra 180,000 vaccinations.
Dr Vanessa Saliba, a consultant epidemiologist at the UKHSA, said the agency’s 2023 projections are still valid as vaccination rates remain a concern.
She said: “You can argue on the size of the outbreaks, [but] we all agree you are going to see outbreaks. It’s not a surprise what we’re seeing at the moment, so it’s very important we work as a system to reverse that trend. If vaccine coverage is below 95 per cent, we will see cases, outbreaks, and potentially deaths.”
Dr Saliba said the UK has never met the WHO targets for measles, so the current outbreaks are not unexpected. The agency has brought forward the MMR jab schedule to allow children to receive it at 18 months instead of at three years old, in a bid to boost uptake.
The UKHSA said projections within the Imperial College research should be treated with caution as they assume no action would be taken by health authorities following an outbreak – something that is unlikely to be the case.
Professor Hauck said that poor vaccine uptake is due to a range of issues, including difficulties accessing primary care services that provide the vaccine, as well as misinformation. “Past medical accidents, and poor communication of the benefits of vaccination, have also caused vaccine hesitancy to spike in some areas, including parts of Britain,” she said.
She listed a number of interventions that can help promote vaccine uptake, including information campaigns, opening up access to vaccinations, and building trust in authorities.
However, Professor Hauck suggested there should also be “discussions” around measures such as mandating vaccination, which is done in other countries, and taxing the unvaccinated.
Azeem Majeed, a professor of primary care and public health at Imperial College, said the modelling “highlights the serious public health implications” of allowing vaccine coverage to remain below optimal levels.
“In a ‘no change’ scenario, with coverage at around 90 per cent, the population is vulnerable to large-scale outbreaks every few years, as the number of susceptible individuals builds up over time, and the main message to be taken is the need for sustained high vaccine coverage,” he said.
He added that the precise number of cases would depend on the assumptions made, and that the response mounted by the government and the NHS in the event of an outbreak would reduce the total number of infections and deaths.
