Vaccine Coverage Gaps Fuel Measles Crisis in Bangladesh

Dhaka, Bangladesh — The death of one-year-old Saif Hasan at Dhaka’s Infectious Diseases Hospital (IDH) on August 27 highlights the deadly persistence of a measles epidemic that has claimed more than 1,000 lives since March. Although Saif had received his first measles-rubella vaccine, doctors believe the infection occurred before the shot could take effect, exacerbating his pre-existing respiratory condition.

The tragedy underscores a broader public health challenge: despite an emergency campaign administering nearly 20 million vaccine doses since April, the virus continues to spread. Health authorities recorded 1,009 deaths by September 9, including 909 suspected cases, while 19.75 million children were vaccinated against a target of 18 million.

Public health experts argue that high national vaccination figures mask significant local immunity gaps. Mushtuq Hussain, a former principal scientific officer at the Institute of Epidemiology, Disease Control and Research (IEDCR), noted that population estimates used to set vaccination targets were too low. A subsequent campaign targeting vitamin A supplementation in late June identified approximately 24 million children aged six months to five years—nearly six million more than the original vaccine target.

Bangladesh’s vulnerability stems from years of declining immunization coverage. Routine vaccinations were disrupted during the COVID-19 pandemic, and misinformation fueled vaccine hesitancy. The last nationwide supplementary campaign ran from December 2020 to January 2021, leaving coverage below the 95 percent threshold required to interrupt transmission. Political upheaval following the July 2024 uprising further delayed vaccine procurement, causing shortages in 2024 and 2025.

As cases surged in early 2026, Bangladesh notified the World Health Organization of a nationwide outbreak on April 4. By mid-April, infections had reached 58 of the country’s 64 districts. Emergency vaccinations were launched in high-risk areas on April 5, followed by a nationwide drive starting April 20.

Hussain emphasized that maintaining equity is critical, warning that average coverage rates can conceal susceptibility in hard-to-reach communities. A second epidemiologist, speaking anonymously due to the sensitivity of the issue, called for data analysis by age, vaccination history, and location to identify and target remaining vulnerable populations.

At the IDH, Dr. Shrebash Paul observed that most admitted patients are unvaccinated. Hospital data reveals that 86 percent of measles-related deaths occurred in children under 15 months, with 31 deaths involving infants under nine months—the typical age for the first routine dose. Pneumonia was identified as the leading complication in 50 of the documented deaths.

While hospital admissions have declined from their peak, suggesting some impact from the vaccination program, experts warn that sustained transmission requires precise micro-planning rather than broad coverage statistics. Halimur Rashid, director of disease control at the Directorate General of Health Services, announced preparations for another vaccination round expected within two weeks. However, for families like that of nine-month-old Mostakim from Kishoreganj, who died on August 30 after missing vaccination entirely, the window for prevention has already closed.