Routine Immunization

Ideally, every child should have two doses of measles vaccine and a rubella-containing vaccine through routine services.


Global average coverage with a first dose of measles vaccine (MCV1) through routine immunization improved globally from 72% in 2001 to 85% in 2010, but it has remained stagnant the last ten years. The percentage of countries that achieved more than 90% coverage rose from 44% in 2000 to 58% in 2019.

The Measles & Rubella Initiative advocates and offers technical support to countries to strengthen their routine services, and will assist countries to introduce a measles second dose and measles-rubella vaccine.

Encouragingly, by the end of 2019, 177 countries introduced a second dose of measles vaccine into their routine program. Estimated global MCV2 coverage increased from 15% in 2000 to 71% in 2019.

Financial support offered by the Gavi, the Vaccine Alliance since  2012 has helped fourteen countries to introduce a second dose of measles-containing vaccine in their routine vaccination program.

Countries have also introduced a rubella-containing vaccine and to date 173 (89%) countries have done so, with an estimated coverage of 71% globally. Here again Gavi funding offers an encouraging opportunity for improvement as Gavi will support countries to introduce a rubella-containing vaccine (combined with measles vaccine), first through a campaign and then via routine immunisation services.

It’s important to remember that an estimated 19.8 million infants did not receive the first routine measles vaccination in 2019. 9.3 million were in six countries: Nigeria (2.4 million), India (2.3 million), Pakistan (1.4 million), Ethiopia (1.3 million), Indonesia (1.2 million), and the Philippines (0.7 million).

The world’s poorest children, who are less likely to receive the vaccine through the routine health system in the near future, are at a greater risk of contracting measles and dying from complications. Without interventions by the Measles & Rubella Initiative, including support for outreach and intensified campaigns, they remain vulnerable, and it will be a major challenge to reach the 95% mortality reduction and measles elimination goals.

Updated on March 25, 2021

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