This blog will explore the prevalence of measles in Scotland and the United Kingdom, following the recent World Health Organisation announcement that the UK has lost its measles elimination status. The blog will also discuss Scotland’s childhood immunisation programme and challenges affecting immunisation rates.
Measles symptoms and management
Measles is a highly contagious viral infection. The first symptoms of measles include cold-like symptoms, a high temperature, sore or watery eyes, and aches and pains. The characteristic measles rash usually develops around two to four days after the initial symptoms. For most people, the symptoms of measles can be managed at home by taking paracetamol and ibuprofen, drinking plenty of water, and cleaning the eyes. People with more severe symptoms, or those experiencing complications, may require hospital treatment.
Although most people who contract measles will recover after around 7 to 10 days, the virus can cause serious complications for some people, including infections of the lungs and brain, seizures, and blindness. Babies under twelve months old, immunocompromised people, and pregnant women face an increased risk of complications. Measles can be fatal; the World Health Organisation estimated that there were 95,000 deaths from measles worldwide in 2024, mostly in unvaccinated or under-vaccinated children under five.
Prevalence of measles in Scotland and the United Kingdom
In January 2026, the World Health Organisation (WHO) announced that the United Kingdom had lost its measles elimination status. The WHO defines measles elimination as “the absence of endemic measles transmission in a defined geographical area (e.g. region or country) for more than 12 months in the presence of a well performing surveillance system.” After examining data on measles transmission in the UK from 2024, the WHO concluded that measles had been consistently present and spreading within the country.
Although the overall number remains relatively low, cases of measles have increased in Scotland in recent years. There were 28 laboratory-confirmed cases in 2025, an increase from 24 cases in 2024, and 18 cases in 2019. There have been seven laboratory-confirmed cases of measles in Scotland so far in 2026.
Transmission of measles significantly reduced in Scotland during the peak of the COVID-19 pandemic. In addition to reduced opportunities for transmission of the virus, data analysed by researchers at the University of Edinburgh showed that uptake of the MMR vaccine increased in Scotland during the first COVID-19 lockdown, and over the first year of the pandemic. The researchers concluded that the more flexible working arrangements afforded to many people during this period may have helped to remove a barrier to attending vaccination appointments.
Source: Public Health Scotland
Measles cases have also increased in the other three UK nations. In England, there were 959 laboratory confirmed cases of measles in 2025, and 2,911 cases in 2024, a significant increase from 367 laboratory confirmed cases in 2023. In Wales, there were nine confirmed cases of measles in 2023, and 20 confirmed cases in 2024, largely linked to an outbreak in south-east Wales. Northern Ireland reported 22 laboratory confirmed cases of measles in 2024 and four cases in 2025, after previously having no confirmed cases of measles since 2017.
Measles immunisation in Scotland
Measles can be prevented through vaccination. In Scotland, two doses of the measles, mumps, and rubella (MMR) vaccine are offered to children as part of the routine childhood immunisation programme. People of any age can be vaccinated if they did not receive the MMR vaccine as a child.
The MMR vaccine is highly effective in protecting against measles. After two doses, around 99% of people will be protected against measles. Receiving two doses of the MMR vaccine offers lifelong protection against measles. Without vaccination, measles is highly contagious; one infected person can generate up to 18 secondary infections.
The MMR vaccine was previously offered to children in Scotland at the ages of 12 months and 3 years 4 months. However, from 1 January 2026, children born on or after 1 July 2024 will receive their second dose of the MMR vaccine at 18 months. This change was made in response to advice from the Joint Committee on Vaccination and Immunisation (JCVI), and is intended to increase uptake of the MMR vaccine and prevent outbreaks of measles, mumps, or rubella.
Challenges affecting immunisation rates
For vaccines to provide an effective means of disease prevention, a significant percentage of the population must be vaccinated. A high level of vaccine coverage can help to achieve herd immunity – the indirect protection from disease that occurs when the majority of the population is immune, whether through vaccination or exposure to a disease.
Different diseases require varying levels of vaccination coverage to achieve herd immunity. Because measles is so easily transmissible, a high level of coverage – 95% – is needed to maintain herd immunity.
Although uptake for the childhood MMR vaccine is relatively high in Scotland, current immunisation rates in all four UK nations are below the level needed to achieve herd immunity. In 2024-25, 89.2% of children in Scotland had received both doses of the MMR vaccine at the age of five. By comparison, 83.7% of children in England, 89.5% in Wales, and 86.4% in Northern Ireland had received both doses of the vaccine at age five.
According to Public Health Scotland, uptake of the MMR vaccine has fallen in recent years. Vaccination rates are also lower among certain groups, including people living in Scotland’s most deprived areas, those living in remote and rural areas, and people from some minority groups, including people of Caribbean origin and Gypsy/Traveller people.
There are a number of potential factors affecting vaccine uptake rates. A rise in vaccine hesitancy is thought to have contributed to the recent decline in uptake of the MMR vaccine, both in Scotland and elsewhere. Much of the hesitancy surrounding the MMR vaccine is believed to be due to misinformation concerning a link between the vaccine and autism. This stems from the findings of a study conducted in the 1990s, which has since been repeatedly disproven.
However, concerns regarding the safety of the MMR vaccine and others persist. Most vaccines can potentially cause mild side effects, and in very rare cases, some people may experience vaccine injury. Fear of judgement for expressing concern regarding these potential side effects has been identified as a barrier to vaccination among parents.
For some people from ethnic minority communities, reservations about vaccines may be held as part of a wider mistrust in the medical system. Factors such as institutional racism, cultural segregation, and historic medical mistreatment of ethnic minority groups have contributed to vaccine hesitancy in some communities. Additionally, some people may struggle to understand information on vaccines written in English.
A Public Health Scotland report recommended that tailored, in-person information sessions, and honest information from trusted sources regarding the potential side effects of vaccines, may offer reassurance to people experiencing vaccine hesitancy.
Some people face practical and logistical barriers to vaccination, such as struggling to fit appointments around work, and experiencing difficulty accessing clinics via public transport. In Scotland, it has been suggested that the transfer of responsibility for vaccine delivery to centralised clinics under the 2018 GP contract may have exacerbated some of the logistical challenges affecting access to vaccination. Delivering vaccines in local, easily accessible locations, using mobile vaccination clinics, sending appointment reminders, and offering appointments outwith normal working hours, may help to address some of the practical barriers faced by people who wish to access vaccination for themselves or their children.
Sarah Swift, Researcher, SPICe
Featured image credit: Picipedia under Creative Commons licence