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Measles in the Eastern Mediterranean 2023-2024
Measles and Rubella Elimination Trends in the WHO Eastern Mediterranean Region, 2023-2024: Progress and Recent Epidemiological Shifts.
Overview
Farid M et al.. Vaccines (Basel) 2026 · PMID 42646678 · DOI 10.3390/vaccines14080659
Egypt, with about 96% of children vaccinated twice, had no measles in 2024, while low-coverage neighbours had large outbreaks.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Track measles elimination in the region
- How was the study done?
Analysis of WHO surveillance data
- How many people, animals or samples were studied?
22 countries
- What was actually found?
Outbreaks where coverage is low; elimination in Egypt
- How large was the observed effect?
Egypt 0 cases per million in 2024
- What do the results mean in everyday life?
High vaccination keeps measles away
- What are the study's limitations?
Descriptive data; under-reporting
- What does it say about Elawady's specific claim?
Contradicts banning vaccines
- Do the results apply to Germany and Europe?
Egypt-specific
- What can explicitly not be concluded from this study?
Causal effect size (not a trial)
Scientific in-depth review
1. Full reference
- Authors
- Farid M et al.
- Journal
- Vaccines (Basel)
- Year
- 2026
- Identifier
- PMID 42646678 DOI 10.3390/vaccines14080659
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works record checked
- Retracted
- no
- Corrections
- none
- Extent checked
- full text
- Conflicts of interest and funding
Authors declare no conflict of interest; WHO-affiliated authors' views are their own.
2. Research question
What progress has the WHO Eastern Mediterranean Region made toward measles and rubella elimination in 2023-2024?
3. Study design and population
- Study design
- Ecological study – Retrospective descriptive analysis of WHO surveillance and coverage data (22 countries)
- Population
22 EMR countries including Egypt
- Country
WHO Eastern Mediterranean Region (incl. Egypt)
- Period
2023-2024
- Sample size
22 countries; 111,760 measles cases with age and vaccination status
- Inclusion and exclusion criteria
All EMR countries
4. Methods and endpoints
- Exposure / intervention
MCV1/MCV2 coverage
- Comparator
Between countries and years
- Endpoints
Measles/rubella incidence, coverage, elimination status
- Statistical methods
Descriptive
5. Actual results
- Results
Regional measles incidence rose from 110.8 to 116.3 per million; large outbreaks in Yemen, Iraq and Afghanistan. 72.9% of cases in children under 5, many zero-dose or one-dose; cases with >=2 doses comparatively low. Egypt: MCV1/MCV2 coverage 96%/95% (2023) and 97%/96% (2024); measles incidence 2.2 per million (2023) and 0 (2024); Egypt verified as having sustained measles and rubella elimination for 2024.
- Absolute risks
Egypt measles incidence 0 per million in 2024 (Table 1).
- Authors' conclusion
The EMR remains off track for elimination; equity-focused strengthening of routine immunisation is needed.
6. Strengths
- Official WHO data for all countries
- Egypt-specific figures
- Full text read
7. Weaknesses
- Descriptive, ecological
- Under-reporting acknowledged
- Coverage data discrepancies
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Surveillance data quality varies by country (authors' limitation).
9. Assessment of the statistical interpretation
No inferential statistics; the contrast between high-coverage Egypt (elimination) and low-coverage conflict settings (large outbreaks) is descriptive but consistent with vaccine trial evidence (I-INTB-16).
10. Relevance to the specific claim
Egypt-specific: with about 95-97% two-dose coverage, measles was eliminated in Egypt, while neighbouring low-coverage countries had large outbreaks mainly among unvaccinated children. A vaccination ban would remove this protection.
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
Regional (Egypt/EMR).
13. Overall methodological judgement
Strong regional context supporting vaccination.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- There are to be no vaccinations: vaccinations, medicines and herbs are forbidden. – Studies contradicting or limiting the claim