Bangladesh’s devastating measles outbreak is showing little sign of slowing despite government claims that more than 100% of targeted children have been vaccinated, prompting immunization experts to question whether sufficient immunity is being developed after vaccination and whether critical gaps remain in the country’s response.
More than a month after the completion of a nationwide emergency measles vaccination campaign, over 1,000 children are still being admitted to hospitals every day with measles or measles-like symptoms, while deaths continue to be reported across the country.
According to the latest figures from the Directorate General of Health Services (DGHS), another 1,282 people were hospitalized with measles and measles symptoms in the past 24 hours, while seven more deaths were reported.
Since March 15, nearly 88,700 people have received treatment for measles-related illness and 620 people have died.
The continued surge has raised concerns among public health specialists who say vaccination coverage alone does not guarantee protection unless children develop adequate antibodies.
“Measles transmission should decline significantly once vaccine coverage exceeds 90%,” said Professor Dr Be-Nazir Ahmed, former director of the government’s disease control branch.
“If vaccination has truly reached the reported level, then infections should have fallen much more sharply by now.”
He said Bangladesh urgently needs age-based antibody studies to determine whether vaccinated children are developing adequate immunity and whether the vaccine remains fully effective throughout the distribution chain.
Experts stressed that immunity typically develops within two to three weeks after vaccination.
Since the nationwide campaign ended nearly a month ago, they say the persistence of widespread transmission warrants closer scientific investigation.
Questions are also being raised about the accuracy of reported coverage rates.
Official reports indicate that vaccination targets were exceeded in some areas, with coverage reportedly reaching more than 100%.
However, Be-Nazir Ahmed warned that administrative targets do not always reflect the actual number of eligible children.
“In some cases, coverage may appear to be 100% on paper while thousands of children remain unvaccinated in reality,” he said.
Experts are also urging authorities to examine whether cold-chain systems maintained the required temperatures from storage to administration, as even minor disruptions can reduce vaccine effectiveness.
Vaccine specialist Dr Tajul Islam A Bari said antibody surveys should be conducted immediately to determine whether vaccinated children have developed protection at the required level.
“We need to know not only whether antibodies were produced, but whether they are sufficient to prevent infection,” he said.
He also called for research into why increasing numbers of children are becoming infected before reaching the regular vaccination age and whether immunity levels differ among children vaccinated at different ages.
Public health specialists warn that unless these questions are answered quickly, Bangladesh risks prolonging one of the worst measles outbreaks in its recent history.
While health authorities continue to emphasize vaccination, experts say the next phase of the response must focus on verifying immunity, identifying children who remain unprotected and conducting targeted catch-up campaigns in high-risk areas.
Asked when the outbreak might begin to ease, DGHS Disease Control Director Halimur Rashid acknowledged that there is no clear timeline.
“It may take time,” he said. “We have to be patient.”
