Measles is often described as a “solved” disease, given the availability and effectiveness of its vaccine. Yet recent experience in Central Asia shows that measles remains under control only when immunisation systems continuously adapt to real-world pressures: population growth, mobility, vaccine hesitancy, and the practical challenge of reaching every child on time - twice.
Across the broader WHO European Region, which includes Central Asia, WHO and UNICEF recorded 127,350 measles cases in 2024, the highest total since 1997. The agencies warned that persistent immunity gaps are the primary driver of this resurgence. For Central Asia, this regional trend is tangible rather than theoretical. Several countries have faced sustained outbreaks, with case numbers high enough to place pressure on paediatric wards, outbreak response teams, and routine vaccination services.
This evergreen analysis reviews what the most recent 2025-2026 data reveals about measles trends in Central Asia, how vaccination systems and catch-up campaigns are performing, and what steps governments and partners can take to prevent repeated outbreak cycles.
The 2025-2026 Snapshot: What The Latest Data Shows
Kyrgyzstan illustrates how rapidly measles can return when immunity gaps widen. According to WHO’s Europe office, the country reported 7,463 measles cases in 2023, rising sharply to 14,380 cases in 2024. By 10 June 2025, Kyrgyz Ministry of Health figures already showed 7,985 registered cases. Reporting from humanitarian partners during 2025 also pointed to thousands of suspected or confirmed cases in the first half of the year, indicating a nationwide outbreak rather than isolated clusters.
Kazakhstan experienced a major regional wave and continues to see elevated transmission. Local health authorities, cited by Kazakh media, reported 4,240 measles cases in 2025, with children accounting for the majority of infections. In early 2026, the National Public Health Center registered 1,368 cases by late January, noting that 89% of those infected were unvaccinated - a clear indicator of ongoing immunity gaps.
Uzbekistan has faced warning signs of a different kind. In late January 2026, reports circulated widely that WHO assessed the country as having lost its measles elimination status, meaning it no longer met the benchmark of at least 12 months without sustained local transmission. This designation signals the presence of ongoing transmission chains, which are significantly harder to interrupt than isolated imported cases.
In Tajikistan, public reporting in 2025 focused largely on prevention efforts. State media described supplementary measles and rubella immunisation activities across multiple districts and cities from 25 August to 6 September 2025, citing the health ministry. While official case totals are not always published in easily comparable formats, large-scale targeted campaigns often indicate that authorities have identified and are attempting to close immunity gaps.
For Turkmenistan, recent transparency is limited. Publicly comparable 2025-2026 case figures are difficult to verify through open sources. WHO’s immunisation data portal includes country-reported measles totals up to 2024, submitted through annual WHO/UNICEF reporting. As a result, analysts should be cautious about drawing firm conclusions about current trends without updated primary data.
This country-level picture sits within a broader regional context. The WHO/UNICEF-reported surge across Europe and Central Asia in 2024 means the region is operating in a high-pressure environment, where travel-related introductions, importations, and cross-border spread are more likely.
Why Measles Keeps Returning
Measles is among the most contagious human viruses. When population immunity drops, even briefly, transmission accelerates faster than health systems can respond.
The central driver is not simply vaccine refusal but immunity gaps created by several overlapping factors. These include children who miss their first dose due to access barriers, migration, documentation issues, or service disruptions; children who receive the first dose but miss the second, leaving them partially protected; and pockets of under-immunised communities where the virus can circulate intensely even when national coverage appears adequate. High birth rates and youthful populations further compound the challenge by constantly adding new cohorts that must be vaccinated on schedule.
WHO and UNICEF consistently stress that measles elimination requires very high and sustained coverage, typically around 95% with two doses. When coverage falls below this threshold in specific districts - even if national averages look acceptable - outbreaks become far more likely.
Mobility adds another layer of risk. Central Asia is closely interconnected through labour migration, education, trade, and family ties. Imported cases can easily seed outbreaks in low-immunity areas, outbreaks in one country raise the likelihood of introductions into neighbouring states, and measles spreads before many infected individuals realise they are contagious.
Large outbreaks can also create damaging feedback loops. Surging cases crowd clinics and hospitals, especially paediatric wards. Routine immunisation sessions may be disrupted as staff are redeployed, parents avoid health facilities, or supply chains are strained. As more children miss vaccinations, the susceptible population grows, prolonging outbreaks or allowing them to recur. WHO reporting on Kyrgyzstan has explicitly linked the continued outbreak there to missed vaccinations and the difficulty of catching up large numbers of children quickly enough. Kazakhstan’s early-2026 data, showing most infections among unvaccinated children, fits this pattern closely.
When WHO or its partners report that a country has lost measles elimination status, the implication is sustained transmission rather than sporadic importations. Uzbekistan’s reported loss of elimination status in January 2026 is therefore a regional warning, signalling that routine approaches alone may not be sufficient in the short term.
Vaccination in Practice: Routine Delivery, Catch-Up, and Outbreak Response
Effective measles control in Central Asia rests on three interlinked layers: routine immunisation, catch-up vaccination, and outbreak response.
Routine immunisation is the foundation. Most countries use a two-dose measles-containing vaccine schedule, often delivered as MMR or MR. Two doses are essential because the first dose does not protect all children, while the second dose both captures non-responders and strengthens overall population immunity. In periods of active transmission, timeliness is critical: children vaccinated late remain susceptible during the months when measles is circulating.
Catch-up vaccination is needed when cohorts have been missed, whether due to service disruptions, migration, or increased hesitancy. Typical approaches include tracing defaulters through health registries, schools, and community health workers; checking vaccination status in schools and kindergartens; and offering low-barrier access through extended hours, mobile teams, and pop-up clinics. Kyrgyzstan’s multi-year rise in cases from 2023 through 2025 demonstrates how missed-vaccination backlogs can accumulate when catch-up efforts are insufficient.
Outbreak response adds a third layer when transmission is ongoing. This may involve ring vaccination of contacts and contacts of contacts, targeted campaigns in high-incidence districts, temporary surge staffing for immunisation and surveillance, and enhanced laboratory confirmation and case investigation. Tajikistan’s additional immunisation days in late summer 2025 align with this approach, aiming to close gaps before transmission widens.
In the context of the broader regional resurgence reported by WHO and UNICEF, countries that successfully stabilise measles in 2025-2026 are likely to show rising two-dose coverage, fewer zero-dose children, declining shares of cases among unvaccinated individuals, shorter outbreak durations, and faster detection and response to new cases.
What to Watch Next: Indicators, Risks, and a Practical Checklist
To assess whether Central Asia is moving toward sustained control, a small set of indicators is particularly informative. Two-dose coverage at the district level matters more than national averages, as outbreaks tend to start in specific pockets. The proportion of cases among unvaccinated people reveals whether access or acceptance problems persist. Timeliness of vaccination, outbreak duration, and hospitalisation rates provide further insight into system performance and strain.
Looking ahead through 2026, several risks stand out. Under-immunised clusters may persist even after campaigns if missed children are not fully reached. Cross-border seeding remains likely in a region experiencing widespread resurgence. There is also a risk of routine immunisation fatigue following emergency campaigns, as staff burnout and system strain allow gaps to re-emerge. Misinformation surges during outbreaks can further suppress uptake at critical moments.
A pragmatic response checklist for health authorities and partners includes mapping immunity gaps using clinic records, school enrolment data, and community lists; prioritising completion of the full two-dose schedule; reducing access barriers through extended hours and mobile services; communicating clearly about where cases are rising and where vaccination is available; protecting routine services during outbreaks by adding surge capacity rather than diverting existing staff; and coordinating regionally, recognising that viruses do not respect borders.
Key Takeaway
Central Asia’s measles resurgence in 2025-2026 reflects a simple but unforgiving equation. Whenever the number of susceptible people rises above a critical threshold - through missed doses, delayed schedules, or localised gaps - measles returns. The signals from across the region are consistent: Kyrgyzstan’s sustained high case counts, Kazakhstan’s continued early-2026 burden dominated by unvaccinated children, and Uzbekistan’s loss of elimination status all point to immunity gaps that require sustained, system-wide solutions rather than one-off campaigns.
