A collapsing immunisation drive and widespread malnutrition are fuelling a devastating measles outbreak among children under five in Bangladesh, with 1,01,077 suspected cases and 6,258 associated deaths recorded between March 2026 and 30 June 2026, according to a report by Bangladeshi newspaper The Daily Star. The findings point to a systemic failure across vaccination, nutrition, and primary healthcare — one that is exacting a disproportionate toll on the country's youngest and most vulnerable.

Scale of the Outbreak

Measles, a highly contagious viral infection with a transmission rate higher than that of coronavirus, has re-emerged as a critical public-health threat in Bangladesh. The disease is compounding an already grim picture: the country records approximately 24,000 under-five deaths from pneumonia every year, equivalent to roughly 60 pneumonia-related deaths daily. National under-five mortality stands at about 33 per 1,000 live births, with lower-income groups bearing a disproportionately higher burden, according to the report.

Vaccination Coverage in Decline

The report flags a troubling slide in immunisation rates. Full vaccination coverage (FVC) for children aged 12–23 months peaked at 83.9 per cent in 2019 but had dropped to 81.6 per cent by 2023. Urban coverage, at 79 per cent, trails rural areas at 84.6 per cent — a reversal of the pattern seen in most developing economies, where urban populations typically enjoy better access to services.

While the BCG birth-dose rate remains high at over 98 per cent, significant dropout occurs before children complete the full vaccination schedule at 15 months, which includes MR2 — the second dose of the measles-rubella vaccine. Shortages of EPI cards, tally books, and register books, along with vaccine supply gaps, were reported by frontline Expanded Programme on Immunisation (EPI) workers, the report noted.

Malnutrition and Breastfeeding Gaps

Nutrition deficits are amplifying the risk. Exclusive breastfeeding rates stand at only around 56 per cent, depriving nearly half of all infants of the immune protection provided by colostrum and breast milk in the critical early months of life.

'Adolescent motherhood, inadequate maternity leave, the absence of breastfeeding facilities for working mothers, misconceptions, lack of awareness and the unregulated availability of formula milk are among the contributing factors,' the report said.

Micronutrient deficiencies compound the problem further. Regular access to foods rich in iron, vitamin A, vitamin D, and zinc remains inadequate. Approximately 43.6 per cent of children under five suffer from varying degrees of anaemia, with prevalence highest among those below two years of age — the cohort most vulnerable to severe measles complications.

Structural Barriers to Care

The report identifies unhealthy living conditions, insufficient primary healthcare infrastructure, delays in treatment-seeking, and high out-of-pocket costs as the primary structural drivers of the crisis. Children with undernutrition face a markedly elevated risk of life-threatening measles complications, creating a dangerous overlap between the country's nutrition emergency and its immunisation failure.

This comes amid broader concerns about Bangladesh's public-health capacity following recent political and economic turbulence, which has strained government service delivery across sectors. Unless vaccination coverage is urgently restored and nutrition interventions scaled up, health experts warn that the under-five mortality rate could worsen further through the remainder of 2026.