Since the start of an outbreak this past April, 698 children have died from measles in Zimbabwe, according to the country’s health ministry, and there there has been a total of 6,291 cases recorded in as of 4 September 2022. The deaths have been attributed to unvaccinated children who did not receive a vaccine because of religious beliefs. While the outbreak was originally reported in the Manicaland province, in the eastern part of Zimbabwe, measles cases have since been reported in all regions of the country.

UNICEF has stated that it is deeply concerned about this outbreak and that it is assisting the government to address it through immunization programs. Fiona Braka, team lead for emergency operations at the World Health Organization, said “it’s the first in many years [that we’ve seen measles] at this scale and it’s been progressing quickly among a community that is reticent to accept vaccines.”

President of the Medical and Dental Private Practitioners of Zimbabwe Association, Johannes Marisa, said, “because of the resistance, education may not be enough so the government should also consider using coercive measures to ensure that no one is allowed to refuse vaccination for their children.” Marisa urged Zimbabwe to implement legislation for mandatory vaccinations of diseases such as measles.

Measles is a highly contagious viral illness that is spread through direct contact with droplets or by airborne spread through breath, coughs, or sneezes. Children under five are at high risk of complications from a measles infection. Vaccination is highly effective at prevention, with one dose of the combined measles-mumps-rubella (MMR) vaccine being 93% effective.

The Zimbabwean government has a mass vaccination program for children between the ages of six months and 15 years, including engagement with traditional and faith leaders. Before this outbreak, Zimbabwe did not have a single measles case for over 10 years. This program continued during the COVID-19 pandemic but has faced significant challenges from anti-vaccine religious groups. A national measles vaccination campaign was announced in response to the outbreak. Over 50% of the cases have involved unvaccinated people. There is hope that this campaign can prevent the outbreak from becoming an epidemic, with Zimbabwe’s government calling for international support to bolster its vaccination campaign.

In the face of this measles outbreak, a coordinated strategy is essential. If international support is combined with local coordination and leadership, a more comprehensive countrywide approach can be implemented. Public health infrastructure and communications must be strengthened to ensure that vaccines, including those for children, are reaching as many regions as possible. With issues around social trust, a campaign must be able to challenge misinformation, so that the entire population can access important and potentially life-saving vaccinations. A vaccine mandate is needed for measles and other diseases, but it must be backed by an institutional capacity that ensures all Zimbabweans can receive a vaccine. Engagement at the community level must continue, with greater resources dedicated to outreach to minimize anti-vaccine sentiments.