1PhD Scholar (Public Health), Noida International University, India.
2Assistant Professor (Public Health), Noida International University, India.
Corresponding Author: Subhajit Chakraborty, PhD Scholar (Public Health), Noida International University, India.
Background: India adopted measles elimination as a national goal in 2019 (revised target from 2023 to 2025/2027–2028), aligning with WHO South-East Asia Region (SEARO) benchmarks. This systematic review assesses progress over 25 years amid vaccination scale-up, MR campaign implementation, and COVID-19 disruptions.
Methods: PRISMA 2020-compliant systematic analysis of measles epidemiology, vaccination coverage, and surveillance data from January 2000 to December 2025. Literature searched via PubMed, Scopus, Web of Science, EMBASE, and grey literature (WHO, UNICEF, MoHFW, SEARO, IDSP, GBD 2023). Inclusion criteria: national/state-level measles data; MCV1/MCV2 coverage estimates; case surveillance; outbreak reports. Quality assessed using JBI checklist.
Results: Measles incidence declined 83% from 628.8 per million (2013 peak) to 52.0 per million (2020), reaching ~40 per million (2024). MCV1 coverage increased from 68% (2000) to 91% (2023), while MCV2 increased from 0% (2012) to 82% (2021). However, only 94% of states achieved ≥95% MCV1 coverage, and ≥94% MCV2 coverage remains elusive nationally. COVID-19 caused a 60% vaccination decline in April 2020, with incomplete recovery through 2023. District-level analysis revealed persistent coverage disparities (60–95%), with North-East and low-income states lagging. Laboratory network expansion (13 to 27 laboratories, 2011–2021) improved surveillance, though non-measles/non-rubella discard rates remain suboptimal. Case fatality rate fluctuated (0.13% in 2014 to 3.3% in 2020), indicating resurgence risk.
Conclusion: India has achieved substantial measles mortality reduction but faces structural barriers to elimination. District-level MCV2 bottleneck, surveillance sensitivity gaps, immunity gaps from COVID-19 disruptions, and socioeconomic disparities persist. Realistic elimination feasibility: 2027–2028 (conditional on intensified district-focused strategies). This review identifies 8–10 prioritized policy recommendations including zero-dose registries, digital immunization tracking, and school-entry MCV2 mandates.
Keywords: measles elimination; vaccination coverage; MCV2; COVID-19 pandemic disruption; surveillance; India; district-level immunization; immunization equity; SEARO; policy implications
How to cite this article: Chakraborty S, Lenka AK. Progress Toward Measles Elimination in India: Epidemiological Trends, Gaps, and Policy Implications (2000–2025). Int J Drug Deliv Technol. 2026;16(11s): 639-651. DOI: 10.25258/ijddt.16.11s.64
Source of support: Nil.
Conflict of interest: None