In 2023, Kyrgyzstan faced a significant public health crisis due to a large-scale measles outbreak. The first cases were reported in the first epidemiological week of the year in Bishkek city and Chui regions. By the eighth week, the disease had spread to Osh city and Osh region, and eventually affected 34 districts across five regions of the country. Between January 2023 and April 2024, a total of 15,237 measles cases were reported, along with 11 fatalities. This resulted in an incidence rate of 1402.60 cases per 1 million population, one of the highest in the world. Additionally, 11 cases of rubella were reported between May 2022 and April 2023, placing Kyrgyzstan fourth in the WHO Europe region for rubella incidence.
By the end of August 2023, when the Disaster Relief Emergency Fund (DREF) operation began, 3,289 measles cases had already been reported. This number surged to 7,028 cases by the end of the year, with the highest number of cases registered in Bishkek (2,294), followed by Jalal-Abad region (1,823), Chui region (1,214), Osh region (878), and Osh city (417). Smaller numbers of cases were reported in Batken, Talas, Issyk-Kul, and Naryn regions. The outbreak resulted in nine deaths, with four fatalities in Bishkek, three in Chui, one in Jalal-Abad, and one in Batken.
The Kyrgyz health authorities noted that the rise in measles cases was linked to reduced childhood vaccination coverage during the COVID-19 pandemic. Although vaccination rates have improved in the past two years, they still remain below pre-pandemic levels. In 2022, the coverage for the first dose of the measles-mumps-rubella (MMR) vaccine was 94.4%, and the second dose was 94.5%. However, supplementary immunization campaigns conducted in 2023 led to an increase in vaccination coverage, with the first dose reaching 96.4% and the second dose reaching 96% by the end of the year.
Despite these efforts, the country continues to face challenges related to vaccine hesitancy. The Republican Center for Immunoprophylaxis (RCI) has reported a rising number of vaccination refusals since 2016. As of February 2024, over 24,000 refusal forms had been recorded in health facilities across the country. A significant proportion of these refusals were concentrated in the Chui region and Bishkek city, which together account for approximately 34.3% of the country’s population.
The measles outbreak in Kyrgyzstan highlights the ongoing challenges in achieving high vaccination coverage and addressing public health concerns. While efforts to increase immunization rates have been successful, the lingering impact of the COVID-19 pandemic on vaccination coverage, combined with increasing vaccine hesitancy, continues to pose a significant threat to public health. The situation remains critical, and ongoing efforts to control the outbreak, increase vaccination rates, and address public concerns about vaccination are essential to prevent further spread and reduce the impact of the disease.
