Effect of Measles Vaccination on Disease Severity and Complications: A Systematic Review and Meta-Analysis

Authors

  • Alifa Sya’bani Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Chiara Filaely Kamesywara Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Nadwa Salma Munir Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Zaldy Arroja Fadillah Setiyawan Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Rianty Putri Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Nailah Fairuz Suharjo Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Qonita Aulia Azka Aqila Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Patriwa Rahmat Syahputra Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Rafly Arezky Revandhika Alfajr Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Giresh Joequin Medical Undergraduate Program, Faculty of Medicine Universitas Padjadjaran, Sumedang, Indonesia
  • Adhi Kristianto Sugianli Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia https://orcid.org/0000-0002-2898-6719 (unauthenticated)
  • Sofiati Dian Department of Neurology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia https://orcid.org/0000-0001-9909-4171 (unauthenticated)

DOI:

https://doi.org/10.15850/ijihs.v14n1.4910

Keywords:

Compliacations, Measles, Severity, Vaccination

Abstract

Background: Measles remains a highly contagious vaccine-preventable disease-causing substantial morbidity and mortality, particularly among unvaccinated and under-vaccinated populations. Declining immunization coverage, vaccine hesitancy, and post-pandemic disruptions highlight the need to assess the association between vaccination status and measles severity, complications, and clinical outcomes.

Objectives: To evaluate the effects of measles vaccination on disease severity and complications among infected individuals.

Methods: This systematic review and meta-analysis adhered to PRISMA guidelines. The study included patients diagnosed with measles and compared clinical severity and complications between vaccinated and unvaccinated individuals. A comprehensive search of PubMed, Scopus, EBSCO Host, and the Cochrane Library was conducted to identify observational studies comparing clinical outcomes between the two groups. Pooled odds ratios (ORs) with 95% confidence intervals were calculated using a random-effects model, and heterogeneity was assessed using the I² statistic.

Result: Of 2,661 identified records, after removing duplicates (n=765) and screening (n=1860), 14 out of 36 studies met eligibility criteria for final analysis. Measles vaccination was linked to reduced odds of hospitalization (OR 0.58, 95% CI 0.42–0.81), severe disease (OR 0.53, 95% CI 0.33–0.85), complications (OR 0.62, 95% CI 0.51–0.75), and pneumonia (OR 0.63, 95% CI 0.50–0.80), but not encephalitis (OR 1.95, 95% CI 0.67–5.66) nor mortality (OR 0.50, 95% CI 0.13–1.82). Heterogeneity ranged from low to substantial, especially for hospitalization and severe disease.

Conclusion: Measles vaccination significantly reduces severe outcomes and complications, underscoring its important role in disease prevention and severity reduction while reinforcing the need for stronger global immunization efforts.

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Author Biography

  • Adhi Kristianto Sugianli, Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia

    1. Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia

    2. Department of Supporting Medicine, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

    3. Department of Pathology, RS Unpad University Hospital, Jatinangor Sumedang, Indonesia

References

Parums DV. A review of the resurgence of measles, a vaccine-preventable disease, as current concerns contrast with past hopes for measles elimination. Med Sci Monit. 2024;30. doi: 10.12659/MSM.944436.

World Health Organization. Measles cases surge worldwide, infecting 10.3 million people in 2023. 2024.

World Health Organization Regional Office for Europe. European Region reports highest number of measles cases in more than 25 years—UNICEF, WHO/Europe. 2025.

Centers for Disease Control and Prevention. Global measles vaccination. Centers for Disease Control and Prevention; 2025.

World Health Organization. Measles. World Health Organization; 2025.

Cagnotta C, Lettera N, Cardillo M, Pirozzi D, Catalán-Matamoros D, Capuano A, et al. Parental vaccine hesitancy: recent evidences support the need to implement targeted communication strategies. J Infect Public Health. 2025;18(2):102648. doi: 10.1016/j.jiph.2024.102648.

Novilla MLB, Goates MC, Redelfs AH, Quenzer M, Novilla LKB, Leffler T, et al. Why parents say no to having their children vaccinated against measles: a systematic review of the social determinants of parental perceptions on MMR vaccine hesitancy. Vaccines (Basel). 2023;11(5):926. doi: 10.3390/vaccines11050926.

UNICEF. UNICEF annual report 2025: continuing to deliver, in crises and beyond. New York: UNICEF; 2026.

Suffel AM, Warren-Gash C, McDonald HI, Kucharski A, Robert A. Impact of vaccination timing and coverage on measles near elimination dynamics: a mathematical modelling analysis. Nat Commun. 2025;16:8601. doi: 10.1038/s41467-025-63710-w.

Au S, Saini S, Cruz WD, Venketaraman V. Measles: an updated literature review of the host response, pathogenesis, complications, prevention measures, and recent outbreaks. Curr Issues Mol Biol. 2026;48(2):206. doi: 10.3390/cimb48020206.

Pawaskar M, Schmidt E, Marshall GS, Fergie J, Richardson E, Saldutti LP, et al. Use of M-M-R II outside of the routinely recommended age range—a systematic literature review. Hum Vaccin Immunother. 2022;18(1):1–7. doi: 10.1080/21645515.2021.1933874.

Haeuser E, Byrne S, Nguyen J, Raggi C, McLaughlin SA, Bisignano C, et al. Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10500):235–60. doi: 10.1016/S0140-6736(25)01037-2.

Plans-Rubió P. Measles vaccination coverage and anti-measles herd immunity levels in the world and WHO regions worsened from 2019 to 2023. Vaccines (Basel). 2025;13(2):157. doi: 10.3390/vaccines13020157.

Robert A, Suffel AM, Kucharski AJ. Long-term waning of vaccine-induced immunity to measles in England: a mathematical modelling study. Lancet Public Health. 2024;9(10)–75. doi: 10.1016/S2468-2667(24)00181-6.

Schenk J, Abrams S, Theeten H, Van Damme P, Beutels P, Hens N. Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2021;21(2):286–95. doi: 10.1016/S1473-3099(20)30442-4.

Mawlood SK, Al-Ani MM, Al-Ani RM, Alshibib A. Impact of measles vaccination on clinical characteristics and outcomes in children in Ramadi, Iraq. World J Clin Pediatr. 2025;14(3):107253. doi: 10.5409/wjcp.v14.i3.107253.

Bonneton M, Antona D, Danis K, Aït-Belghiti F, Levy-Bruhl D. Are vaccinated measles cases protected against severe disease? Vaccine. 2020;38(29):4516–9. doi: 10.1016/j.vaccine.2020.05.005.

Laksono BM, de Vries RD, Duprex WP, de Swart RL. Measles pathogenesis, immune suppression and animal models. Curr Opin Virol. 2020;41:31–7. doi: 10.1016/j.coviro.2020.03.002.

Ferren M, Horvat B, Mathieu C. Measles encephalitis: towards new therapeutics. Viruses. 2019;11(11):1017. doi: 10.3390/v11111017.

Moss WJ. Measles. Lancet. 2017;390(10111):2490–502. doi: 10.1016/S0140-6736(17)31463-0.

Laksono BM, de Vries RD, McQuaid S, Duprex WP, de Swart RL. Measles virus host invasion and pathogenesis. Viruses. 2016;8(8):210. doi: 10.3390/v8080210.

Petrova VN, Sawatsky B, Han AX, Laksono BM, Walz L, Parker E, et al. Incomplete genetic reconstitution of B cell pools contributes to prolonged immunosuppression after measles. Sci Immunol. 2019;4(41). doi: 10.1126/sciimmunol.aay6125.

Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science. 2015;348(6235):694–9. doi: 10.1126/science.aaa3662.

Muñoz-Alía MÁ, Nace RA, Zhang L, Russell SJ. Serotypic evolution of measles virus is constrained by multiple co-dominant B cell epitopes on its surface glycoproteins. Cell Rep Med. 2021;2(4):100225. doi: 10.1016/j.xcrm.2021.100225.

Ozawa S, Clark S, Portnoy A, Grewal S, Brenzel L, Walker DG. Return on investment from childhood immunization in low- and middle-income countries, 2011–20. Health Aff (Millwood). 2016;35(2):199–207. doi: 10.1377/hlthaff.2015.1086.

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Published

2026-06-30

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How to Cite

Effect of Measles Vaccination on Disease Severity and Complications: A Systematic Review and Meta-Analysis. (2026). International Journal of Integrated Health Sciences, 14(1), 58-69. https://doi.org/10.15850/ijihs.v14n1.4910