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Decline in vaccine uptake must be reversed, urgently On 19 January 2024 a national incident was announced in England because of a rapidly growing outbreak of measles centred on the West Midlands.1 Such outbreaks were predicted by the UK Health Security Agency last summer, particularly in London.2 In April 2023, when cases were rising in Europe, Jose Hagan of the World Health Organization’s Regional Office for Europe, warned that “All countries, including those verified as having eliminated endemic transmission of measles, must be vigilant for possible importation and spread of this highly contagious disease.”3 Globally, comparing 2022 with 2021, cases of measles rose by 18% and deaths by 43%.4 In 2023, over 42 200 cases were reported across 41 EU states by the end of November, with five deaths.56 In 2014 and 2015, the UK reported fewer than 100 cases of measles a year, the lowest ever recorded, and WHO declared that the UK had eliminated measles. This does not necessarily mea

United kingdomWest midlandsUnited kingdom generalCity ofBorough of bedfordDavid ellimanJose haganHelen bedfordWorld health organization regional office for europeUnited kingdom health security agencyWorld health organizationRegional office