Measles in the Post-COVID Era: Incidence Trends, Vaccination Coverage, Demographic and Subnational Distribution in Saudi Arabia, 2015-2024.

Publication date: May 16, 2026

Background/Objectives: The COVID-19 pandemic disrupted routine immunisation globally. Saudi Arabia presents a unique epidemiological context for measles, combining high vaccination coverage with mass pilgrimages and a large expatriate workforce. This study examined measles incidence trends, vaccination coverage, and demographic and geographic burden distribution in Saudi Arabia (2015-2024), with comparative analysis against GCC countries, the Eastern Mediterranean Region (EMR), and global data. Methods: Annual incidence and vaccination coverage data were obtained from the WHO Global Health Observatory and WHO/UNICEF WUENIC; monthly, regional, age- and nationality-stratified data from the Saudi Ministry of Health Annual Statistical Book (2015-2024). Incidence was expressed per 1,000,000 population across three epochs: pre-COVID-19 (2015-2019), pandemic disruption (2020-2021), and post-COVID-19 rebound (2022-2024). Descriptive analyses included period means, percentage changes, rate ratios, and rate differences. Results: Pre-COVID-19 incidence (mean 19. 7/1,000,000) remained below EMR and global averages. The pandemic produced near-complete suppression (-96. 6% to 1. 1/1,000,000 in 2020), exceeding global (-82. 2%) and EMR (-61. 2%) declines. A marked rebound occurred in 2023 (67. 8/1,000,000), surpassing the pre-pandemic peak despite MCV1/MCV2 coverage above 96%. Non-Saudi nationals bore disproportionate burden in 2021 (20. 7 vs. 1. 1/1,000,000) and 2023 (70. 4 vs. 64. 8/1,000,000). Children under 15 accounted for 71. 6-90. 6% of annual cases, with the 5-

Concepts Keywords
Pandemic COVID-19 pandemic
Saudi Eastern Mediterranean Region
Unicef Gulf Cooperation Council
immunisation disruption
mass gatherings
measles
post-pandemic rebound
Saudi Arabia
vaccination coverage

Semantics

Type Source Name
disease MESH Measles
pathway KEGG Measles
disease MESH COVID-19 pandemic
disease MESH COVID-19 rebound
disease MESH included

Original Article

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