Measles outbreaks across Kerala, particularly in Kozhikode, Malappuram and Palakkad, have prompted public health experts to call for a detailed reassessment of the disease’s epidemiology, with infections increasingly reported across different age groups. Once commonly associated with children aged one to five, measles is now being detected among older individuals, fully vaccinated people and infants below nine months, who are not yet eligible for routine vaccination. According to the Integrated Disease Surveillance Programme, Kerala had recorded 824 confirmed and 1,681 probable measles cases as of November 6. Five deaths had been reported in connection with the outbreak, although only one had been confirmed as measles-related at that stage. KhanList +1 K.K. Purushothaman, former Professor of Paediatrics at Government Medical College, Thrissur, said infections among younger infants could be associated with lower levels of measles antibodies in mothers. He suggested that the State Technical Advisory Group on Immunisation examine whether an additional vaccine dose for adolescents or women before marriage should be considered. However, experts have emphasised the need for further research before changing vaccination recommendations. A study by the Rajiv Gandhi Centre for Biotechnology involving 684 children aged four to 18 in Kerala and Tamil Nadu found that 8.5% had antibody levels below the protective threshold despite receiving at least two vaccine doses. The findings were published in JAMA Network Open in August 2025. Kerala’s first-dose measles-rubella vaccination coverage is generally around 95%, while second-dose coverage is lower, at approximately 85–88%. Experts say larger investigations are needed to determine how many infections involve children with verified vaccination records and whether outbreaks are primarily driven by incomplete immunisation or additional immunity gaps. 

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