The Ministry of Health and Consumption of the Andalusian Government has activated the search for groups of people who, for various reasons, are not immunized against measles, despite it being a preventable disease through vaccination. The goal is to offer the MMR vaccination to these individuals in order to prevent epidemic outbreaks of the disease. These ‘pockets of susceptibles’ are made up of unvaccinated children, whether due to parental decision, access issues to vaccination, or failures in vaccination program coverage; young adults without complete immunization (individuals who only received one dose in childhood or those born in periods where vaccination was not mandatory or widely implemented); individuals with medical contraindications (patients with immunosuppressive diseases and individuals allergic to vaccine components); and individuals with immune response failures to the vaccine, as a small percentage of individuals (between 2 and 5%) do not develop immunity after the first dose of the vaccine.
The Directorate General of Public Health and Pharmaceutical Regulation warns of the danger of these ‘pockets’ that allow the virus to continue circulating in the community, despite having a vaccination coverage of over 95% of the population, as recommended by the World Health Organization (WHO), and thus, facilitating the emergence of epidemic outbreaks in schools, communities, or cities where vaccination coverage is lower. Additionally, these unvaccinated groups put vulnerable individuals at risk who cannot be vaccinated for medical reasons and can create a chain effect that diminishes collective protection.
In fact, in Andalusia, the increase in measles cases being experienced this year is partly due to the presence of these unvaccinated groups, especially young adults and unvaccinated children in areas such as the Costa del Sol District. In Europe, countries like Romania have experienced major outbreaks of this disease due to low vaccination rates in certain communities. Therefore, eliminating ‘pockets of susceptibles’ is key to eradicating preventable diseases like measles and preventing their reappearance in countries with advanced vaccination systems.
The vaccination schedule in Andalusia establishes the administration of two doses of the MMR vaccine (measles, rubella, and mumps) in children. The first dose is given at 12 months and the second at three years. The first dose immunizes the majority of children, but a small percentage do not develop immunity (between 2 and 5%), while the second dose ensures that over 99% of individuals are protected for life. Adults who do not remember if they have received the vaccine or had measles should go to their health center so their primary care physician can refer them to the vaccination clinic, where they will receive the MMR vaccine if there are no medical contraindications.
Five new cases in the last week
So far this year, there have been 72 cases of measles reported in Andalusia, five new cases in the last nine days. These new cases include an adult in Vera (Almería), part of a family outbreak with a previous case; two more cases in the outbreak at La Axarquía Hospital in Málaga (where the two cases that were probable last week have also been confirmed), one in Málaga capital, and one in Torrox, a minor of 15 years old, part of a family outbreak with a previous case.
Therefore, in 2025, a total of 13 outbreaks have been reported so far, with seven still active and six already closed. Thus, Málaga has a new outbreak in Torrox, with two affected individuals; a family outbreak with five confirmed cases, of unknown origin, declared on March 18 in the capital; in addition to the outbreak declared in the health sector, specifically at La Axarquía Hospital in Málaga, declared on April 29, with five affected individuals, one of them imported from Morocco.
In the province of Huelva, there are currently active a family outbreak in Moguer, with two confirmed cases of two Moroccan worker siblings, declared on March 29, and the family outbreak imported from Morocco in Lucena del Puerto, with four total cases in a Moroccan family. Finally, in El Ejido (Almería), a family outbreak was declared on April 14 with two confirmed cases in two Moroccan workers sharing a home and the new outbreak declared in Vera (Almería) with two cases, one of them coming from Morocco.
Of the six closed outbreaks, two were located in Huelva, totaling six affected individuals, and four in Málaga, with 22 affected individuals in total.
So far, 26% of the cases have been imported cases, these imported cases come from Morocco (17), Belgium (1), and Denmark (1). Of the non-imported cases, 14 are isolated cases where the source of infection is unknown (seven cases in Málaga capital, two in Marbella, one in Álora, one in Calañas, one in Huelva, one in Palos de la Frontera, and one in Sevilla).
In addition, eight cases are under 1 year old, from a closed outbreak in a nursery in Fuengirola (Málaga). 31.9% have been under 15 years old and 62.5% adults (ranging from 15 to 70 years). Only two cases had a documented history of vaccination with one dose, the rest of the cases were not vaccinated or their vaccination status could not be determined (including minors from Morocco and Russia). 35% of the cases required hospitalization.
Eight cases have been reported in Almería (one in Adra, three in El Ejido, one in Níjar, one in Roquetas de Mar, and two in Vera), three in Granada capital; 16 cases in Huelva (one in Calañas, two in Gibraleón, one in Huelva capital, four in Lucena del Puerto, two in Moguer, three in Palos de la Frontera, one in San Bartolomé de la Torre, and two in San Juan del Puerto); 44 cases in Málaga (one in Álora, one in Casabermeja, nine in Fuengirola, 18 in Málaga capital, two in Marbella, seven in Mijas, one in Ojén, one in Rincón de la Victoria, one in Torremolinos, and two in Torrox) and one case in the capital of Seville. In Málaga, the majority of cases are mainly concentrated in the Costa del Sol Health District (20 cases) and the Málaga District (19 cases).
Incidence decreases and imported cases increase
For the past eight weeks, cases have only occurred in adults, mainly between 26 and 47 years old, except for the new case of the 15-year-old child in Torrox (Málaga) and once the case of the 13-month-old baby in Seville has been ruled out. Most of these cases are imported from Morocco, related to an imported case, or associated with an outbreak, significantly reducing isolated cases of unknown origin (two cases in the last six weeks). The active outbreaks at this time are family outbreaks in adults with a small number of cases and generally with two generations of cases.
Health and Consumption recalls, as confirmed by the recorded data, that measles is an easily transmissible infection, can be severe, and can affect both unvaccinated children and adults. For this reason, it recommends vaccination for children according to established guidelines and for adults who are not sure if they are vaccinated to protect those who cannot be vaccinated.
The epidemiological situation in the vicinity of Andalusia, especially in Morocco, which has been experiencing a significant measles outbreak since October 2023 and has spread throughout the country with over 40,000 reported cases, including 150 deaths; 3,012 cases in 15 European Union countries as of April 15 (Romania has 5,104 cases, followed by the Netherlands with 251 and France with 180. Spain reported 203 cases by April 27; 712 confirmed cases in the United States, with two deaths, by April 10 or 731 in Canada by April 11; as well as the presence of susceptible pockets and the seasonality of measles (spring), anticipate new outbreaks in the coming weeks and months. The Ministry of Health and Consumption will provide a weekly report on Tuesdays with updated data.