Introduction
On December 18, the Chiapas Health Secretariat issued an urgent circular due to a surge of 45 measles cases in just one day, with 64 total cases in the state. The measure, effective from December 21 to March 20, advises municipalities to cancel mass gatherings during the winter season. However, this response raises concerns about a systemic crisis in Mexico’s vaccination coverage that has persisted for nearly two decades.
The Measles Crisis in Mexico
As of December 19, Mexico has reported 5,860 measles cases and 24 deaths. The country leads the regional outbreak, surpassing Canada (5,298 cases) and the United States (1,958 cases). Measles accounts for 40.8% of the 13,399 cases reported across the Americas.
Geographical Distribution and Vulnerable Populations
Measles cases have been confirmed in 29 states and 196 municipios. Chihuahua leads with 4,473 cases and an incidence rate of 113 per 100,000 inhabitants. However, Chiapas’ recent spike of 45 cases in a single day highlights active virus circulation in regions with limited access to healthcare services, such as San Cristobal, Tuxtla Gutiérrez, Chamula, and Comitán.
Children aged 0-4 are the most vulnerable group, accounting for 1,502 cases with the highest incidence rate of 14.44 per 100,000 inhabitants. Alarmingly, 97% of affected individuals were not vaccinated.
Government Response and Legal Obligations
Since February 2025, when the first case was confirmed in Chihuahua, Mexico has implemented a “historic response,” including over 8.8 million doses administered by October, acquiring 96 million biologicals for more than $15,000 million pesos, and expanding vaccination to 49-year-olds.
Despite nearly a year of intensive campaigning, national coverage only reaches 81-87%, falling short of the OMS and OPs minimum 95% required for herd immunity.
The Chiapas circular uses the ambiguous term “exhortation” to request municipal authorities to cancel mass gatherings. Legally, exhortation implies a formal request between equals among judges for actions outside their jurisdiction. However, state health authorities should issue orders rather than exhortations when addressing public health matters, which are shared federal and state responsibilities under the General Health Law.
The Role of the National Health Council
The National Health Council (CSG) is conspicuously absent in this crisis. The Chiapas circular cites the International Sanitary Regulations (RSI) and various General Health Law articles but fails to mention the CSG, which constitutionally has the power to make its dispositions obligatory nationwide.
The CSG, directly under the President of the Republic, is the second-highest health authority in the country. Its dispositions are obligatory throughout the national territory.
The CSG’s responsibilities include dictating measures against alcoholism, toxic substance production and sale, preventing harmful effects, adding medication and transmissible disease priority lists, and providing suggestions to the Federal Executive for improving the National Health System’s efficiency.
The CSG has not declared measles an emergency or issued binding dispositions, leaving the strategy fragmented between federal and state health secretariats.
Measles Outbreak in Chiapas: Justification and Delay
The mass gathering suspension from December 21 to March 20 is epidemiologically justified, given measles’ airborne transmission and survival in droplets for up to two hours. However, the response is tardy, as the outbreak began in February 2025, with no preventive measures implemented in severely affected states from March or April.
The lack of federal-state-municipal coordination is evident, as Chihuahua, the outbreak’s epicenter with 4,473 cases, did not implement similar restrictions. Jalisco, with 462 cases, also lacked such measures.
Socioeconomic Impact and Vaccination
Mass gathering cancellations have significant socioeconomic consequences, as these events are income sources for vendors, artisans, and service providers in communities where informal economies dominate.
While vaccination is the correct measure, it comes two decades too late. The 22.5 million unadministered doses between 2006 and 2024 cannot be resolved in a year. Current coverage of 81-87% is insufficient, and Mexico needs to reach and maintain 95% for years to rebuild herd immunity.
Standard measures like surveillance, isolation protocols, and information campaigns are necessary but reactive. Mexico must move from reacting to preventing outbreaks.
Conclusion
The 2025 measles outbreak in Mexico is not a fate but the predictable result of two decades of underinvestment, institutional discoordination, and political reluctance to prioritize prevention.
Authorities cannot continue reacting late with insufficient measures. The cost in lives, economy, and institutional credibility is too high.
It’s time for decisive action, CSG constitutional role assumption, health information system modernization, prevention investment, and understanding that diseases with externalities like measles require coordinated, obligatory, evidence-based responses.
Bibliography:
- [1] Daily Report on the Measles Outbreak in Mexico: https://www.gob.mx/cms/uploads/attachment/file/1044143/INFORME_DIARIO_SARAMPION_20251219.pdf
*The author (www.ectorjaime.mx) is a general surgery specialist, certified in public health, and holds doctorates in health and public administration sciences. He is a legislator and advocate for Mexico’s public health, reelected PAN group member in the LXVI Legislature.
