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  • Review Article
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The global threat of vaccine-preventable neurological diseases

Nature Reviews Neurology volume 22, pages 110–122 (2026)Cite this article

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This article has been updated

Abstract

Vaccination is widely considered to be the pre-eminent public health achievement of modern history, but declining coverage resulting from vaccine hesitancy and from interruptions in immunization campaigns in geopolitically unstable regions threatens progress against vaccine-preventable diseases. The global burden of vaccine-preventable neurological diseases is substantial, resulting in acute and chronic complications as well as high case fatality rates. In recent years, outbreaks of dengue, poliomyelitis, measles, pertussis, meningococcal disease and Japanese encephalitis virus have been linked to lack of access to vaccines, overwhelmed health-care systems, misinformation and disinformation regarding vaccine safety, and gaps in vaccination coverage caused by environmental factors and geopolitical conflicts. Coordinated global strategies, including addressing barriers to vaccination and ensuring equitable access; targeted health education about vaccine benefits and risks; integration with other public services; and advances in next-generation vaccine technologies to tackle antimicrobial resistance and non-vaccine serotype replacement, will be crucial to prevent a resurgence of vaccine-preventable neurological diseases, especially in vulnerable populations, to maintain global health security.

Key points

  • A global resurgence of vaccine-preventable neurological diseases, including recent outbreaks of measles and poliomyelitis, is being driven by declining vaccination coverage worldwide.

  • Neurological involvement in vaccine-preventable diseases leads to severe acute and chronic morbidity, including cognitive impairment, encephalitis and paralysis — conditions that are avoidable with readily available and effective vaccines.

  • Reduced immunization rates following the COVID-19 pandemic have been compounded by disruptions to targeted immunization campaigns in regions vulnerable to climate crises and geopolitical instability, as well as vaccine hesitancy fuelled by misinformation, disinformation and pervasive distrust in public health agencies.

  • Inequitable access to vaccines for low-income and middle-income countries is disproportionately high owing to inadequate public health infrastructure, economic insecurity and geographical or conflict-associated disruptions in resource-limited settings.

  • Tackling vaccine hesitancy necessitates multimodal and transparent communication strategies to repair public trust in public health officials and to increase health literacy.

  • The mRNA vaccine platforms implemented during the COVID-19 pandemic, along with nanoparticle-encapsulated delivery systems, might address gaps in vaccine availability through modular, rapid and scalable production pipelines for thermostable vaccine formulations.

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Fig. 1: Timeline of vaccine availability.
Fig. 2: Vaccine-preventable neurological diseases: incidence and immunization coverage.

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Change history

  • 18 December 2025

    In the version of the article initially published, Julia Granerod’s affiliation was incorrect and has now been amended to “Dr JGW Consulting AS, Sandefjord, Norway” in the HTML and PDF versions of the article.

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Authors and Affiliations

  1. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

    Felicia C. Chow

  2. Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA

    Felicia C. Chow

  3. Dr JGW Consulting AS, Sandefjord, Norway

    Julia Granerod

  4. Department of Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA

    Carla Y. Kim, Temesgen Nurye & Kiran T. Thakur

  5. Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

    Temesgen Nurye

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All authors researched data for the article and wrote the article. F.C.C., J.G. and K.T.T. contributed substantially to discussion of the content. F.C.C., J.G., C.Y.K. and K.T.T. reviewed and/or edited the manuscript before submission.

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Correspondence to Kiran T. Thakur.

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Chow, F.C., Granerod, J., Kim, C.Y. et al. The global threat of vaccine-preventable neurological diseases. Nat Rev Neurol 22, 110–122 (2026). https://doi.org/10.1038/s41582-025-01172-w

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