|People at the highest risk of measles and its complications are unvaccinated young children and pregnant women. / Photo by fotohay via Shutterstock|
More than 117 million children in 37 countries are at risk of measles as mass immunization programs are stopped to reduce the risk of spreading Covid-19, warned two UN agencies.
Millions of children at risk of measles
The World Health Organization (WHO) and the UN Children’s Fund (UNICEF), joined with other health partners, said in a statement that measles immunization campaigns have been called in 13 countries and delayed in 24 others. They highlight the support of global partnership the Measles & Rubella Initiative (M&RI). The initiative led by Red Cross, Centers for Disease Control and Prevention, WHO, UNICEF, and the United Nations Foundation is committed to ensuring that no child dies from measles or is born with rubella syndrome.
UNICEF pointed out that health services in many countries have been stretched by Covid-19 health crisis, but it is also important now more than ever to protect and invest in life-saving newborn, child, and maternal health services.
The UN agencies state that if the decision to pause vaccination is made to lessen the risk of spreading the coronavirus, they encourage leaders to intensify their efforts to identify unvaccinated children so that the most vulnerable populations will receive measles vaccines the moment it is possible to do so. While the agencies have acknowledged the demands on frontline workers and health systems during the pandemic, they stressed that delivering immunization services is also essential to save lives that would otherwise be lost because of preventable diseases.
Protecting health workers and the communities where Covid-19 risks are high should not mean that kids will permanently miss out. They noted that despite having an effective and safe vaccine for more than 50 years, measles still claimed the lives of more than 140,000 people in 2018 and most of these victims were babies and children. Between 2000 and 2018, measles vaccination caused a 73% drop in measles death worldwide or an estimated 23.2 million deaths prevented. People at the highest risk of measles and its complications are unvaccinated young children and pregnant women.
|Protecting health workers and the communities where Covid-19 risks are high should not mean that kids will permanently miss out. / Photo by andriano.cz via Shutterstock|
Global vaccination coverage
The share of one-year-olds who received the first dose of measles shot in 2018 was 86% but only 69% received the second dose of measles shot. The global vaccination coverage was provided by scientific online publication Our World in Data.
Measles is a serious and highly contagious disease caused by a virus. Before the measles vaccine was introduced in 1963, major epidemics happened approximately every 2 to 3 years and it caused an estimated 2.3 million deaths every year during such period.
Vaccination coverage is low in low- and middle-income countries. In Equatorial Guinea, for instance, only 16% of children between 12 and 23 months were immunized against diphtheria, tetanus, and pertussis per capita of 18,984.14 adjusted for price differences between countries. The country has high measles immunization coverage though among 1-year-olds. Data shows that 88% of 1-year-olds have been vaccinated against measles.
But the chart also indicates that some poor countries, such as Bangladesh, Rwanda, and Burundi, achieve high vaccination coverage of more than 50%. Qatar is a country with high measles immunization. The World Bank detailed that 99% of children ages 12 to 23 months in Qatar received measles shot. Some countries with the same percentage of children who were immunized were Tanzania, Iran, Andorra, United Arab Emirates, St. Vincent and the Grenadines, Sri Lanka, Kazakhstan, Kuwait, Cabo Verde, China, Nauru, Nicaragua, and Mauritius.
In wealthier countries, parents can typically make an appointment for a routine vaccine that is scheduled at private pediatric offices or clinics. These nations inoculate a large number of children and infants in communal settings too, such as in mosques, churches, schools, and marketplaces.
UNICEF’s chief of immunization Dr. Robin Nandy acknowledged that achieving a balance between preventable diseases and protecting people against the spread of coronavirus was difficult and delicate. He said that in the quest to vaccinate children, it is also important not to contribute to the number of Covid-19 cases. What they don’t want in UNICEF is to have a country that is recovering from a pandemic that also deals with another outbreak.
Dr. Nandy also urged countries to already plan for the shipment of syringes and vaccines so that it will be available the moment Covid-19 restrictions are eased. Considering also that there may only be limited international flights to handle the shipment, countries may consider chartering planes.
For now, countries can compile the immunization registries, track their previous campaigns, and then conduct risk assessments so they can prioritize areas where outbreaks may likely occur. However, the London School of Hygiene and Tropical Medicine Vaccine Center’s director Dr. Beate Kampmann said via American newspaper the New York Times that some countries that have fragmented or weak healthcare systems cannot gather reliable immunization data. In West Africa, for instance, they have no registers for vaccinations other than the parent-held records. This means that the birth cohort of infants in the region may miss vaccinations altogether and such pose serious health consequences.
Before the Covid-19 outbreak, measles was making a resurgence. An estimated 7,585,900 measles cases and 124,000 estimated deaths were recorded in 2017 according to WHO. In 2019, the US has recorded 1,282 measles cases, its highest record in more than 25 years. Other countries that are currently fighting against measles outbreaks are Kazakhstan, Ukraine, Nigeria, South Sudan, the Democratic Republic of Congo, Bangladesh, and Brazil.
Meanwhile, among the countries that have postponed their measles vaccination programs are Uzbekistan, South Sudan, Somalia, Nepal, Paraguay, Lebanon, Honduras, the Dominican Republic, Djibouti, Ethiopia, Colombia, Chile, Chad, and Bolivia.
Dr. Kampmann is also concerned that there may be potential measles outbreaks in wealthier nations in Europe and North America, which do not yet have national immunization programs. People’s fear of Covid-19 has also caused the decline of well-child visits, such as routine vaccines. There is an upside though to the current social distancing measures adopted by the government. That is, if measles occurs, its transmission will also be limited.
Measles poses another global health threat. This is why health departments from around the world will have to prepare for catch-up vaccinations to close the immunity gaps.