Biggest increase in unvaccinated children in 20 years and critical gaps in disease surveillance increase risk of measles outbreak, putting lives at risk: WHO, CDC
ATLANTA / GENEVA, November 10, 2021 — While reported measles cases have declined from previous years, progress towards measles elimination continues to decline and the risk of an outbreak is increasing, according to a new report from the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC). . In 2020, more than 22 million infants missed their first dose of measles vaccine, 3 million more than in 2019, marking the largest increase in two decades and creating dangerous conditions for the outbreak of epidemics .
Compared to the previous year, reported measles cases decreased by more than 80% in 2020.
However, measles surveillance has also deteriorated with the lowest number of samples sent for laboratory testing in more than a decade. Poor measles surveillance, testing and reporting compromises the ability of countries to prevent outbreaks of this highly infectious disease. Major measles outbreaks occurred in 26 countries and accounted for 84 percent of all reported cases in 2020.
“The large number of unvaccinated children, measles outbreaks and the detection and diagnosis of diseases diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children “, said Kevin Cain, MD, CDC Global Director of Immunization. “We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade returns to pre-pandemic levels, to prevent deadly measles outbreaks and mitigate the risk. other vaccine-preventable diseases. â
Decline in reported measles cases in 2020 should not mask growing risk of measles to children around the world
The ability of countries to ensure that children receive the recommended two doses of measles vaccine is a key indicator of global progress towards measles elimination and the ability to prevent the spread of the virus. Coverage for the first dose fell in 2020, and only 70 percent of children received their second dose of measles vaccine, well below the 95 percent coverage needed to protect communities from the spread of the measles virus. measles.
In addition to worsening immunity gaps around the world, 24 measles vaccination campaigns in 23 countries, originally scheduled for 2020, have been postponed due to the COVID-19 pandemic – leaving more than 93 million people to risk of contracting the disease. These additional campaigns are needed where people have not received measles vaccines as part of routine immunization programs.
“As reported measles cases declined in 2020, evidence suggests we are likely seeing the calm before the storm as the risk of an epidemic continues to rise globally,” said Dr Kate O’Brien, Director of the Department of Immunization, Vaccines and Biologicals, WHO. âIt is essential that countries vaccinate against COVID-19 as quickly as possible, but this requires new resources so that this does not come at the expense of essential immunization programs. Routine immunization should be protected and reinforced; otherwise, we risk swapping one deadly disease for another.
** Vaccination and surveillance systems must be strengthened to reduce the increasing risks of measles **
The COVID-19 pandemic has caused significant disruptions in immunization services and changes in health-seeking behaviors in many parts of the world. As measures used to mitigate COVID-19 – masking, hand washing, distancing – also reduce the spread of the measles virus, countries and global health partners must prioritize research and immunization of children against measles to reduce the risk of explosive epidemics and preventable deaths. sickness.
Measles is one of the most contagious human viruses in the world, but it is almost completely preventable by vaccination. Over the past 20 years, the measles vaccine is estimated to have prevented more than 30 million deaths worldwide. The estimated number of measles deaths increased from around 1,070,000 in 2000 to 60,700 in 2020. The estimated number of measles cases in 2020 was 7.5 million worldwide. Measles transmission within communities is not only a clear indicator of low measles immunization coverage, but also a known marker, or “tracer,” that vital health services are not reaching populations. most at risk.
The Measles and Rubella Initiative
The Measles and Rubella Initiative (M&RI) is a partnership between the American Red Cross, the United Nations Foundation, the US CDC, UNICEF and WHO. Together with Gavi, the Vaccine Alliance and other stakeholders, the Initiative is committed to achieving and sustaining a world free of measles, rubella and congenital rubella syndrome. Since 2000, M&RI has helped deliver the measles vaccine to children around the world and has saved more than 31.7 million lives worldwide by increasing immunization coverage, responding to epidemics, monitoring and assessment, and supporting confidence and demand for vaccination.
By the end of 2020, 81 countries (42%) had succeeded in maintaining their measles elimination status despite the pandemic, but no new countries have been verified as having achieved measles elimination. There are still 15 countries that have not included the second measles dose in their national immunization schedules, leaving children and adolescents in these countries particularly vulnerable to measles outbreaks.
âFor more than two decades, Red Cross volunteers have reached members of their communities in need of life-saving vaccines. Volunteers provide essential health information to families through encouragement and a familiar face. It has helped change minds and hearts to immunize millions of children within these communities, âsaid Koby Langley, Senior Vice President of American Red Cross International Services and Services to the Armed Forces. âWith the lingering global effects of the COVID-19 pandemic, this work is vital. Now more than ever, we need to reach children who are unprotected from deadly diseases and prevent new epidemics. ”
âThe pandemic is having a huge impact on the ability of countries to provide essential health services such as routine immunizations, exposing millions of people, mainly children, to highly infectious diseases such as measles. Our priority at Gavi is to help countries mitigate this risk and prevent epidemics by closing growing immunity gaps by stepping up routine immunization and conducting well-planned and targeted catch-up campaigns, âsaid Anuradha Gupta, Deputy Managing Director, Gavi the Vaccine Alliance. âWe urgently need to address critical gaps in measles immunity with a special focus on reaching zero-dose children who are most at risk of devastating measles epidemics. “
âEven before the pandemic, we were seeing how even small pockets of low measles vaccine coverage could fuel unprecedented epidemics, including in countries where the disease was considered eradicated. And now COVID-19 is creating growing coverage gaps at a rate we haven’t seen in decades, âsaid Ephrem Tekle Lemango, UNICEF Associate Director for Immunization. âAlthough we haven’t seen an increase in cases yet, measles is just too contagious. If we don’t act, the gaps will turn into epidemics and many children will be exposed to preventable but potentially fatal disease, âhe added.
“The drop in reported measles cases means we must redouble our efforts to protect the millions of children at risk of dying from a fully preventable disease,” said Lori Sloate, Senior Director of Global Health at the United Nations Foundation. âThe most direct path is to work together to leverage scarce resources that invest in local health system strengthening efforts to tackle both covid and basic immunization. One cannot come at the expense of the other.
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