UNICEF and WHO warn of perfect storm conditions for measles outbreak, affecting children

The increase in measles cases in January and February 2022 is a worrying sign of an increased risk of spreading vaccine-preventable diseases and could trigger larger epidemics, especially measles that will affect millions of children in 2022, the WHO and UNICEF warn.

Pandemic-related disorders, growing inequalities in access to vaccines, and diversion of resources from routine immunization leave too many children unprotected from measles and other vaccine-preventable diseases.

The risk of major epidemics has increased as communities mitigate social distancing practices and other preventive measures for COVID-19 implemented during the peak of the pandemic. In addition, with millions of people displaced by conflicts and crises, including Ukraine, Ethiopia, Somalia and Afghanistan, disruptions in routine immunization and vaccination services against COVID-19, lack of clean water and sanitation, and overcrowding increase the risk of vaccines. outbreaks of preventable diseases.

Nearly 17,338 cases of measles were reported worldwide in January and February 2022, compared to 9,665 during the first two months of 2021. As measles is highly contagious, cases occur quickly when vaccination levels decline. Agencies are concerned that measles epidemics could also warn of an outbreak of other diseases that are not spreading so quickly.

In addition to having a direct effect on the body, which can be deadly, the measles virus also weakens the immune system and makes a child more vulnerable to other infectious diseases such as pneumonia and diarrhea, including months after measles infection among survivors. Most cases occur in environments that have faced social and economic difficulties due to COVID-19, conflict or other crises, and have a chronically poor health system infrastructure and insecurity.

“Measles is more than a dangerous and potentially deadly disease. It is also an early indication that there are gaps in our global immunization coverage, gaps that vulnerable children cannot afford, ”said Catherine Russell, UNICEF Executive Director. “It is encouraging that people in many communities are beginning to feel sufficiently protected from COVID-19 to return to social activities. But in places where children do not receive routine vaccinations, this creates the perfect storm for the spread of measles-like diseases. ”

In 2020, 23 million children missed basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.

As of April 2022, agencies are reporting 21 major and disturbing measles epidemics worldwide in the last 12 months. Most cases of measles have been reported in Africa and the eastern Mediterranean. The numbers are probably higher because the pandemic has disrupted surveillance systems globally, with a possible lack of reporting.

The countries with the largest measles epidemics since last year include Somalia, Yemen, Nigeria, Afghanistan and Ethiopia. Insufficient measles vaccine coverage is a major cause of outbreaks, wherever they occur.

“The COVID-19 pandemic has disrupted vaccination services, health systems are overloaded and we are now seeing a re-emergence of deadly diseases, including measles. For many other diseases, the impact of these disorders on immunization services will be felt for decades, ”said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Now is the time to get essential immunization back on track and launch catch-up campaigns so everyone can have access to these life-saving vaccines.”

As of April 1, 2022, 57 campaigns against vaccine-preventable diseases in 43 countries that have been held since the beginning of the pandemic continue to be delayed, affecting 203 million people, most of whom are children. Of these, 19 are anti-measles campaigns, which have put 73 million children at risk of measles due to missed vaccinations. In Ukraine, the measles campaign in 2019 was interrupted due to the COVID-19 pandemic, and after that due to the war. Routine and compensatory campaigns are needed wherever access is possible to ensure that recurrences do not occur as in 2017-2019, when there were more than 115,000 measles cases and 41 deaths in the country – this was the highest incidence in Europe .