This pandemic is leaving a long wake. A whole generation may be saddled with persistent symptoms from covid-19, and efforts to combat other infectious diseases such as tuberculosis have been severely disrupted. For the third time in a year, global public health officials are warning that the pandemic has had a negative impact on childhood vaccination for measles, which will probably lead to major outbreaks.
Measles is one of the most contagious human viruses — more so than the coronavirus — and is spread when an infected person coughs or sneezes. It can cause serious complications and death, especially among children. There was a major outbreak in 2019. When the pandemic first hit in 2020, and people responded by wearing masks, measles cases went down significantly. But even as cases declined, other problems cropped up.
Measles is almost entirely preventable through vaccination but requires that 95 percent or more of the population receive two doses. On Nov. 25, the World Health Organization and the Centers for Disease Control and Prevention reported that last year only 81 percent of children worldwide received their first vaccine dose, the lowest coverage since 2008. That means that 25 million children missed the first dose and 14.7 million missed their second dose. The agencies warned that the decline “is a significant setback” to global efforts to eliminate measles and “leaves millions of children susceptible to infection.”
Why? Vaccination campaigns have been postponed because of logistical hurdles and resource shortfalls during the pandemic. Some of the missed doses were to be delivered in catch-up or supplementary campaigns. In 2021, the report says, 25 campaigns postponed since the start of the pandemic were conducted, but 18 of them planned since March 2020 still had not been carried out, resulting in an estimated 61 million postponed or missed doses.
Preliminary data from the WHO shows that measles cases this year are running well above 2021. Large and disruptive measles outbreaks this year were reported in 22 countries, 18 of them in the African region. Another problem, the agencies report, is underperformance in surveillance for measles, making it harder to detect and track.
The report comes on the heels of two earlier warnings. Last November, the WHO and CDC found a “growing risk of measles to children worldwide” because of interrupted or canceled immunization campaigns. Then in April, the WHO and UNICEF expressed alarm that measles cases were rising significantly. In the United States, measles cases remain low. But a new outbreak is spreading in Columbus, Ohio, where 46 cases have been reported — all among unvaccinated children. Experts warn that measles anywhere is a threat everywhere; the disease can be carried by travelers from abroad. A 2019 outbreak of 1,300 cases reported in 31 states was due entirely to travel-related cases that reached under- or unvaccinated populations here.
The solution is clear: to recognize the growing potential for a new health emergency, and accelerate the delivery of two measles vaccine doses to as many children as possible. A lot of progress against measles was made in the years before the pandemic; it is time to resume the fight.
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