by Ruggiero Corcella
Unicef data: over 30 thousand cases from January to 5 December, compared to 909 in 2022. Collapse of vaccination coverage. The causes? Misinformation, mistrust, disruption of health services and weak primary healthcare
There are only seven years left until the fateful 2030, the year by which to eradicate measles and rubella in the world according to the Misleas and rubella strategic framework (Measles and Rubella Strategic Framework 2023), adopted in 2020 by the Misleas Initiatives group (American Red Cross, US Centers for Disease Control and Prevention, the United Nations Foundation, UNICEF and the World Health Organization).
But the infection situation around the world continues to worsen. A UNICEF report, released today, warns that between January and 5 December 2023, 30,601 cases of measles were confirmed in Europe and Central Asia, compared to 909 in 2022, with a 3,266% increase in cases of this preventable disease. the vaccine. HERE The situation in Italy
The collapse of vaccination coverage
The data also points to a more recent worsening trend, as the rate of measles cases in Europe and Central Asia nearly doubled between October and November 2023. Cases in the region are expected to rise further due to vaccination gaps. There is no clearer sign of the collapse in vaccination coverage than an increase in measles cases. Such a marked increase requires urgent attention and public health measures to protect children from this dangerous and deadly disease, underlines Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia.
Measles has a devastating effect on a child’s health, sometimes with fatal consequences. It causes a lasting weakening of children’s immune systems, making them more vulnerable to other infectious diseases, including pneumonia. The highest rate of measles cases was detected in Kazakhstan with 69 cases per 100,000 inhabitants, equal to 13,254 cases, according to the latest available data. Kyrgyzstan ranks second in terms of number of measles cases, with 58 cases per 100,000 inhabitants, equal to 3,811 cases. Romania, which announced a nationwide measles outbreak last week, has a reported rate of 9.6 cases per 100,000, or 1,855 cases.
The negative effects of misinformation and mistrust on vaccines
The increase in measles cases attributable to a decrease in vaccination coverage in the region. A decrease in demand for vaccines – fueled in part by misinformation and mistrust that worsened during and after the COVID-19 pandemic, disruption to health services and weakness in primary healthcare systems are some of the contributing factors . The latest data shows that around 931,000 children in Europe and Central Asia did not receive all or part of their routine vaccines between 2019 and 2021. In Europe and Central Asia, the first-dose measles vaccination rate fell from 96% in 2019 to 93% in 2022.
Unicef’s requests
As these children pass the age at which vaccines are routinely administered, a dedicated effort is needed to ensure that they catch up on vaccinations. To reach every child, Unicef calls on countries in the region to: •Urgently identify and reach all children, especially those who have not received the vaccine
•Strengthen demand for vaccines, including by building trust;
•Prioritize funding for vaccination services and primary medical care; •Build resilient health systems through investments in health workers, innovation and local manufacturing.
The complaint from WHO and CDC
Already in mid-November, a joint publication by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) in the United States highlighted an alarming increase in measles casesdisruptive outbreaks and deaths in 2022. Global measles cases increased 18% in 2022 to more than 9 million, deaths increased 43% (136,200) compared to 2021, while 37 countries recorded outbreaks in 2022. The findings reiterate the need to accelerate efforts to support recovery from the COVID-19 pandemic and strengthen health systems, especially in low-income countries hardest hit by this deadly disease.
22 million unvaccinated children in 2022
Of the 22 million children who have not received the first dose of measles vaccine in 2022, more than half live in just ten countries, six of which are low-income countries supported by Gavi, the Vaccine Alliance: Democratic Republic of Congo, Ethiopia, India, Madagascar, Nigeria and Pakistan. Aurlia Nguyen, Chief Program Officer of Gavi, the Vaccine Alliance, commented: Measles is a highly contagious and deadly disease: to prevent epidemics it is necessary to consistently vaccinate at least 95% of eligible children. This was already a challenge before the COVID-19 pandemic, and with cases, outbreaks and preventable deaths rising sharply due to widening immunity gaps related to the pandemic, it is even more important that our Alliance provides a level of support unprecedented to countries in 2024.
Routine immunization
With routine immunization hit hard by the COVID-19 pandemic, Gavi supported nine low-income countries in accelerated efforts to plan and launch follow-up measles and rubella vaccination campaigns in 2023, providing more than 12 million dollars to support outbreak response in six countries. Three more preventive vaccination campaigns are expected before the end of the year. In response to the sustained and alarming trend in measles cases, in 2024 Gavi will support a record number of low-income countries – at least 15 in total – to undertake preventive measles and rubella vaccination campaigns with the aim of reaching approximately 38 .5 million children, as well as the introduction of routine vaccines and response to outbreaks.
The Vaccine Alliance supports measles vaccination efforts in low-income countries in close collaboration with WHO, UNICEF, CDC, American Red Cross, United Nations Foundation, Bill & Melinda Gates Foundation and others partners, also through the Measles & Rubella Partnership (M&RP).
How measles vaccination works in low-income countries
Measles, one of the main causes of vaccination prevention, is highly contagious and requires vaccination coverage of at least 95% through routine vaccination and very effective supplementary campaigns. This represents a significant challenge for countries, particularly low-income ones, who continue to struggle to close immunity gaps.
The measles vaccine is safe, effective and inexpensive. Children should receive two doses of the vaccine through a combination of routine and supplementary activities to ensure their immunity: the first dose at 9 months and the second dose at 15-18 months of age. Measles vaccination also represents an important opportunity to strengthen health systems.
Measles is a tracer and when an unimmunized child is identified and reached through a measles or rubella (MR) vaccination campaign, it serves as a critical entry point for routine immunization and other essential services. Gavi supports low-income countries in introducing two doses of measles vaccine (MCV1 and MCV2) into routine programs. Furthermore, the Vaccine Alliance supports the planning, application, implementation and evaluation of regular preventative follow-up and catch-up measles/measles-rubella (M/MR) vaccination campaigns, which complement immunization activities. routinely, with the specific aim of identifying and reaching missing communities with non-immunised or under-immunised children, thus reducing immunity gaps where possible. Gavi is the primary funder of immunization activities in response to measles outbreaks in low-income countries, through contributions to the Measles & Rubella Partnership (M&RP)’s Outbreak Response Fund. 2023: Recovery from the COVID-19 pandemic
Preventive vaccination campaigns
So far in 2023, nine low-income countries have planned and launched follow-up vaccination campaigns in an accelerated effort with Gavi support: Democratic Republic of Congo (DRC), South Sudan, Cameroon, Malawi, Mozambique, Papua New Guinea, Yemen, Syria and Nigeria. Two of these countries (DRC and Nigeria) are among the top ten countries with unvaccinated or zero-dose children. Three more countries are expected to launch campaigns later this year: Chad, Central African Republic and Sudan.
Routine immunization
In 2023, Mauritania introduced a second dose of measles vaccine into its routine immunization programme. In 2023, Gavi committed more than $12 million to the Measles & Rubella Partnership (M&RP) Measles and Rubella Outbreak Response Fund to support outbreak response in six low-income countries. In April 2023, Gavi joined global and national health partners for The Big Catch-up, a targeted global effort to increase vaccination among children following declines caused by the COVID-19 pandemic. This effort aims to reverse declines in childhood vaccinations seen in more than 100 countries since the pandemic.
By 2024, Gavi plans to support at least 15 low-income countries in carrying out catch-up and follow-up vaccination campaigns against measles and rubella, with the aim of reaching approximately 38.5 million children – a number of unprecedented campaigns. These 15 countries – Burkina Faso, Cambodia, Chad, Ivory Coast, Eritrea, Ghana, Laos, Liberia, Madagascar, Mali (rubella recovery), Mauritania, Nepal, Rwanda, Sierra Leone and Tanzania – represent those with plans approved so far . In parallel, Alliance partners continue to work with other priority and at-risk countries.
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December 14, 2023 (changed December 14, 2023 | 10:34)
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