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UNICEF and WHO warn of ‘perfect storm’ of conditions for measles outbreaks, affecting children

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UNICEF and WHO warn of ‘perfect storm’ of conditions for measles outbreaks, affecting children

Reported worldwide measles cases increased by 79 per cent in the first two months of 2022, compared to the same period in 2021, as WHO and UNICEF warn conditions ripe for serious outbreaks of vaccine-preventable illnesses

New York/Geneva, 27 April 2022 – An increase in measles cases in January and February 2022 is a worrying sign of a heightened risk for the spread of vaccine-preventable diseases and could trigger larger outbreaks, particularly of measles affecting millions of children in 2022, warn WHO and UNICEF.

Too many children are left without immunity against measles or other vaccine-preventable illnesses due to pandemic-related disturbances and increasing inequalities regarding vaccine access.

The risk for large outbreaks has increased as communities relax social distancing practices and other preventive measures for COVID-19 implemented during the height of the pandemic. In addition, with millions of people being displaced due to conflicts and crises including in Ukraine, Ethiopia, Somalia and Afghanistan, disruptions in routine immunization and COVID-19 vaccination services, lack of clean water and sanitation, and overcrowding increase the risk of vaccine-preventable disease outbreaks.

Almost 17,338 measles cases were reported worldwide in January and February 2022, compared to 9,665 during the first two months of 2021. Because measles can be contagious and quickly spreads, it is common for cases to appear when vaccine levels drop. These agencies worry that measles outbreaks could be a warning sign for other diseases, which don’t spread nearly as quickly.

Besides the direct effects on the body that can prove fatal, measles also weakens immune systems and leaves children more susceptible to infections like diarrhoea and pneumonia, even months later, among the survivors. Most cases occur in settings that have faced social and economic hardships due to COVID-19, conflict, or other crises, and have chronically weak health system infrastructure and insecurity.

“Measles can be more than just a deadly and dangerous disease. This is an indication that global immunization coverage gaps exist, which vulnerable children can’t afford. Catherine Russell, UNICEF Executive director, said, “It also indicates there may be gaps.” “It is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities. However, doing this in areas where kids aren’t receiving routine vaccines creates the ideal storm for spreading a disease such as measles.”

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

Top 5 countries with reported measles cases in the last 12 months, until April 2022 1
Country Reported Measles cases Rate per million cases First dose measles coverage (%), 20192 First dose measles coverage (%), 20203
Somalia 9,068 554 46 46
Yemen 3,629 119 67 68
Afghanistan 3,628 91 64 66
Nigeria 12341 58 54 54
Ethiopia 3039 26 60 58

As of April 2022, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months. The majority of measles cases in the world were reported from Africa and the East Mediterranean. These numbers are more likely to be higher because of the disruption in surveillance systems worldwide and potential underreporting.

The countries with the highest measles epidemics in the last year are Somalia, Yemen and Afghanistan. Regardless of where they are occurring, insufficient coverage for measles vaccinations is the main reason that outbreaks occur.

“The COVID-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. The disruptions in immunization will have a lasting impact on many other diseases,” Dr Tedros Adhanom Gebreyesus (Director-General, World Health Organization) said. Now is the time to get vital immunization on track, and to launch catch-up campaigns to ensure that everyone has access to these lifesaving vaccines

As of 1 April 2022, 57 vaccine-preventable disease campaigns in 43 countries that were scheduled to take place since the start of the pandemic are still postponed, impacting 203 million people, most of whom are children. Of these, 19 are measles campaigns, which put 73 million children at risk of measles due to missed vaccinations. In Ukraine, the measles catch-up campaign of 2019 was interrupted due to the COVID-19 pandemic and thereafter due to the war. Routine and catch-up campaigns are needed wherever access is possible to help make sure there are not repeated outbreaks as in 2017-2019, when there were over 115,000 cases of measles and 41 deaths in the country – this was the highest incidence in Europe.

Coverage at or above 95 per cent with two doses of the safe and effective measles vaccine can protect children against measles. However, COVID-19 pandemic related disruptions have delayed the introduction of the second dose of the measles vaccine in many countries.

As nations work together to combat measles outbreaks and other vaccine-preventable illnesses, UNICEF, WHO and partners like Gavi and the Vaccine Alliance and the Measles & Ruby Initiative (M&RI), Bill & Melinda Gates Foundation, and many others support efforts to improve immunizations by:

  • Restoring services and vaccination campaigns so countries can safely deliver routine immunization programmes to fill the gaps left by the backsliding;
  • Helping health workers and community leaders communicate actively with caregivers to explain the importance of vaccinations;
  • Rectifying gaps in immunization coverage, including identifying communities and people who have been missed during the pandemic;
  • Ensuring that COVID-19 vaccine delivery is independently financed and well-integrated into overall planning for immunization services so that it is not carried out at the cost of childhood and other vaccination services;
  • Implementing country plans to prevent and respond to outbreaks of vaccine-preventable diseases and strengthening immunization systems as part of COVID-19 recovery efforts.

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1 Source: Provisional data based on monthly data reported to WHO as of April 2022

2 Source: WHO/UNICEF estimates of national immunization coverage, 2020 revision.

3 Source: WHO/UNICEF estimates of national immunization coverage, 2020 revision.

For more information on the 24-30 April WHO World Immunization Week campaign and all resources.

About UNICEF

UNICEF is active in the most difficult places on the planet, helping the poorest children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org.

About WHO

The World Health Organization is the global leader in public health for the United Nations. Founded in 1948, WHO works with 194 Member States across six regions, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being. For more information about WHO visit who.int

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