More children in middle income countries missing out on vaccines

New data by WHO and UNICEF shows 14 million children missing out on vaccines every year even as 30 measles vaccination campaigns disrupted due to COVID-19

NEW YORK – More and more children in middle-income countries are missing out on life-saving vaccines against diseases such as measles, rubella, diphtheria, tetanus and pertussis.

Latest data on vaccine coverage estimates from WHO and UNICEF, two of the five founding partners of the Measles & Rubella Initiative (M&RI) — a global partnership against measles and rubella — shows that immunization uptake have markedly decreased in several middle income countries (MICs), and not just in low-income countries, over the past decade. Brazil, Philippines, Venezuela, El Salvador, Bolivia and Mexico have all experienced more than 10 per cent point decreases since 2016, the new estimates show.

Globally, in 2019, nearly 14 million children missed out on the measles and combined diphtheria, tetanus and pertussis (DTP) vaccines, according to the vaccine coverage estimates. While the coverage of the first dose of measles containing vaccine has stalled at 85 per cent, the second dose is only reaching 71 per cent of children. Three of the 10 countries that accounted for most of the under and un-vaccinated children (62% or two-thirds), are MICs including Brazil, Mexico and Philippines.

©UNICEF/2020/S.Karahoda

Additionally, due to the COVID-19 pandemic, at least 30 measles vaccination campaigns were or are at risk of being cancelled across the world, which could result in further outbreaks in 2020 and beyond, a news release issued by WHO and UNICEF along with the vaccine coverage estimates stated. The latest UNICEF, WHO and Gavi “pulse” survey conducted in collaboration with the CDC, the Sabin Vaccine Institute and Johns Hopkins Bloomberg School of Public Health, found that three quarters of the 82 countries that responded reported COVID-19 related disruptions in their immunization programmes as of May 2020.

The new coverage estimates paint an alarming picture of the world not meeting its promise of protecting its young ones. While immunization is often noted as the most successful public health intervention, vaccinating 85 per cent of infants against measles is not enough to keep this incredibly infectious disease under control. This became evident in 2019, when 863,000 cases of measles were reported, more than twice as many as the 360,000 in 2018. The 2019 case count represents the largest number of measles cases reported in one year since 1996. Most of the cases occurred in children living in low income countries in Africa who are likely to lack access to other health services.

“We cannot afford to forget about measles. All the warning signs are there that measles will be back in a big way if we don’t act soon, and children will suffer the most. Measles simply does not care about COVID-19, and that’s why we are working together as M&RI partners. We are all stronger together,” said Dr. Natasha Crowcroft, WHO Senior Technical Adviser for Measles and Rubella.

M&RI is a partnership between the American Red Cross, the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, the United Nations Foundation and the World Health Organization (WHO). Working with Gavi, the Vaccine Alliance, the Initiative seeks to achieve and maintain a world without measles, rubella and congenital rubella syndrome. The Initiative is specifically able to meet some funding needs of MICs especially when they are not eligible for Gavi support as the Vaccine Alliance focuses its support to the world’s poorest countries.

Since the COVID-19 pandemic is seriously disrupting immunization programmes, global immunization coverage is in danger of declining for the first time since early 90s. As the risk of outbreaks increases, measles is likely to be the first disease to resurge because of how contagious it is. If action is not taken soon to get immunization programmes back on-track, we are likely to see children affected by other vaccine preventable diseases that were previously under control.

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