Childhood analysis

WHO warns of missed measles vaccinations


Measles vaccination has fallen sharply globally, but Australian vaccination rates appear to have held up despite challenges from COVID-19.

The pandemic has caused measles vaccination rates to drop in many countries (Image: AAP).

The World Health Organization (WHO) has warned that global progress in the fight against measles is being compromised by the pandemic.

In a press release this month, the WHO cited evidence in a new report it was conducted with the United States Centers for Disease Control and Prevention (CDC). Their analysis found that more than 22 million infants missed their first dose of measles vaccine in 2020, an increase of three million children from the figures recorded for 2019.

The WHO said it was the “biggest increase in two decades” and that the situation “created dangerous conditions for epidemics to occur”.

The global number of reported measles cases has declined since the start of the COVID-19 pandemic, with an 80% drop in 2020 from the previous year.

In Australia it no cases have been recorded this year, while the level of immunization appears to have been maintained at pre-pandemic levels. Current tables recording vaccination rates among two-year-old children in Australia show that the coverage of the MMR vaccine is well over 90% in every state and territory.

Globally, however, WHO’s Dr Kate O’Brien has warned that the decrease in cases is “the calm before the storm”.

The organization reports that measles surveillance deteriorated over the past year, with the number of samples sent for laboratory testing at the lowest in more than a decade. This suggests that weak surveillance and testing will affect the ability of some countries to prevent outbreaks of the highly infectious disease.

Professor Kim Mulholland, a pediatrician at the Murdoch Children’s Research Institute (MCRI), describes the situation as “very worrying”.

“I would say it’s an accident waiting to happen, if it’s not happening already,” he said. gp news.

Professor Mulholland, who is also a member of the WHO Strategic Advisory Group of Experts on Immunization, says one of the main challenges is getting accurate data on the international presence of measles.

“My feeling is frustrated because the world of measles, like the world of COVID-19, has been dominated by mathematical models in part because it is very difficult to see what is really going on out there in the world. “, did he declare.

“But perhaps more than with COVID, the situation with measles is that most deaths happen out of sight, out of mind.”

In Australia, the impact of the pandemic does not appear to have reduced vaccination rates. A report published by the National Immunization Surveillance and Research Center (NCIRS) last November, the rates suggested rates had been maintained, at least in the first few months of the pandemic until July 2020.

Using data from the Australian Immunization Register (AIR), he monitored the vaccination rate in Australian children for the National Immunization Program. The report assessed the impact of physical distancing and movement restrictions across Australia, and ultimately came to reassuring conclusions.

The authors found “no evidence of a substantial impact” on the uptake of vaccination in children at the national or individual level of a state or territory.

“This is a welcome finding, which likely reflects the consistent message from health authorities that it is important to maintain immunization during the pandemic and efforts to provide safe COVID-19 immunization services,” they wrote. .

A suite study in the Australian Medical Journal also found early childhood vaccination rates to be ‘resilient’ during the 2020 lockdown in Victoria.

Dr Frank Beard, a public health physician and associate director of NCIRS, was one of the authors of this study. He is “fairly confident” that the high vaccination rates against measles, mumps and rubella (MMR) have been maintained.

“However, that is not the only story,” he said. gp news. “We know there are gaps in immunity in older populations, especially adults [in their] in their twenties to mid-fifties, knowing that when they were children, immunization coverage rates were lower. ‘

He said these age groups include a high proportion of people likely to travel.

“It would be a message for general practitioners to ensure that anyone who comes for a travel consultation who [measles immunisation] is something that is considered.

“A lot of times people didn’t have good immunization records so long ago. If it is not clear whether people have received two doses of the vaccine, then it is quite safe to give them one or two more doses.

He said that as more international travelers return to the country, GPs will need to be vigilant for measles cases so that contact tracing and a public health response can be put in place when the disease inevitably reappears.

“Many GPs these days have probably never seen measles, so they certainly need to be on the alert, especially among people who have returned from overseas, but also generally because ‘Obviously, people can still catch it from other people who “came back from overseas,” he said.

Major outbreaks occurred in 26 countries in 2020, which the WHO said accounted for 84% of all cases reported last year.

Before the pandemic, the disease represented a estimated at 207,500 deaths worldwide in 2019.

Professor Mulholland believes the pandemic is masking what is really going on with the highly infectious disease.

“There are real measles outbreaks right now and we should be collecting real data from these places, finding out what’s going on, [like] in DR Congo where many children contract measles and die, and are trying to find out more about it.

“We didn’t do that. I feel like the world has taken [its] eyes closed on measles to be honest.

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