Massive outbreaks of the disease, which kill mainly children, are spreading across the world, a tragic legacy of the disruption of health systems caused by the COVID-19 pandemic, and are a devastating legacy of the disruption of health systems caused by the COVID-19 pandemic. More than half a million children remain without even one dose of standard pediatric vaccines.
By the middle of this year, 47 countries had reported severe measles outbreaks, up from 16 in June 2020. Nigeria is currently facing the largest diphtheria outbreak in its history, with more than 17,000 suspected cases and nearly 600 deaths. Poliovirus outbreaks have been reported in her 12 countries, from Afghanistan to Zimbabwe.
Many of the children who missed out on vaccinations are now older and no longer eligible for routine immunization programs. So-called “zero-dose children” Vaccine-preventable diseases account for almost half of child deathsaccording to Gavi, an organization that helps finance vaccinations in low- and middle-income countries.
An additional 85 million children are unvaccinated as a result of the pandemic. This means they have only received a portion of the standard course of several vaccinations required to be fully protected against a particular disease.
The cost of not reaching these children is rapidly becoming clear.According to the data, the number of deaths due to measles increased by 43% (136,200 people) in 2022 compared to the previous year. new report From the World Health Organization and Centers for Disease Control and Prevention. The numbers for 2023 show: The total could double further.
“The decline in vaccination coverage due to the COVID-19 pandemic has directly led to this situation of increased illness and child deaths,” it said. Efrem Lemango, UNICEF’s deputy director for immunization, said: . “Each new outbreak increases the toll on vulnerable communities. We must act now and make the investments needed to bring back the children lost during the pandemic. ”
One of the biggest challenges is that children who missed their first immunization between 2020 and 2022 will now receive fewer children than the age groups typically seen in primary health care centers and regular vaccination programs. He is also getting older. Further efforts and new investments will be needed to save and protect people from potentially deadly diseases in countries with the weakest health systems.
“If they were born within a certain period of time, they would have been completely missed. Just restoring normal services won’t catch them,” said Lily Caprani, UNICEF’s global advocacy director. .
UNICEF is seeking $350 million from Gabi to purchase vaccines to reach these children. Gabi’s board is expected to consider the request next month.
UNICEF is calling on countries to implement catch-up vaccinations, an exceptional one-time program to reach all children aged 1 to 4 who have missed out.
Many developing countries have experience in responding to measles outbreaks with measles catch-up campaigns targeting children aged 1 to 5 and even 1 to 15 years. But these countries now need to distribute other vaccines, train staff (usually community health workers only accustomed to vaccinating infants), and procure and distribute the actual vaccines. .
Dr. Lemango said it was difficult to plan such a campaign despite the urgency of the situation, and said he hoped most of the campaigns would be wrapped up in 2024.
“After the pandemic ended, there was a kind of hangover. No one wanted to campaign,” he said. “Everyone wants to get back to normal and ramp up vaccinations on a regular basis. But we already had unfinished business.”
In some countries, including Brazil, Mexico and Indonesia, health systems have recovered from severe disruption caused by the coronavirus and vaccination rates have returned to or exceeded the levels reached before the pandemic. However, other countries, primarily those whose vaccination rates are already well below the targets set by UNICEF, have not caught up to previously low levels.
Countries with the highest number of children receiving zero doses include Nigeria, Ethiopia, India, Democratic Republic of Congo, and Pakistan. Many of the countries with the lowest levels of protection face complex challenges, such as civil wars in Syria, Ethiopia and Yemen. The growing population of climate refugees in Chad. and both of those issues in Sudan.
Ghana’s experience is representative of the challenges in many low-income countries. According to Priscilla Obiri, a community health worker in charge of vaccinations, when communities were on lockdown to prevent the coronavirus, parents were unable to take their children for routine vaccinations, and those restrictions Even after the restrictions were lifted, many parents still refrained from going out for fear of infection in a low-income fishing community on the outskirts of the capital, Accra.
Of the children Obiri sees recently at a typical pop-up vaccination clinic, set up with a few tables and chairs in the shade of an intersection, as many as one-third have received incomplete vaccinations. They may be vaccinated, or they may not have been vaccinated at all. , she said. She agrees with her mother and her plan to close the gap.
However, some parents do not or cannot bring their children to the clinic. “We have to go out into the community and look for them,” she said.
Obiri and his colleagues are trying to make up for lost ground, but they face other challenges. According to Vaccine Magazine, disinformation campaigns and hesitancy surrounding the coronavirus vaccine are eroding some of the traditional enthusiasm of parents to get their children vaccinated. The Confidence Project is a long-running research initiative at the London School of Hygiene and Tropical Medicine.
“Between 2015 and 2022, 55 countries saw a sharp decline in the number of people who said routine immunizations were important for their children,” said Heidi Larson, director of the project. , said its team had collected what it described as “robust global polling data.” ” was evaluated in more than 100 nationally representative surveys.
Even as people around the world seek information about vaccines, misinformation and disinformation are surging, and people with low trust in authorities and government guidance are more likely to believe alternative sources, she said. said.
Dr. Kwame Amponsah Aquiano, who oversees Ghana’s childhood immunization program, said he did not think confidence had waned during the coronavirus pandemic. Demand remains high and exceeds the program’s supply capacity in some areas, he said.
Ms Kaplani said UNICEF found that both problems were occurring in parallel.
“Not only is demand outstripping physical supply, it may outstrip access (convenient, affordable and reachable access), and at the same time we may see a decline in confidence.” she said. “It’s not necessarily the same person.”
Last year, 22 million children missed out on routine measles vaccination in their first year of life, an increase of 2.7 million from 2019, and a further 13.3 million missed out on their second dose. To achieve herd immunity and prevent outbreaks, 95 percent of children need to receive both vaccines. Because measles is highly contagious, it serves as an early warning system for vaccination shortfalls.
“In some places, a measles outbreak is a bad thing, while in others it is a death sentence, due to a combination of other risk factors such as malnutrition, poor access to health care, and poor access to clean water.” Caprani said.