Children falling behind on measles shots, study shows

While the world witnessed impressive progress in vaccinating children against measles between 2000 and 2010, in the past 10 years these efforts have stalled in low- and middle-income countries, according to a new scientific study.

The pre-pandemic vulnerabilities identified by this analysis are likely to be exacerbated as efforts to immunize children have been further disrupted by the COVID-19 pandemic.

“As the world responds to the COVID pandemic, it will be vital to address these pre-existing gaps in coverage while ensuring that children lost during the pandemic receive the necessary vaccinations,” said Alyssa Sbarra, lead author of the study and researcher at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. “If that doesn’t happen, the pandemic will exacerbate existing weaknesses in immunization systems and put more children at risk for measles.”

The study, published today in the journal Nature, examines vaccine delivery in 101 low- and middle-income countries in five-by-five-kilometer increments through 2019. It is the first analysis to examine trends in measles vaccine coverage worldwide at such a geographic level. precise.

“These community-level analyzes of where children are vaccinated and not vaccinated help identify the areas of greatest vulnerability before the onset of the pandemic,” Sbarra said.

The study found that in 2019, there was a higher percentage of children vaccinated in urban areas than in rural communities; however, due to overcrowded conditions in cities, most of the world’s unvaccinated children lived in cities.

“Policy makers should focus on remote urban and rural areas to fairly vaccinate all children,” Sbarra said.

The study examines vaccination rates between 2000 and 2019. In 2000, the three communities with the lowest coverage were in Ethiopia and Nigeria. Nineteen years later, the three communities with the lowest coverage were all in Afghanistan.

“This valuable local mapping of measles vaccination coverage provides crucial information to guide decision-makers.” said Prof. Heidi Larson, study author; Professor at the London School of Hygiene and Tropical Medicine; and author of “Stuck: How Vaccine Rumors Start and Why They Don’t Go Away”. “National coverage rates alone mask important geographic variations. India, Chad and Ethiopia, for example, showed an increase in overall measles vaccination coverage. But behind these similarities, India’s geographic disparities decreased, while that inequalities in Chad and Ethiopia increased. These inequalities may expose pockets of vaccine vacillation, as well as access issues. Hesitation in the context of COVID fears or anxieties surrounding a new COVID vaccine should not inhibit any father to make sure his children are vaccinated against measles. “

Even before the current pandemic, few low- and middle-income countries had reached the global goal of 80% coverage in all communities or districts. In 2017, there were almost 18 million cases of measles; more than 83,000 children died from the disease. The study notes that the “safe and highly effective measles vaccine,” which was developed in the 1960s, has been recommended globally for children since 1974.

“It is inconceivable that even though it has been more than 50 years since the measles vaccine was developed, we continue to see so many children die of measles,” said Dr. Jonathan Mosser, IHME assistant professor and lead author of the study. . “Health leaders must recognize the magnitude of this problem. We need new strategies to identify communities that are lagging behind and enable them to reach all unimmunized children with this safe and effective vaccine.”