The measles situation is potentially explosive. According to the World Health Organization (WHO) and Unicef, there is currently a “perfect combination” factors conducive to the appearance of outbreaks on the planet. Over the past year, 21 measles outbreaks have been reported, mainly in African countries, Afghanistan and Pakistan. In 2022, more than 17,000 cases were recorded in the first two months of the year. This is almost twice as many as those of January and February 2021.
→ REREAD. Coronavirus: fall in the number of children vaccinated, the UN is concerned
In addition to wars, humanitarian crises and population displacements conducive to the spread of contagious diseases, the UN particularly points to the devastating impact of the fall in vaccination campaigns since the start of the Covid pandemic. Efforts to curb the disease, which had reduced mortality by 94% in twenty years, from 2000 to 2020, are being undermined. Before the introduction of the vaccine in 1963, this deadly disease was responsible for an average of 2.6 million deaths per year. Mortality then steadily declined: 536,000 deaths in 2000, 142,000 in 2018, mainly among children under 5 years old. This dynamic is now halted.
Vaccination campaigns postponed in 43 countries
In 2020, 23 million children were not vaccinated against childhood diseases, 3.7 million more than the previous year. And since then, 53 vaccination campaigns that were to be carried out in 43 countries are still postponed due to the saturation and disorganization of health systems, faced with the Covid-19 pandemic. Nineteen of these campaigns were to focus on measles. This deficit puts 73 million children at risk of measles.
This return of measles is “an early indication that there are gaps in our global immunization coverage, gaps that vulnerable children cannot afford,” said Catherine Russell, Director General of Unicef on the occasion of World Immunization Week, which ends this Saturday, April 30. Tedros Adhanom Ghebreyesus, Director General of WHO, further estimated that “The impact of these disruptions to immunization services will be felt for decades.”
For Odile Launay, the head of the vaccinology clinical investigation center at Cochin hospital “it will be very difficult, in the absence of a register in many countries and sometimes weak vaccination capacities, to recover these cohorts of children from 2020 and 2021, or even from 2022, who have not been vaccinated; these will remain “pockets” ofyears the population vulnerable to the virus and will maintain its circulation”.
The endemic disease in Somalia
Good protection against measles requires vaccination coverage of at least 95% of the population. Because, due to the extreme contagiousness of the disease, 90% of unvaccinated people are infected when they are in the presence of the virus, for which there is no antiviral treatment. However, in 2018, coverage was only 69% for the required two doses of vaccine, and 86% for a single dose. Nearly a third of unvaccinated infants were in India, Nigeria and Pakistan.
This primary vaccination rate has fallen in Ethiopia, from 60% in 2019 to 58% in 2020. It is only 54% in Nigeria. It even drops to 44% in Somalia, where measles is endemic and where the risk is considered very high due to the high prevalence of malnutrition and the humanitarian crisis, due to both conflict and drought.