Infectious Disease

Progress in vaccinating kids in opposition to measles has slowed at LMIC

17th December 2020

1 min read

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Although vaccine coverage for pediatric measles has improved largely around the world over the past decade, more than half of the low- and middle-income countries included in a study published in Nature saw slower progress, researchers reported.

Alyssa N. Sbarra, MPH, A researcher at the Institute of Health Metrics and Assessment at the University of Washington and colleagues evaluated the trends in routine administration of measles-containing vaccines (MCV1) in 101 low and middle income countries (LMIC) where more than 99% of vaccines are administered cases were measles and deaths are still occurring – from 2000 to 2019.

According to their study, MCV1 coverage in children living in an LMIC increased from 65.6% (95% uncertainty interval) [UI], 64.2% -75.2%) in 2010 to 81% (95% UI, 79.2% -82.7%) in 2019, far behind the herd immunity target of at least 95% coverage. The authors reported that vaccination rates increased in 69.9% of countries (95% UI, 64.4% -75.2%) from 2010 to 2019 at the national level.

According to the researchers, more profits are needed to meet the Global Vaccine Action Plan (GVAP) coverage targets of 80% and 95% in countries and districts, respectively.

Researchers at the CDC and WHO recently reported that more than 207,000 people worldwide died of complications from measles in 2019 when cases hit a 23-year high.

“As the world reacts to the COVID-19 pandemic, it will be important to fill these pre-existing gaps in reporting while ensuring that children who are missing during the pandemic receive the vaccinations they need,” Sbarra said in a press release. “If this does not happen, the pandemic will exacerbate existing weaknesses in immunization systems and put more children at risk of measles.”

In 2000, the areas with the lowest MCV1 coverage were in Hari Rasu, Ethiopia (4%; 95% UI, 1.1% -9.7%), Gabi Rasu, Ethiopia (4.8%; 95% UI , 1.4% -11.4%) and Isa, Nigeria (4.9%; 95% UI, 1.5% -10.8%). During this time, 60 districts had coverage rates below 10%.

In 2019, the three areas with the lowest MCV1 coverage were all in Afghanistan – – Poruns (9.2%; 95% UI 2% -25.5%), Wama (12.1; 95% UI, 2.8% -32.6%) and Waygal (12.7%; 95% UI , 3% -34.2%).

In 2000, 38.4% of districts had a high chance of meeting the GVAP target of 80%, while the number “stagnated” in 2019 at 33.2%, the researchers said.

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

The authors also compared vaccination status in urban and rural areas and found that 2019 MCV1 coverage was lower in children in remote rural areas than in children in remote urban areas – – 33.3% versus 15.2% not vaccinated. The authors said that more unvaccinated children live in urban areas (47.9% of all unvaccinated children) than in remote rural areas (16% of all unvaccinated children).

“Policymakers need to target both urban and remote rural areas to vaccinate all children fairly,” said Sbarra.

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Peter Hotez, MD, PhD, FASTMH, FAAP

Peter J. Hotez

While international attention is focused on the disruption to global health systems from COVID-19, there is growing evidence that these may resolve before 2020. This study identified a decrease in measles vaccinations in children in 2019. It mirrors our observations, which declined in 2019. Vaccinations accelerated from 2015 onwards. We found that the main drivers are social determinants such as war, political collapse, human migration and deforestation, and a globalizing movement against vaccines. Many of these social determinants act in concert with climate change. In this regard, COVID-19 is a high point for the forces released in recent years.

Peter Hotez, MD, PhD, FASTMH, FAAP

Professor of Pediatrics at Baylor College of Medicine

Texas Children’s Hospital Center Director for Vaccine Development

Disclosure: Hotez does not report any relevant financial information.

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