Risk of major measles outbreaks as countries delay vaccination drives

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Fifteen African countries delayed measles immunization drives last year as they dealt with the COVID-19 pandemic. While seven of these countries have now completed the campaigns, eight remain outstanding, posing a risk of major measles outbreaks.

On the eve of the African Vaccination Week – the annual campaign for universal access to life-saving vaccines on the continent – new, early data shows that an estimated 16.6 million children in Africa missed planned supplemental measles vaccine doses between January 2020 and April 2021 and eight African countries reported major measles outbreaks that affected tens of thousands during the period. The outbreaks were largely due to low routine immunization coverage or delayed vaccination drives. In addition, the quality of measles surveillance in Africa fell to the lowest level in seven years in 2020, with just 11 countries meeting their target.

“Recent outbreaks of measles, but also yellow fever, cholera and meningitis all point to worrying gaps in immunization coverage and surveillance in Africa. As we fight COVID-19, we cannot leave anyone dangerously exposed to preventable diseases. I urge all countries to double down on essential health services, including life-saving vaccination campaigns,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.

Measles is highly contagious, requiring at least 95% immunization coverage in the population to prevent outbreaks, yet coverage with the first dose of the measles-containing vaccine has stagnated at around 69% in the WHO African Region since 2013. Only seven countries in the region achieved 95% measles-containing vaccine coverage in 2019.

The low measles coverage reflects a wider stagnation in routine immunization in Africa that, in some countries, has been exacerbated by the pandemic and related restrictions. Most diseases, including tetanus, diphtheria and yellow fever, require 90% coverage in the population, yet rates in Africa remained stuck at around 70 to 75% over the last decade.

Around 9 million children in the African region miss life-saving vaccines each year and one in five children remain unprotected from vaccine preventable diseases, which claim the lives of over 500 000 children under 5 years in Africa every year.

Despite challenges, Africa was declared wild polio-free in 2020. Vaccines are having a huge impact on diseases like cervical cancer, hepatitis and Ebola. The region has made significant gains against meningitis A in recent years and new and underutilized vaccines have been introduced, including the pneumococcal conjugate vaccine in 40 African countries. Over 116 million children were vaccinated with the third dose of the pneumococcal conjugate vaccine between 2015 and 2019.

Alongside the rollout of COVID-19 vaccines, WHO is working with African countries to ensure that routine immunization service delivery is scaled up to close the gaps created at the start of the pandemic. This includes providing policy guidance, helping strengthen health systems, training health care professionals, reinforcing disease surveillance and the use of data for action, as well as assisting with periodic mass vaccination campaigns for a range of vaccine preventable diseases.

“Integrated action is needed to increase and expand access to immunization as part of primary health care. This must be backed by a well-trained workforce, strong surveillance, health information systems, national leadership, management and coordination. We must also engage more with community leaders and influencers to ensure that everyone understands the life-saving, transformative promise of vaccines,” said Dr Moeti.

WHO and Member States will observe the 11^th African Vaccination Week from 24 to 30 April 2021 – an annual campaign that unites partners in calling for universal access to life-saving vaccines and greater collective action on immunization in Africa.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Hon Dr Austin Demby, Minister of Health and Sanitation, Sierra Leone. Also on hand from the WHO Regional Office for Africa to answer questions were Dr Ambrose Talisuna, Programme Manager Emergency Preparedness, Dr Phionah Atuhebwe, Vaccines Introduction Officer, Dr Thierno Balde, Team Leader, Operational Partnerships, and Dr Ado Bwaka, Team Leader for Vaccine Preventable Diseases.

Distributed by APO Group on behalf of WHO Regional Office for Africa.