Annals of Medicine and Surgery · 5 authors, 6 centres
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The COVID-19 pandemic caused a historic drop in measles vaccination, with nearly 40 million children missing a dose by November 2022, leading to 9 million cases and over 100,000 deaths in 2021. This immunization gap has fueled outbreaks globally, especially in low-income and conflict-affected regions. The paper calls for urgent catch-up campaigns, lowering the vaccination age to 6 months, and integrating vitamin A supplementation to prevent blindness and other complications.
**Background:** The COVID-19 pandemic severely disrupted routine immunization services worldwide, leading to a dangerous decline in measles vaccination coverage. Measles is a highly contagious, vaccine-preventable disease that can cause severe complications, including blindness, pneumonia, encephalitis, and death. The paper highlights the scale of missed vaccinations and the resurgence of measles as a public health emergency.
**Methods:** This is a correspondence article that synthesizes data from WHO, UNICEF, and other global health sources up to November 2022. It reports on vaccination coverage gaps, measles case numbers, and outbreak patterns, with a focus on low-income countries and conflict-affected regions. The authors also discuss strategies to address the crisis, including catch-up campaigns and vitamin A supplementation.
**Key Results:** By November 2022, nearly 40 million children worldwide had missed a measles vaccine dose in the past year. A record 25 million children missed their first dose, and 14.7 million missed their second dose. In 2021, there were approximately 9 million measles cases and over 100,000 deaths. Twenty-two nations experienced large disruptive outbreaks. In early 2022, 17,500 cases were identified in African countries, with Zimbabwe having the highest number. The pandemic exacerbated existing inequities, with children in conflict zones (Ukraine, Ethiopia, Somalia, Pakistan, Afghanistan) facing additional barriers to vaccination. Nonvaccinated children have a 70% higher risk of mortality compared to vaccinated children.
**Clinical Implications:** The resurgence of measles underscores the urgent need to restore and strengthen routine immunization programs. The authors recommend lowering the age of primary vaccination to 6 months, prioritizing malnourished children, and ensuring two doses of vitamin A alongside the measles vaccine to prevent ocular morbidity (e.g., xerophthalmia, corneal ulcers, blindness). Catch-up campaigns, door-to-door surveillance, and community engagement (including religious leaders) are essential to address vaccine hesitancy and reach unvaccinated children. Robust surveillance systems are needed to detect and respond to outbreaks quickly. The paper emphasizes that measles outbreaks may foreshadow epidemics of other vaccine-preventable diseases, requiring sustained efforts from public health experts, virologists, and pediatricians.