On Monday, a press release issued by the UN noted that due to the COVID-19 pandemic, measles immunisation campaigns have been delayed in 24 countries and will be canceled in 13 others since healthcare workers are required to deal with the pandemic in countries where healthcare systems are already inadequate. While there is a vaccine for measles, the disease claimed 140,000 lives of mostly infants and babies in 2018.
The coronavirus pandemic, which has necessitated many prevention measures including strict lockdowns, has kept infants from getting routine immunisation services from some other diseases such as polio, yellow fever and cholera.
What is measles?
Measles is a highly contagious viral disease and despite the availability of a vaccine against it, it remains to be a leading cause of death among young children globally. The disease is transmitted via droplets released from the nose, mouth or throat of infected persons. The initial symptoms occur 10-12 days after contracting the infection and include high fever, a runny nose, bloodshot eyes and the appearance of white spots on the inside of the mouth.
Some of the most serious complications arising out of the disease include blindness, encephalitis (brain swelling), severe diarrhea, dehydration and severe respiratory infections such as pneumonia. The disease is still common in parts of Africa and Asia and is more likely among poorly nourished children, especially those who are deficient in vitamin A.
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Mass immunisation drives and routine vaccination for children are the key public health strategies against the disease, as per the WHO. Therefore, delaying the campaigns affects these strategies, potentially putting the life of thousands of children at risk.
Which countries are affected by the delayed and canceled immunisation campaigns?
Countries including Mexico, Bolivia, Lebanon, Nepal and Chile among others have delayed their immunisation campaigns. An article in the journal Nature noted that a measles outbreak has killed more than 6,500 children in the Democratic Republic of Congo (DRC) and the outbreak is still spreading after the cases began to spike after 2018. It notes that children in rich countries are also not totally immune to this disease, since many parents (presumably a part of the anti-vaccination movement) refuse to get their children vaccinated.
Further, the reproduction number for measles, which is the number of people who get infected by an individual who has the disease is somewhere between 12-18, “which makes it the most contagious virus known” the Nature report says. Some of the countries currently amid measles outbreak include Nigeria, Ukraine, DRC and Kazakhastan among others.
What has the WHO said about immunisation activities?
The WHO released an interim guideline for carrying out immunisation activities during COVID-19 on March 26, which says if immunisation actvities are negatively impacted during the pandemic, respective countries will need to design strategies for delivering “catch-up” vaccines after the outbreak subsides. Implementing this will require strategies to track and follow-up with individuals who missed getting vaccinated, assessing immunity gaps and re-establishing community demand.
Further, it has advised that mass immunisation campaigns be “temporarily suspended” in light of the COVID-19 pandemic and that countries should monitor the necessity of delaying these campaigns at regular intervals.
“The conduct of outbreak response mass vaccination campaigns will require a careful risk-benefit analysis on a case-by-case basis, assessing risks of a delayed response against the risks associated with an immediate response, both in terms of morbidity and mortality for the VPD (vaccine preventable diseases) and the potential impact of further transmission of the COVID-19 virus,” it has said.
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