Under-Vaccinated Children At-Risk During Measles Outbreaks

While reported measles cases have fallen compared to previous years, progress toward measles elimination has also declined. 

In addition, the risk of future measles outbreaks is mounting, according to a new report from the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDC).

This report found in 2020, more than 22 million infants missed their first dose of the measles vaccine, an increase of 3 million compared to 2019. 

And measles outbreaks occurred in 26 countries.

And these outbreaks have continued into 2021. The top countries reporting measles outbreaks are as follows:

• Nigeria: 6,595
• Pakistan: 6,395

While in the U.S., the CDC confirmed very few measles cases in 2020 (13) and during the first half of 2021.

However, as of November 10, 2021, the CDC reported four jurisdictions had reported 47 measles cases. With Northern Virginia confirming about half of the recent measles cases.

This data represents the most significant under-vaccination increase in two decades and creates dangerous conditions for measles outbreaks to occur.

“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, MD, CDC’s Global Immunization Director.  

“We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent­­ deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases.”

According to the CDC and WHO, measles surveillance also deteriorated in 2020.

The number of specimens submitted was the lowest in over a decade. Many countries did not report, and a few countries (32%) achieved the measles surveillance sensitivity indicator. 

Increased population susceptibility and suboptimal measles surveillance portend an immediate elevated risk for measles transmission and outbreaks, threatening the already fragile progress toward regional elimination goals.

The Measles Outbreaks Strategic Response Plan 2021–2023 recommends annual risk assessments to strengthen preparedness and response, investigation of every outbreak, rapid implementation of effective interventions to stop transmission, and root cause analysis to close immunity gaps and prevent future episodes through tailored approaches.

Progress toward measles elimination during the COVID-19 pandemic and beyond necessitates robust case-based surveillance systems to document immunity gaps and quickly identify cases and outbreaks. 

Outbreaks should be viewed as opportunities to identify weaknesses across the immunization system and develop tailored strategies to close immunity gaps. Together, these actions will bolster measles elimination efforts while strengthening immunization systems, concluded the CDC and WHO statements.

In the U.S., the M-M-R vaccine is most often available at clinics, community centers, and local pharmacies.

PrecisionVaccinations publishes fact-check, research-based vaccine news.