Earlier this month, the World Health Organization (WHO) reported that the number of measles-related deaths worldwide has decreased 79 percent from the beginning of the century to 2014. The WHO report on the measles vaccine attributes increased vaccination coverage to the saving of an estimated 17 million lives since 2000.
In addition, the WHO report on the measles vaccine shows that vaccination has played a key role in reducing overall childhood deaths, and, in progress towards Millennium Development Goal 4, lowering child mortality rates.
But despite these successes, UNICEF says that measles remains one of the primary killers of children in the developing world. While measles rarely kills in industrial countries, it can cause up to 40 percent mortality among infected children in dire and overcrowded situations which may occur following earthquakes, floods or when populations are displaced by conflict.
UNICEF reports that “the measles death toll in Africa is so high — every minute one child dies — that many mothers don’t give children real names until they have survived the disease.” Measles weakens the immune system and renders children very susceptible to fatal complications from diarrhea, pneumonia and malnutrition. Those that survive may suffer blindness, deafness or brain damage, the organization says.
While vaccine programs have made great strides in reducing the viral respiratory infection, new data published by the Centers for Disease Control and Prevention and WHO shows that overall progress towards increasing global immunization coverage has recently stalled. While coverage with the first dose of the measles vaccine increased globally from 72 percent to 85 percent between 2000 and 2010, it has remained unchanged the past four years.
“We cannot afford to drop our guard,” says Dr Jean-Marie Okwo-Bele, Director of WHO’s Department of Immunization, Vaccines and Biologicals. “If children miss routine vaccination and are not reached by national immunization campaigns, we will not close the immunization gap.”
Although all countries include at least one dose of measles-containing vaccine in their routine vaccination schedule, only 63 percent of nations have met the target minimum of 90 percent of children receiving vaccination, with at least the first dose. One dose of MMR (measles, mumps, rubella) vaccine is about 93 percent effective at preventing measles if exposed to the virus. But only half of the world’s children receive the recommended second does of the vaccine, which brings the vaccine to about a 97 percent effectiveness rate when administered.
In 2014, mass vaccination campaigns led by country governments with support from the Measles & Rubella Initiative and the Global Vaccine Alliance reached approximately 221 million children. Twenty-nine countries supplemented their routine vaccination programs with mass immunization campaigns. This aided the reduction of measles incidence in four out of six WHO regions last year.
“Despite the welcome reduction in measles deaths, this highly-infectious disease continues to take a terrible toll on the lives of children around the world,” Dr Seth Berkley, CEO of the Global Vaccine Alliance said. “A coordinated approach that puts stronger routine immunization at its core will be central to getting measles under control and securing further reductions in mortality from this vaccine-preventable disease.”
Dr. Robert Perry, a vaccine specialist who wrote the WHO report on the measles vaccine, says this can be done. “Reinvigorating the monitoring, doing spot checks, going door-to-door to find out if kids are vaccinated,” he told National Public Radio. “Doing good planning to get to hard to reach areas — renting a boat or a camel when necessary.”
“One bottleneck now is that the vaccine is injected. We have to have people trained for that,” he said. “It might be safer if it’s a patch with thousands of microneedles on it. Just put the patch on the skin and the person gets the dose that way, and it can immunize them. We’re hoping that will come online in two to three years. We’ll be able to work in areas with real security challenges. It’s hard to send teams into places like Syria. A patch vaccine might be a game changer.”
Sources: CDC, Measles&Rubella Initiative, NPR, UNICEF, UN, WHO