Action needed now to prevent further increases in measles and measles deaths in the coming years

Mulholland, Kim; Kretsinger, Katrina; Wondwossen, Liya; Crowcroft, Natasha S.

doi:10.1016/s0140-6736(20)32394-1

Cited by 36 publications

(33 citation statements)

References 15 publications

(20 reference statements)

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“…Our model is inline with very recent reports on the decline in pediatric vaccination, that show a substantial impact of the pandemic on routine vaccination in the United States and across the world and concerns around decrease in vaccination worldwide [9] , [10] , [11] . Our results add to the literature by translating possible declines in vaccination to a common benchmark, recognized by infectious disease modelers and policy makers alike.…”

Section: Discussionsupporting

confidence: 66%

Potential impact of COVID-19 pandemic on vaccination coverage in children: A case study of measles-containing vaccine administration in the United States (US)

Carias

Pawaskar

Nyaku

et al. 2021

Vaccine

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Background The COVID-19 pandemic and stay-at-home orders have caused an unprecedented decrease in the administration of routinely recommended vaccines. However, the impact of this decrease on overall vaccination coverage in a specific birth cohort is not known. Methods We projected measles vaccinationcoverage for the cohort of children becoming one year old in 2020 in the United States, for different durations of stay-at-home orders, along with varying catch-up vaccination efforts. Results A 15% sustained catch-up rate outside stay-at-home orders (compared to what would be expected via natality information) is necessary to achieve projected vaccination coverage similar to previous years. Permanent decreases in vaccine administration could lead to projected vaccination coverage levels below 80%. Conclusion Modeling measles vaccination coverage under a range of scenarios provides useful information about the potential magnitude and impact of under-immunization. Sustained catch-up efforts are needed to assure that measles vaccination coverage remains high.

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Section: Discussionsupporting

confidence: 66%

Potential impact of COVID-19 pandemic on vaccination coverage in children: A case study of measles-containing vaccine administration in the United States (US)

Carias

Pawaskar

Nyaku

et al. 2021

Vaccine

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“…With global gains in childhood vaccine coverage stalling in recent years and most locations already falling short of 90% global coverage targets in 2019, 8 any additional declines in vaccination rates pose massive risks to child health and survival. 9 …”

Section: Introductionmentioning

confidence: 99%

Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study

et al. 2021

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Background The COVID-19 pandemic and efforts to reduce SARS-CoV-2 transmission substantially affected health services worldwide. To better understand the impact of the pandemic on childhood routine immunisation, we estimated disruptions in vaccine coverage associated with the pandemic in 2020, globally and by Global Burden of Disease (GBD) super-region.Methods For this analysis we used a two-step hierarchical random spline modelling approach to estimate global and regional disruptions to routine immunisation using administrative data and reports from electronic immunisation systems, with mobility data as a model input. Paired with estimates of vaccine coverage expected in the absence of COVID-19, which were derived from vaccine coverage models from GBD 2020, Release 1 (GBD 2020 R1), we estimated the number of children who missed routinely delivered doses of the third-dose diphtheria-tetanus-pertussis (DTP3) vaccine and first-dose measles-containing vaccine (MCV1) in 2020. FindingsGlobally, in 2020, estimated vaccine coverage was 76•7% (95% uncertainty interval 74•3-78•6) for DTP3 and 78•9% (74•8-81•9) for MCV1, representing relative reductions of 7•7% (6•0-10•1) for DTP3 and 7•9% (5•2-11•7) for MCV1, compared to expected doses delivered in the absence of the COVID-19 pandemic. From January to December, 2020, we estimated that 30•0 million (27•6-33•1) children missed doses of DTP3 and 27•2 million (23•4-32•5) children missed MCV1 doses. Compared to expected gaps in coverage for eligible children in 2020, these estimates represented an additional 8•5 million (6•5-11•6) children not routinely vaccinated with DTP3 and an additional 8•9 million (5•7-13•7) children not routinely vaccinated with MCV1 attributable to the COVID-19 pandemic. Globally, monthly disruptions were highest in April, 2020, across all GBD super-regions, with 4•6 million (4•0-5•4) children missing doses of DTP3 and 4•4 million (3•7-5•2) children missing doses of MCV1. Every GBD super-region saw reductions in vaccine coverage in March and April, with the most severe annual impacts in north Africa and the Middle East, south Asia, and LatinAmerica and the Caribbean. We estimated the lowest annual reductions in vaccine delivery in sub-Saharan Africa, where disruptions remained minimal throughout the year. For some super-regions, including southeast Asia, east Asia, and Oceania for both DTP3 and MCV1, the high-income super-region for DTP3, and south Asia for MCV1, estimates suggest that monthly doses were delivered at or above expected levels during the second half of 2020.Interpretation Routine immunisation services faced stark challenges in 2020, with the COVID-19 pandemic causing the most widespread and largest global disruption in recent history. Although the latest coverage trajectories point towards recovery in some regions, a combination of lagging catch-up immunisation services, continued SARS-CoV-2 transmission, and persistent gaps in vaccine coverage before the pandemic still left millions of children under-vaccinated or unvaccinated against p...

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“…All countries and global partners must prepare for expected measles outbreaks and apply 'prevention, preparedness, response and recovery' emergency-management principles 6 . When outbreaks occur, they should be investigated to elucidate and define immunity-gap demography for targeted strengthening of immunization services.…”

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confidence: 99%

A dangerous measles future looms beyond the COVID-19 pandemic

Dürrheim

Andrus

Tabassum

et al. 2021

Nat Med

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Action needed now to prevent further increases in measles and measles deaths in the coming years

Cited by 36 publications

References 15 publications

Potential impact of COVID-19 pandemic on vaccination coverage in children: A case study of measles-containing vaccine administration in the United States (US)

Potential impact of COVID-19 pandemic on vaccination coverage in children: A case study of measles-containing vaccine administration in the United States (US)

Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study

A dangerous measles future looms beyond the COVID-19 pandemic

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