The Impact of War on Vaccine Preventable Diseases

Abstract

Introduction:During the war in Bosnia and Herzegovina, which lasted from 1992-1995, the functioning of all sectors was disturbed, including the health sector. The priority of the heath sector was treatment and less attention was paid to prevention, and this applies also to the Program of implementation of obligatory immunization, as one of the most important prevention measures. This program was conducted with difficulty and sometimes was completely interrupted because of the lack of necessary vaccines and the inability of adequate maintenance of the cold chain. It was difficult and sometimes completely impossible to bring children to vaccination. Because of these problems, a great number of children stayed unvaccinated so they suffered from vaccine-preventable diseases several years after the war.Materials and methods:This is a retrospective epidemiological study. We analyzed data from January 1994 to July 2014 in Canton Sarajevo, and data about measles outbreak in 2014.Results:In the period from January 1994 to July 2014, 3897 vaccine-preventable diseases were registered in Canton Sarajevo. Among them measles, rubella and mumps were the most frequent. In March 2014, measles outbreak was registered. Almost all cases are unvaccinated (99%) and 43% of all cases are connected with failure of vaccination during the war.Conclusion:During the war, routine immunization program was disrupted in Bosnia and Herzegovina (also in Canton Sarajevo). The consequences are presented as vaccine preventable diseases cases.

Changes in childhood vaccination coverage over time in the Democratic Republic of the Congo

“…However, the accuracy of these estimates are called into question as the Service Readiness and Availability assessment in 2014 found that while 75% of all facilities offered vaccination, only 42% of these facilities had the necessary equipment or personnel available on the day of the assessment [19]. Furthermore, armed conflict has impacted the country for decades, and reports suggest that both short-term [20] and prolonged interruptions in vaccination activities due to violence and unrest may result in increased child mortality and significant immunity gaps in both older children and adults [21,22]. Furthermore, official country estimates identified that coverage with a routine first dose of measles vaccine increased from 46% in 2000 to 92% in 2017; however, DRC has experienced large-scale outbreaks of measles in recent years [14,23].…”

Public Health Crisis: The Need for Primary Prevention in Failed and Fragile States

“…Polio is vaccine preventable and had a greatly diminishing incidence and prevalence until recent conflict and state instability in places like Afghanistan, Pakistan, states affected by the Arab spring and more recently Ukraine. The use of polio as an indicator of health security in war in recent research has been accepted as a barometer of health systems (23,24).…”

Measles, the need for a paradigm shift

“…Therefore, in some areas, vaccine shortages have made the coverage worse, as in Ukraine in 2016, a year when only 42% of infants were vaccinated [28], and currently in Madagascar, Chad and New Zealand [29]. Conflicts and wars also play a role in vaccine-preventable disease resurgence by disrupting health and prevention systems [30], as currently observed in Yemen [31] and Venezuela [32]. Finally, regional and global travel has significantly amplified the risk of importation and spread of the virus within susceptible areas and has re-introduced the disease in areas free of endemic transmission [29,33,34].…”