A record high of nearly 40 million children have missed a measles vaccine dose in 2021, said the World Health Organization, pointing to the backslide in vaccination coverage during the Covid-19 pandemic.

This was a concern fore-warned by several global public health voices, early in the pandemic and the latest development comes even as India too reports measles cases, in Maharashtra, Kerala, Gujarat and Jharkhand, for instance.

About 25 million children missed their first dose and an additional 14.7 million missed their second dose, a joint publication by the WHO and the United States Centers for Disease Control and Prevention (CDC) said. This decline is a setback in global progress towards achieving and maintaining measles elimination and leaves millions of children susceptible to infection, it added.

“In 2021, there were an estimated 9 million cases and 128,000 deaths from measles worldwide. Twenty-two countries experienced large and disruptive outbreaks. Declines in vaccine coverage, weakened measles surveillance, and continued interruptions and delays in immunization activities due to Covid-19, as well as persistent large outbreaks in 2022, mean that measles is an imminent threat in every region of the world,” the report said.

“The paradox of the pandemic is that while vaccines against Covid-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programmes were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Getting immunization programmes back on track is absolutely critical. Behind every statistic in this report is a child at risk of a preventable disease.,” he added.

The situation is grave: measles is one of the most contagious human viruses, but is almost preventable through vaccination, the UN health agency said. Coverage of 95 per cent or greater of 2 doses of measles-containing vaccine is needed to create herd immunity to protect communities and achieve and maintain its elimination. “The world is well under that, with 81 per cent of them receiving their first measles-containing vaccine dose, and only 71 per cent the second ,” the report said, adding, “these were the lowest global coverage rates of the first dose of measles vaccination since 2008, although coverage varies by country.”

No measles elimination, yet

Pointing out that measles anywhere is a threat, as the virus spreads to multiple communities and across international borders, the report said, that no WHO region had achieved and sustained measles elimination. Since 2016, ten countries that had previously eliminated measles experienced outbreaks and reestablished transmission.

In 2021, nearly 61 million measles vaccine doses were postponed or missed due to Covid-19-related delays in immunization campaigns in 18 countries. “Delays increase the risk of measles outbreaks, so the time for public health officials to accelerate vaccination efforts and strengthen surveillance is now,” the report said.

“For three years, we have been sounding the alarm about the declining rates of vaccination and the increasing risk to children’s health globally. Widening gaps in immunization coverage are letting measles – the most contagious yet vaccine-preventable killer disease – spread and cause illness and death. We have a short window of opportunity to urgently make up for lost ground in measles vaccination and protect every child. The time for decisive action is now,” said Ephrem Tekle Lemango, UNICEF Chief of Immunization.