While the world is understandably focused on countering the coronavirus pandemic, a secondary global public health crisis has been brewing: a drop-off in vaccination rates against a range of other dangerous infectious diseases.
A year ago, when much of the world’s population began to socially distance to reduce the spread of COVID-19, an unfortunate consequence of that countermeasure was a steep decline in the number of children receiving their routine vaccinations for diseases such as measles, rubella and polio.
Comprehensive figures are not yet available for how many children around the world have missed their shots in the past year because of COVID-19, but experts say it is a serious worry.
“I am very concerned that a lot of children are not getting the vaccinations they would normally have received, and I think that’s another issue underneath the pandemic that we’re going to have to address,” Sen. Rob Portman of Ohio, the top Republican on the Senate Foreign Relations subcommittee with oversight of international development, told CQ Roll Call.
Last May, the World Health Organization, UNICEF and Gavi, a multilateral public-private initiative that provides vaccines to the world’s poorest countries, warned that roughly 80 million children were at risk of missing their routine vaccinations as a result of the coronavirus pandemic. And in July, those U.N. agencies said that for the first time in nearly three decades, the world could see a decrease in the number of people who are vaccinated against diphtheria, tetanus and pertussis because of a “substantial drop” in children receiving their necessary three shots of the DTP3 vaccine.
During the first half of 2020, some 101 mass vaccination campaigns were canceled across 56 countries, according to an op-ed last month in the journal Nature Medicine.
Particularly worrisome have been breakdowns in the vaccination schedules for children receiving their shots against measles, which is the most infectious virus in the world. Even before the COVID-19 outbreak, alarm bells were ringing about the growing spread of measles, as 2019 saw the highest rates of new measles infections in more than two decades.
“One deadly, highly infectious virus — measles — is unforgiving of immunity gaps and is certain to resurge after the COVID-19 pandemic, with a resultant catastrophic impact on young lives,” reads the Nature op-ed, written by a group of six public health experts from Australia, Bangladesh, Kenya, Germany, Syria and the United States.
The experts warn that higher rates of malnutrition among the world’s poor children, another consequence of the coronavirus pandemic’s impact on global food supplies, may lead to an uptick in measles-related deaths.
“The impact of COVID-19 on both routine immunization and campaigns canceled in the countries at highest risk will provide the perfect conditions for a post-pandemic measles catastrophe, unless appropriate action is taken now,” the group said. “Countries must prioritize ‘catch-up’ vaccination so that children who have missed out are not left vulnerable.”
According to a survey of 82 nations conducted by UNICEF, WHO and Gavi last May, three-quarters of the participating countries reported that the pandemic had caused disruptions to their immunization programs, including jeopardizing plans for at least 30 measles inoculation campaigns.
Poliovirus could resurge
The World Health Organization also raised alarms in November about an expected increase in poliovirus transmission in Afghanistan, Pakistan and many areas of Africa. The global health body warned that failure to deal with the brewing polio crisis could spawn a worldwide revival of the disease, with as many as 200,000 new cases annually in the next decade.
Vaccine campaigns have been hindered for a variety of reasons, including individuals’ fear of leaving home and being exposed to the coronavirus at a health clinic; disrupted transportation systems; economic hardship; government-imposed restrictions on freedom of movement; and fewer available health workers to administer vaccines because of a lack of personal protective equipment or travel restrictions.
Additionally, many adults around the world are now at heightened risk of catching and spreading sexually transmitted diseases, including deadly ones such as HIV, because fewer people are seeking testing and treatment as a result of some of the obstacles created by the pandemic.
“Remember, we still have a second pandemic, which has been swept underneath the carpet now, which is the HIV pandemic,” John Nkengasong, director of the Africa Centres for Disease Control and Prevention, said during an online Brookings Institution discussion in February.
He noted that HIV, malaria and tuberculosis already kill about 1.2 million Africans annually.
“My fear is that COVID is going to aggravate those conditions, because we are not paying appropriate attention to those,” Nkengasong said.