Between 2010-17, 2.9 mn Indian kids missed out on measles vaccine

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UNICEF estimates that 169 million children, of them, 2.9 million in India, missed out on the first dose of the measles vaccine between 2010 and 2017

An estimated 169 million children, of them, 2.9 million in India, missed out on the first dose of the measles vaccine between 2010 and 2017, or 21.1 million children a year on average, UNICEF said today.

Widening pockets of unvaccinated children have created a pathway to the measles outbreaks hitting several countries around the world today. “The ground for the global measles outbreaks we are witnessing today was laid years ago,” said Henrietta Fore, UNICEF Executive Director. “The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike.”

In the first three months of 2019, more than 110,000 measles cases were reported worldwide – up nearly 300 per cent from the same period last year. An estimated 110,000 people, most of them children, died from measles in 2017, a 22 per cent increase from the year before.

India with its large annual birth cohort of 25 million has 2.9 million children missing the first dose of the measles vaccine, despite a coverage of 88 per cent, followed by Pakistan and Indonesia (1.2 million each), and Ethiopia (1.1 million)

Two doses of the measles vaccine are essential to protect children from the disease. However, due to lack of access, poor health systems, complacency, and in some cases fear or skepticism about vaccines, the global coverage of the first dose of the measles vaccine was reported at 85 per cent in 2017, a figure that has remained relatively constant over the last decade despite population growth. Global coverage for the second dose is much lower, at 67 per cent. The World Health Organization recommends a threshold of 95 per cent immunization coverage to achieve so-called ‘herd immunity’.

Top ten high-income countries where children not vaccinated with the first measles vaccine dose 2010 - 2017

In high income countries, while coverage with the first dose is 94 per cent, coverage for the second dose drops to 91 per cent, according to the latest data.

The United States tops the list of high-income countries with the most children not receiving the first dose of the vaccine between 2010 and 2017, at more than 2.5 million. It is followed by France and the United Kingdom, with over 600,000 and 500,000 unvaccinated infants, respectively, during the same period.

In low- and middle-income countries, the situation is critical. In 2017, for example, Nigeria had the highest number of children under one year of age who missed out on the first dose, at nearly 4 million. India with its large annual birth cohort of 25 million has 2.9 million children missing the first dose of the measles vaccine, despite a coverage of 88 per cent, followed by Pakistan and Indonesia (1.2 million each), and Ethiopia (1.1 million).

Worldwide coverage levels of the second dose of the measles vaccines are even more alarming. Of the top 20 countries with the largest number of unvaccinated children in 2017, 9 have not introduced the second dose. Twenty-countries in sub-Saharan Africa have not introduced the necessary second dose in the national vaccination schedule, putting over 17 million infants a year at higher risk of measles during their childhood.

“Measles is far too contagious,” said Fore. “It is critical not only to increase coverage but also to sustain vaccination rates at the right doses to create an umbrella of immunity for everyone.”