Cases of measles infections and deaths worldwide rose by double digits in 2022 after vaccination rates declined amid the pandemic, with one U.S. health official characterizing the surge as “staggering.”
Global measles cases rose by 18 percent in 2022 from a year ago, with deaths surging by 43 percent, according to a Nov. 17 report by the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). The report attributes this increase to millions of children missing measles vaccination during the COVID-19 pandemic.
Most of the 9.23 million measles infections and 136,200 deaths last year were found to be largely among children. Last year, the number of nations reporting large or disruptive outbreaks of measles jumped to 37 from 22, out of which 28 countries were in Africa.
“The increase in measles outbreaks and deaths is staggering, but unfortunately, not unexpected given the declining vaccination rates we’ve seen in the past few years,” said John Vertefeuille, director of CDC’s Global Immunization Division, according to a Nov. 16 press release.
“Measles cases anywhere pose a risk to all countries and communities where people are under-vaccinated. Urgent, targeted efforts are critical to prevent measles disease and deaths,” he said.
The report estimates that 57 million potential measles deaths have been averted during a two-decade period between 2000 and 2022 due to vaccination. The WHO and the CDC urged countries to “find and vaccinate all children against measles,” per the release.
Between 2000 and 2019, global measles vaccine coverage for the first dose rose from 72 to 86 percent. But in 2021 amid the pandemic, this fell to 81 percent—the lowest coverage level since 2008. Last year, first-dose coverage rose slightly to 83 percent.
The health agencies pointed out that there were still 33 million kids who missed a dose of the measles vaccine—22 million missing their first dose and 11 million their second.
While the first dose coverage worldwide was at 83 percent, the second dose coverage was 74 percent, both of which are well below the 95 percent two-dose coverage deemed necessary to prevent community outbreaks.
Low-income nations had the highest risk of death from measles and the lowest vaccination rate at only 66 percent. Out of the 22 million kids who missed their first dose, more than half lived in 10 countries—Angola, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Madagascar, Nigeria, Pakistan, and the Philippines.
“The lack of recovery in measles vaccine coverage in low-income countries following the pandemic is an alarm bell for action. Measles is called the inequity virus for good reason. It is the disease that will find and attack those who aren’t protected,” said Kate O’Brien, WHO Director for Immunization, Vaccine and Biologicals.
“Children everywhere have the right to be protected by the lifesaving measles vaccine, no matter where they live,” he added.
Infection and Vaccination
According to the CDC, measles can cause “serious health complications, especially in children younger than 5 years of age.”
One out of five individuals who get measles will end up getting hospitalized. One out of 1,000 measles patients will develop brain swelling, potentially leading to brain damage. And one to three out of 1,000 measles patients will die, “even with the best case,” the agency stated.
It pointed out that measles is a “very contagious” disease that can spread through the air when an infected individual sneezes or coughs.
“It is so contagious that if one person has it, up to 9 out of 10 people around him or her will also become infected if they are not protected. Your child can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left,” the CDC warns.
“An infected person can spread measles to others even before knowing he/she has the disease—from four days before developing the measles rash through four days afterward.”
The CDC recommends children to be immunized with a measles-mumps-rubella (MMR) vaccine that provides “long-lasting protection against all strains of measles.”
The first dose of the vaccine is given to children between 12 and 15 months of age. The second dose is given at four to six years of age.
Childhood vaccination rates have been falling in recent years, including MMR rates. A January report from the CDC pointed out that state-required vaccines among kindergarten students fell to 94 percent in the 2020-21 school year compared to 95 percent in the previous year. This declined further to approximately 93 percent in the 2021–22 school year.
“Nationally, MMR coverage for both the 2020–21 and 2021–22 school years was lower than that reported since 2013–14,” the report said.
In a November 2022 op-ed at the nonprofit media outlet CommonWealth Beacon, Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center, suggested that the “politicized” rollout of COVID-19 vaccines and the subsequent distrust of government institutions could be affecting MMR vaccination.
Childhood vaccination rates for conditions like influenza, polio, and measles are dropping, “suggesting that people who would have vaccinated their children in the past are starting to think differently about vaccines,” she wrote.
“In addition to being a critical public health concern, this represents a serious issue with trust in public health authorities and their messengers. And it is these ‘science communicators’ who need to take ownership of their messaging failures and fix the problem before it is too late,” she added.
As far as the United States is concerned, measles was declared to have been eliminated from the country in 2000 “thanks to a highly effective vaccination program,” per the CDC.
However, a few cases are reported annually. In 2021, there were 49 cases, which rose to 121 infections in 2022. As of Nov. 2 this year, 41 measles cases were reported.