The final week of April saw the passing of World Immunization Week. Organizations, notably the United Nations Children’s Fund (UNICEF), used this as an opportunity to shed light on the importance of vaccination amid the global pandemic. Last year, over 13 million children went unvaccinated. There are fears that immunization rates will decrease further in the face of COVID-19.
Fortunately, demographic data has shown that children represent a small percentage of coronavirus sufferers. One study, performed by the Chinese Centre for Disease Control and Prevention, found that children accounted for fewer than one percent of 72,314 reviewed cases. Similar results were found in the United States. The Centers for Disease Control and Prevention (CDC) discovered that pediatric patients made up only 1.7 per cent of 149,082 studied cases.
Although children have, for the most part, been spared from coronavirus infection, they are not immune to all diseases. The chief of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, is concerned that some countries have suspended vaccination campaigns for certain diseases. These include polio, measles, cholera, human papillomavirus, yellow fever, and meningitis. If countries had not suspended campaigns, they could have administered vaccines to over 13 million people. Commenting on the suspension, the WHO chief said, “the tragic reality is that children will die as a result.”
Since the suspension of vaccination services, a recent outbreak of polio struck Niger. The UN health agency reported that two children were infected with the virus, and one has since become paralyzed. Polio is highly contagious and tends to affect children under the age of five. Much like other infectious diseases, polio requires herd immunity to be eradicated. Poliovirus, in particular, necessitates a vaccination rate of around 80%-85%. The WHO’s coordinator of polio eradication in Africa, Pascal Mkanda, believes that the virus is bound to circulate now that immunization campaigns have been put on hold.
Every year, over 20 million children under the age of one do not have access to vaccines for diseases like measles and polio. These figures do not account for the effects of COVID-19. UNICEF has called for countries to continue delivering immunization services despite the pandemic. The organization intends to double down on its support efforts by providing vaccine supplies to areas vulnerable to outbreaks. So far, UNICEF has delivered vaccine supplies and personal protective equipment to the Democratic Republic of Congo. It aims to ensure that the country can continue administering vaccines in the North Kivu province, an area where 3,000 cases of measles were confirmed this year alone.
UNICEF is partnering with the organizations Gavi, the Vaccine Alliance and the Measles & Rubella Initiative. It is urging governments and donors to prioritize making up for missed vaccinations once quarantine measures have been lifted. In a statement, the CEO of Gavi, the Vaccine Alliance, Dr. Seth Berkley, said, “The legacy of COVID-19 must not include the global resurgence of other killers like measles and polio.” The alliance also stresses that, once developed, the coronavirus vaccine must be delivered to those most in need.
As hospitals prioritize emergency cases, vaccine rates in developed countries have, unsurprisingly, fallen. Physician’s Computer Company, a pediatric software firm, surveyed 1,000 pediatricians across the U.S. (the country with the most reported cases of coronavirus). The company compared vaccination rates between February 16th, when there were roughly 60,000 confirmed cases of the virus worldwide, and April 5th, when cases surpassed one million. It found that vaccination rates for measles, mumps, and rubella decreased by 50 per cent. Additionally, vaccines for diphtheria and whooping cough fell by 42 per cent, and HPV vaccines declined by 73 per cent. One of the major concerns is that young children will miss booster shots during the pandemic. This leads to fears that their immunity will deteriorate as a consequence. Adolescents are also at risk of neglecting critical vaccines for viruses like meningitis and HPV.
Even though poorer countries are more affected, affluent nations are also susceptible to disease outbreaks. This is particularly true for the measles virus. Measles is highly contagious; it is airborne and also spreads by contact with infectious droplets. Around 90% of susceptible individuals, meaning those without antibodies to the virus, will become infected with measles if exposed. Accordingly, the WHO recommends a vaccination rate of 95% to protect a population from measles. But, over the past decade, global trends for measles vaccinations have stagnated at rates well below the WHO’s recommendation. Both UNICEF and the WHO approximate that 86% of children across the globe received the first dose of the measles vaccine in 2018. Fewer than 70% received the second dose. The same year saw over 140,000 deaths caused by the virus. In the U.S., the CDC reported over 1,200 cases of measles in 2019, where 89% of those infected had been unvaccinated. The U.S. had eradicated the virus in 2000. However, reports from 2019 marked the highest number of measles cases in the country in the past 25 years. Recording an infant vaccination rate of 79%, France has also experienced a spike in measles cases. The country faced an increase of over 1,000 cases between November of 2017 and March of 2018 alone. Four other countries in Europe (Albania, Czechia, Greece, and the United Kingdom) lost their measles elimination status in 2018. This means that, before its reappearance, the countries had eradicated the virus and its transmission for over one-year.
The best estimates show a treatment for coronavirus released in a year, at the earliest. Dozens of potential coronavirus vaccines and treatments are currently in their clinical trial phases. Healthcare researchers have been able to expedite the progress of research and testing with the knowledge acquired from past viruses. These include the Ebola virus as well as other respiratory coronaviruses like SARS and MERS. Although a vaccine for coronavirus has yet to be developed, vaccines for other serious diseases are accessible. In most parts of the developed world these are readily available. If anything, the coronavirus pandemic serves as a reminder that vaccines must not be taken for granted. Where possible, organizations such as UNICEF, the CDC, and the WHO all recommend that parents continue to vaccinate their children for the duration of the pandemic. This will ensure that children are properly immunized once reintegration measures are in place.
An outbreak of preventable diseases could be a by-product of coronavirus if vaccination rates remain low. Disinformation surrounding coronavirus has engendered mistrust in the scientific community. Still, it is paramount that parents maintain their confidence in science, and vaccinate their children when it is safe to do so. The international community must continue their delivery of immunization supplies to countries in need. If possible, governments must also sustain their provision of immunization services. The severity of other preventable diseases must not be overlooked because of COVID-19.
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