27-March-2024-Editorial

MEASLES ACCOUNTED FOR MOST EXCESS DEATHS AS A RESULT OF COVID-19 RELATED VACCINE DISRUPTIONS

The COVID-19 pandemic has significantly disrupted global immunization efforts, leading to concerns about increased disease burden and outbreak risks.

A recent study published in The Lancet Global Health titled “Estimating the Health Effects of COVID-19-Related Immunization Disruptions in 112 Countries During 2020–30: A Modelling Study” sheds light on these challenges and provides recommendations for mitigating their impact.

Key Highlights of the Report:

Global Immunisation Decline:

• The pandemic caused a decline in global immunization coverage, potentially resulting in increased disease burden and outbreak risks.
• Disruptions to vaccination programs for diseases such as Measles, Rubella, HPV, Hepatitis B, meningitis A, and yellow fever could lead to approximately 49,119 additional deaths from 2020 to 2030.
• Overall, disruptions in vaccination coverage across 14 pathogens may result in a 2.66% reduction in the long-term effect, translating to fewer deaths averted.

Importance of Catch-Up Vaccines:

• Catch-up vaccination activities are crucial, especially for diseases like measles and yellow fever, which experienced an immediate increase in burden post-pandemic.
• These activities have the potential to prevent approximately 79% of excess deaths related to certain diseases.

Impact on DTP Vaccine Coverage:

• The pandemic affected coverage for Diphtheria, Tetanus, and Pertussis (DTP) vaccines, leading to an additional 6 million children missing out on vaccination globally in 2021.

Resurgence of Measles Cases:

• Several countries reported a resurgence of measles cases, including those where measles was previously eradicated.
• In 2021, around 61 million measles vaccine doses were postponed or missed due to COVID-19-related delays.
• There was an increase in measles cases and deaths globally in 2022 compared to 2021, with millions of children missing vaccine doses, particularly in countries like Nigeria, Pakistan, and India.

Recommendations:

• Implementing catch-up vaccination activities could potentially avert 78.9% of excess deaths between 2023 and 2030.
• Timely and targeted implementation of catch-up vaccination activities tailored to specific cohorts and regions is crucial.
• Continued immunization efforts, especially for vaccines like HPV, are essential for long-term public health benefits.

Major Initiatives Related to Immunisation:

Global:

• Immunisation Agenda 2030 (IA2030): A global vision and strategy aiming to reduce by 50% the number of children receiving zero vaccine doses, achieve 500 introductions of new or under-utilised vaccines, and attain 90% coverage for essential childhood vaccines by 2030.
• World Immunisation Week: Celebrated annually in the last week of April to raise awareness about the importance of immunization.
• Big Catch-Up Initiative: Launched by organizations like WHO, UNICEF, and the Bill & Melinda Gates Foundation to boost vaccination among children following declines driven by the COVID-19 pandemic.

Indian:

• Universal Immunization Programme (UIP): Provides free immunization against 12 vaccine-preventable diseases nationally and three diseases sub-nationally, including milestones such as polio eradication in 2014 and elimination of maternal and neonatal tetanus in 2015.
• Mission Indradhanush: Launched in 2014 by the Ministry of Health and Family Welfare to vaccinate all unvaccinated and partially vaccinated children under the UIP, implemented in several phases.