Disclosures: Cain and O’Brien report no relevant financial disclosures.
November 10, 2021
2 min read

22 million infants went unvaccinated against measles in 2020, report warns

Disclosures: Cain and O’Brien report no relevant financial disclosures.
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In 2020, more than 22 million infants globally did not receive a first dose of measles vaccine — the largest number in 2 decades, according to a report published Wednesday in MMWR.

Although measles cases actually declined globally after hitting a 23-year high in 2019, Kate O’Brien, MD, MPH, director of WHO’s Department of Immunization, Vaccines and Biologicals, warned that this likely represents “the calm before the storm.”

Dixon MG, et al. MMWR Morb Mortal Wkly Rep. 2021;doi:10.15585/mmwr.mm7045a1.

“It’s critical that countries vaccinate as quickly as possible against COVID-19, but this requires new resources so that it does not come at the cost of essential immunization programs,” O’Brien said in a statement. “Routine immunization must be protected and strengthened; otherwise, we risk trading one deadly disease for another.”

According to a joint statement by the CDC and WHO, 24 measles vaccination campaigns in 23 countries were postponed last year because of the COVID-19 pandemic. As a result, in addition to a decrease in first-dose coverage of measles vaccine from 86% in 2019 to 84% in 2020, only 70% of children globally received their second measles vaccine dose last year, according to the new MMWR report — far below the 95% coverage needed to protect the population.

Researchers also reported a deterioration in measles surveillance, as WHO’s global network of measles and rubella laboratories received the lowest number of specimens for measles testing since 2010, despite large measles outbreaks occurring in 26 countries.

“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” CDC Global Immunization Director Kevin Cain, MD, said in a statement. “We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to prepandemic levels to prevent deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases.”

According to the MMWR report, from 2000 to 2010, coverage of first doses of measles-containing vaccine increased globally from 72% to 84% and peaked in 2019 at 86%.

Annual rates of measles cases decreased 88% from 2000 to 2016, from 145 cases per 1 million population to just 18. The rate rebounded in 2019 to 120 but then dropped again in 2020 to 22.

Annual measles deaths decreased by 94% from 2000 to 2020, from 1,072,800 to 60,700, with an estimated 31.7 million measles deaths averted, the researchers wrote.

The new report came just weeks after MMWR published a study showing that global coverage of vaccines against diphtheria and polio also declined in 2020.