Global measles threat: deaths increase by almost 50% in 2022

Measles is called the virus of inequality because the disease will find and attack those who are not protected

Measles, a vaccine-preventable disease, has shown alarming growth in recent years, according to a report released by the World Health Organization (WHO) and the United States Center for Disease Control and Prevention (CDC). According to “ Progress Toward Measles Elimination — Worldwide, 2000–2022 ,” the world saw a 43% increase in measles-linked deaths in 2022. Most of the 9.23 million infections and 136,200 deaths in 2022 occurred mainly among children, especially in poorer countries. An increase of 18% compared to the previous year. In a statement, the CDC explained that the increase in measles outbreaks and deaths is striking, but unfortunately not unexpected given the decline in vaccination rates in recent years.

The new report’s data further reveals that 37 countries faced sizable or disruptive measles outbreaks in 2022, a significant increase from the 22 countries affected the previous year. The impact was also disproportionate: 28 of these nations that faced the disease are in the African region, six in the Eastern Mediterranean, two in Southeast Asia and one in the European Region. The estimated coverage of the second dose of the measles vaccine increased from 17% in 2000 to 74% in 2022. However, 11 million children did not receive the second dose. The report estimates that 57 million potential measles deaths were prevented over a two-decade period (between 2000 and 2022) due to vaccination.

Regarding immunization rates, the document points out that in low-income countries, where the risk of death from measles is higher, between 2019 and 2021, vaccination coverage fell from 71% to 67%, and, in 2022, to 66%. %. Of the 22 million children who missed their first dose of measles vaccine in 2022, more than half live in just 10 countries: Nigeria (3 million), Democratic Republic of Congo (1.8 million), Ethiopia (1.7 million ), India (1.1 million), Pakistan (1.1 million), Angola (0.8 million), Philippines (0.8 million), Indonesia (0.7 million), Brazil (0.5 million) and Madagascar (0.5 million). These countries represented 55% of all children in the world who did not receive the first dose of the measles vaccine.

Vaccination has been one of the main concerns of health organizations, especially after, in 2021, the lowest level of immunization against measles since 2008 was reached. In the last two decades, measles outbreaks have even increased in countries where this was not expected, like Israel, France, Canada, Italy, Spain or Germany. The priority is focused on reinforcing vaccination in the poorest countries, where access to vaccines is difficult, as well as preventing possible drops in countries with higher immunization rates due to the growth in refusal of vaccination due to anti-vax movements. Vaccination coverage equal to or greater than 95% with two doses of measles vaccine can safely and effectively protect against the disease.

Brazil is no longer endemic

Brazil appears in the new WHO report among the 10 countries where the most children missed the first dose of the vaccine in 2022. The result highlights the setbacks in immunization in the country. In 2016, Brazil received certification of elimination of the virus. After having outbreaks recorded again in 2018, the measles-free country certificate was lost in 2019. In 2018, 9,325 cases of the disease were confirmed. The situation worsened in 2019, with 20,901 diagnoses. Since then, the numbers have been falling: 8,100 in 2020, 670 in 2021 and 41 in 2022. The last case was confirmed in June 2022, in the state of Amapá.

At the end of November, after 74 weeks without new records of the disease, Brazil was upgraded from “endemic country” to “country pending re-verification” of measles. To this end, joint actions are being implemented with states and municipalities to stop the circulation of the virus, mainly in four states: Amapá, Pará, Rio de Janeiro and São Paulo. In 2023, R$724.1 million were invested in health surveillance actions, state laboratories, immunobiologicals, training and immunization, with microplanning and multi-vaccination strategies. The new condition allows Brazil to begin the process of recertification as a measles-free country; category lost in 2019.

New platform facilitates access to information about vaccination coverage

With the aim of facilitating the visualization and monitoring of vaccination coverage rate indicators, the Instituto Questão de Ciências (IQC) launched the VacinaBR platform, an interactive virtual space with data, maps and graphs about vaccination in Brazil. The new virtual space, which was developed by the IQC Scientific Policy Observatory, with the support of the Brazilian Society of Immunizations (SBIm), aims to contribute to providing more transparency to immunization actions in the country and facilitate access to this information for researchers, managers, health professionals and journalists. As it is easy to access and intuitive to use, the platform can also be used by anyone interested in this information.