The largest sustained decline in childhood vaccinations in 30 years has been recorded in official data published recently by WHO and UNICEF.
It is the worst figure in a generation. The WHO called it “a red alert for child health.”
The percentage of children who received three doses of the vaccine against diphtheria, tetanus, and pertussis (DTP3) – a marker for immunization coverage within and across countries – fell 5 percentage points between 2019 and 2021 to 81%
As a result, 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone. This is 2 million more than those who missed out in 2020 and 6 million more than in 2019.
First dose measles coverage dropped to 81% in 2021, also the lowest level since 2008. This meant 24.7 million children missed their first measles dose in 2021, 5.3 million more than in 2019. A further 14.7 million did not receive their needed second dose.
The decline was due to many factors including an increased number of children living in conflict and fragile settings where immunization access is often challenging, increased misinformation and Covid-19 related issues such as service and supply chain disruptions, resource diversion to response efforts, and containment measures that limited immunization service access and availability.
But even before Covid-19 impacted us all in 2018, 140 000 people – mostly babies and children under five – died worldwide from measles. A tragedy.
Globally, over a quarter of the coverage of the human papillomavirus (HPV) vaccines that was achieved in 2019 has been lost. This has grave consequences for the health of women and girls, as the global coverage of the first dose of is only 15%, despite the first vaccines being licensed over 15 years ago.
This historic backsliding in rates of immunization is happening against a backdrop of rapidly rising rates of severe acute malnutrition. A malnourished child already has weakened immunity and missed vaccinations can mean common childhood illnesses quickly become lethal to them. The convergence of a hunger crisis with a growing immunization gap threatens to create the conditions for a child survival crisis.
Malnutrition is real in our country. One in four children under the age of five are stunted, a sign of chronic undernutrition that has remained unchanged for 20 years. And 30% of children live below the food poverty line in households with a per capita income of less than R571 per month.
The measles outbreak we had recently in the Tshawne district is over, but we may not be so lucky in the future. It is estimated that about 95% of the population needs to be vaccinated against measles to properly control the spread of this highly contagious virus.
In 2017, there were three measles outbreaks in South Africa, specifically in the Western Cape, Gauteng and KwaZulu-Natal provinces. These outbreaks largely occurred in communities who were unvaccinated or had low vaccination coverage, according to a report from the National Institute for Communicable Diseases. Vaccination against measles started in 1975 and the two-dose regimen was adopted in 1995.
Measles is not an innocent, childhood disease.
Before the introduction of measles vaccination, measles caused substantial human disease and death worldwide, infecting nearly everyone by 15 years of age. Measles was common in all parts of the world and caused an estimated 135 million cases and more than 6 million deaths globally each year.
Common complications are ear infections and diarrhoea. Serious complications include pneumonia and encephalitis. It can cause life-long disability and like some other viral infections it can cause secondary immunodeficiency, even years after the fact. This ‘’immune amnesia” leaves survivors vulnerable to other potentially deadly diseases, like influenza or severe diarrhoea, by harming the body’s immune defences.
Vaccines have always been targets of misinformation and disinformation. It became clear during Covid-19 that damaging falsehoods cost lives.
William Bird, form Media Monitoring Africa, recently spoke about disinformation on the HASA conference. He explained that disinformation is the dissemination of false information with the intention to cause harm. Misinformation is the dissemination of false information.
Disinformation undermines our ability to trust and ultimately, the key institutions in a democracy are undermined. He pointed out that they undermined credibility, crush the truth and most of all take advantage of a public who cannot understand the difference between rubbish information and the truth. They play on existing biases. And where there is an information gap, they fill it with lies.
So, what does this have to do with measles and vaccines? Everything. Every social media post you have seen that claims childhood vaccines are dangerous and cause autism; that they contain toxins; that “natural immunity” is better than vaccine acquired immunity; that they are unsafe and untested; that we do not need to vaccinate because infection rates are low and that childhood diseases are not dangerous, are lies.
Lies which chips away at public health.
Every one of us needs to be an ambassador for childhood vaccines, and share scientifically sound information about it. And if you see disinformation or misinformation in South African on social media, report it here: https://real411.org.za/
