A new report highlights the largest increase in children not vaccinated for measles in two decades happened in 2020, and an Oklahoma pediatrician noted particular concern as the risk for outbreaks of the devastating disease grows.
“The last thing we need are preventable diseases returning,” said Dr. Eve Switzer, a pediatrician in Enid and immediate past president of the Oklahoma Chapter of the American Academy of Pediatrics.
Major measles outbreaks occurred in 26 countries and accounted for 84% of cases reported in 2020, according to a World Health Organization and U.S. Centers for Disease Control and Prevention report released this month.
Reported measles cases overall fell in 2020 compared to prior years, according to the report, but the surveillance for the highly contagious and potentially deadly disease deteriorated with the fewest specimens tested by labs in more than a decade. More than 22 million infants missed their first dose of measles vaccine in 2020, which is 3 million more than in 2019 and the largest increase in 20 years.
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Conditions are dangerous for outbreaks of measles to pop up, according to the report.
“While reported measles cases dropped in 2020, evidence suggests we are likely seeing the calm before the storm as the risk of outbreaks continues to grow around the world,” Dr. Kate O’Brien, director of WHO’s Department of Immunization, Vaccines and Biologicals, said in a statement. “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. Routine immunization must be protected and strengthened; otherwise, we risk trading one deadly disease for another.”
Switzer works in a two-pediatrician practice in Enid, typically administering more than 12,000 vaccine doses to youngsters each year.
Her practice saw a one-third to one-half drop in routine or wellness visits at the height of the pandemic in 2020. That equated to hundreds of missed immunization doses in her practice alone, Switzer said, and there are more than 60,000 pediatricians in the U.S.
The result of the pandemic is millions of missed vaccine doses in the U.S., she said.
“We’re currently overrun with patients — between trying to catch up kids who missed their appointments last year to acute infections of RSV and COVID and other organisms that we’re seeing right now,” Switzer said. “We’ve been seeing RSV all summer.”
Switzer explained how measles is so dangerous and potentially deadly.
A person with influenza on average infects one to two other individuals. A COVID case, in the pandemic’s beginning, on average infected two to three other people. The delta variant raised it to five to seven individuals.
A measles infection on average will spread to 15 to 18 more people — a “very, very contagious organism,” Switzer said.
She said measles complications include ear infections, pneumonia and diarrhea. About one in 100 cases end up in the hospital and one in 1,000 result in encephalitis — inflammation of the brain — which can lead to brain damage.
About one in 1,000 cases of measles lead to death, she added.
“The immune system suppression that happens can last for months to years after an acute (measles) infection, which opens the door to other infections,” Switzer said. “And then on top of that, seven to 10 years later about one per 10,000 cases develop something called Subacute sclerosing panencephalitis, or SSPE, which is 100% fatal.
“So suffice it to say measles is a very highly contagious and devastating disease.”
The Healthier Oklahoma Coalition, comprised of health care professional organizations such as the Oklahoma Chapter of the American Academy of Pediatrics, urges parents to ensure children’s vaccinations are up to date to keep them safe from vaccine-preventable diseases such as measles.
The WHO and CDC report that says progress toward eliminating measles worldwide continues to decline with the additional 3 million missed vaccinations in 2020 above 2019’s figure.
“For us pediatricians, that’s kind of scary,” Switzer said. “We’re the ones that get called to not only immunize these children to protect them from this disease, but we get called up to take care of them when they get sick.
“So this leaves our children vulnerable to not just one highly contagious and devastating disease but many diseases.”
Switzer called for an intentional effort to increase childhood immunizations.
State and local health departments can coordinate public health education campaigns. Schools and pediatricians can highlight vaccine safety and efficacy and the need for catch-up immunizations, too.
“We also need to support legislation that removes financial or administrative barriers to immunizations, “Switzer said. “We need policies implemented in health care to encourage vaccination.”
The New York Times reports cases of COVID-19 among children in the United States has risen 32% in the last two weeks
