Should the immunization for vaccine-preventable diseases be halted or postponed during the pandemic?
Summary:
- Vaccine-preventable diseases are reoccurring around the world due to decreased levels of vaccinations.
- Halting and postponing routine immunization can cause another epidemic or even pandemic following current COVID-19 pandemic.
- It is very important to follow official guidelines regarding immunization procedures and the current COVID-19 pandemic.
COVID-19 pandemic is still on the rise worldwide as number of infected people currently (11.05.2020) reached almost 4’000’000 [1]. With the high risk of infection with the SARS-CoV-2 virus, many people started to be reluctant to follow the usual vaccination protocol for their children [2, 3]. These decisions are mainly driven by fear of further transmission of COVID-19. Fortunately, many pediatricians took steps to make vaccination more accessible during these challenging times.
The current pandemic also causes forced delays of immunization against vaccine-preventable diseases [4]. In the face of COVID-19, vaccination campaigns in developing countries are put on hold. With very prohibitive access to health care, many countries might face outbreaks of diseases such as polio or measles. Based on recorded cases, measles was responsible for around 140’000 deaths in 2018 alone.
Measles is extremely contagious, but it has been on its path toward eradication since the vaccination was introduced in 1963 [5]. A measles infection can lead to severe complications, such as persistent diarrhea, pneumonia, bacterial superinfections, measles encephalitis, or even death. Unfortunately, in countries like the United States, the number of infection cases has recently started to grow again due to vaccine refusal initiatives. Of the people diagnosed with the measles in 2013 in New York, 78% of cases were as a result of refusal to inoculate or an intentional delay of the immunization [6].
The growing resurgence of the measles can also be spotted in Europe [7]. European Union officials recorded 14’732 cases of measles between February 2017 and January 2018. Even before the current pandemic, the vaccination coverage in countries like Italy was 10% below the threshold for herd immunity (95%) [7-9].
On top of the conscious decision of some individuals to refuse vaccination, recent history shows us that the ongoing pandemic can cause even further damage [10]. During the Ebola epidemic in Guinea between 2014 and 2015, immunization programs were stopped to prevent the spread of the virus. That resulted in a measles outbreak in this country in the months directly following the Ebola outbreak.
Measles is just one of the diseases which could potentially cause an epidemic. That is why the level of routine immunizations should not decrease during the COVID-19 pandemic. Accordingly, the WHO is calling for not to stop routine immunizations now [11]. It is of paramount importance not to exchange or, what is even worse, enforce SARS-CoV-2 with any other pathogen.
References:
- WHO, Coronavirus disease (COVID-19) Situation Report – 111. 2020, World Health Organization.
- Pawlowski, A., Vaccine rate drop is ‘huge concern’ for pediatricians during pandemic, in TODAY. 2020.
- Villarreal, A., Delays in childhood vaccinations could lead to outbreaks, experts warn, in The Guardian. 2020.
- Roberts, L., Pandemic brings mass vaccinations to a halt. Science, 2020. 368(6487): p. 116-117.
- Porter, A. and J. Goldfarb, Measles: A dangerous vaccine-preventable disease returns. Cleve Clin J Med, 2019. 86(6): p. 393-398.
- Rosen, J.B., et al., Public Health Consequences of a 2013 Measles Outbreak in New York City. JAMA Pediatr, 2018. 172(9): p. 811-817.
- Siani, A., Measles outbreaks in Italy: A paradigm of the re-emergence of vaccine-preventable diseases in developed countries. Prev Med, 2019. 121: p. 99-104.
- Thompson, K.M., Evolution and Use of Dynamic Transmission Models for Measles and Rubella Risk and Policy Analysis. Risk Anal, 2016. 36(7): p. 1383-403.
- Coughlin, M.M., et al., Perspective on Global Measles Epidemiology and Control and the Role of Novel Vaccination Strategies. Viruses, 2017. 9(1).
- Suk, J.E., et al., Post-Ebola Measles Outbreak in Lola, Guinea, January-June 2015(1). Emerg Infect Dis, 2016. 22(6): p. 1106-8.
- WHO, Guidance on routine immunization services during COVID-19 pandemic in the WHO European Region. 2020, World Health Organization.