There was a 30% increase in measles cases worldwide in 2018.
Given this, overcoming ‘vaccine hesitancy’ is crucial to reduce the global spread of measles infection.
What is measles?
Measles is a highly contagious viral disease.
It is transmitted via droplets from the nose, mouth or throat of infected persons.
Initial symptoms, which usually appear 10-12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth.
Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.
How significant is vaccine?
Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.
Measles viruses kill immune cells, leaving the child vulnerable to infectious diseases for two to three years.
So, measles vaccine not only provides lifelong protection against the virus but also reduces mortality from other childhood infections.
What is vaccine hesitancy?
Vaccine hesitancy is defined as the reluctance or refusal to vaccinate despite the availability of vaccines.
The threat from vaccine hesitancy appears to have grown more dangerous to public health.
With rise in measles cases in 2018, the WHO, in January 2019, included ‘vaccine hesitancy’ as one of the 10 threats to global health in 2019.
How is measles prevalence at present?
After a surge in measles cases in 2018, there have been around 3,65,000 measles cases reported from 182 countries in the first 6 months of 2019.
The biggest increase, of 900% in the first 6 months of 2019 compared with the same period last year, has been from the WHO African region.
(The Democratic Republic of the Congo, Madagascar and Nigeria accounted for most cases.)
There has been a sharp increase in the WHO European region too, with 90,000 cases being recorded in the same period.
This was more than the numbers recorded for the whole of 2018.
The infection spread in the European region has been unprecedented in recent years.
Recently, the U.K., Greece, the Czech Republic and Albania lost their measles elimination status.
How is vaccine confidence in Europe?
A 2018 report on vaccine confidence among the European Union member states gives insights into the reasons for less vaccine coverage.
It shows why vaccine coverage has not been increasing in the European region to reach over 90% to offer protection even to those not vaccinated.
There, younger people (18-34 years) and those with less education are less likely to agree that the measles, mumps, and rubella (MMR) vaccine is safe.
Only 52% respondents from 28 EU member states agree that vaccines are definitely effective in preventing diseases; a 33% felt they were probably effective.
More alarming is that 48% of the respondents believed that vaccines cause serious side effects.
38% of them think vaccines actually cause the disease that they are supposed to protect against.
What is the case with India?
45% of children missed different vaccinations in 121 Indian districts that have higher rates of unimmunised children.
A 2018 study found low awareness to be the main reason for this.
While 24% did not get vaccinated due to apprehension about adverse effects, 11% were reluctant to get immunised for reasons other than this.
What lies ahead?
Much work remains to be done to address misinformation.
Social media plays a crucial role in spreading vaccine misinformation.
A commitment by Facebook to reduce distribution of vaccine misinformation can go a long way in addressing vaccine hesitancy.
