Measles accounted for most excess deaths as a result of COVID-19 related vaccine disruptions

Global immunisation declined during the COVID-19 pandemic, increasing disease burden and outbreak risk, new research has suggested. A new paper published in journal The Lancet Global Health measured the consequences of disrupting several vaccines as part of routine and campaign immunisation services in 112 countries between 2020 and 2030 for 14 pathogens.

The researchers at Imperial College London estimated the excess burden of yellow fever, Human papillomavirus (HPV), rubella, measles and hepatitis B at 49,000 additional deaths, with measles accounting for most of them. The paper emphasised the importance of catch-up vaccines, which is the vaccination of an individual who has missed it according to schedule. 

Read more: WHO launches ‘The Big Catch-Up’ to restore immunisation progress lost during pandemic

The burden for measles and yellow fever increased immediately after the pandemic, the researchers found, noting that the two diseases are good candidates to administer catch-up vaccines. For measles, the potential was high in the World Health Organization’s African and South-East Asia regions.

The researchers studied vaccine breaks for 14 diseases: Yellow fever, rotavirus, Japanese encephalitis, typhoid, measles, meningitis A, rubella, tetanus, diphtheria, pertussis, HPV, hepatitis B and haemophilus influenzae type b or HIB. They found the excess deaths amounted to 967,000 deaths and that catch-up activities could avert 79 per cent of excess deaths with vaccination for measles, rubella, HPV, hepatitis B, and yellow fever.

The pandemic impacted coverage for diphtheria, tetanus and pertussis (DTP) vaccine, with an additional 6 million missing out in 2021. An analysis by the WHO and the United Nations Children’s Fund (UNICEF) found that 25 million children worldwide missed the DTP vaccine. In India, over 3 million did not take the first dose of DTP in 2020, doubling from 2019, the WHO and UNICEF said.

Read more: Africa needs to vaccinate 33 million children within 2 years to be on global immunisation track: WHO

A resurgence of measles cases has been reported in several countries recently, even in countries like the United Kingdom and the United States where it was considered eradicated. In 2021, the WHO stated nearly 61 million measles vaccine doses were postponed or missed due to COVID-19-related delays in immunisation campaigns in 18 countries.

In 2022, the WHO reported an increase in measles cases by 18 per cent and deaths by 43 per cent globally relative to 2021 levels. In 2022, 22 million children missed their first dose of the vaccine and 11 million children missed their second dose. Over half of the 22 million live in Nigeria, Pakistan, the Philippines, the Republic of the Congo, Ethiopia, India, Indonesia, Angola, Brazil and Madagascar.