Nearly 40 Million Children Around the World Are At Risk For Measles

Disruptions in routine childhood vaccinations during the pandemic threatens progress against this highly contagious disease.

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Medically reviewed in December 2022

Updated on December 6, 2022

Nearly 40 million children around the world are at risk for measles due to disruptions in routine childhood vaccinations during the COVID pandemic, according to a joint report from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).  Some 25 million kids missed their first dose of the two-dose MMR (measles-mumps-rubella) vaccine, and another 14.7 million missed their second MMR shot, the November 23 report found.

Health officials warn this worrisome trend marks a major setback in global progress to effectively eliminate the disease. Measles is one of the most contagious known human viruses, but it’s almost entirely preventable through widespread vaccination, the CDC points out.

“The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programs were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Getting immunization programs back on track is absolutely critical.”

At least 95 percent of the population must be fully vaccinated against measles to establish herd immunity, the point at which the spread of a disease is unlikely because enough people survive infection and/or get vaccinated against it. Currently, only 81 percent of kids around the world have received their first MMR dose and just 71 percent are fully vaccinated—the lowest global vaccination rates since 2008.

In 2021, there were an estimated 9 million measles infections worldwide, which resulted in 128,000 deaths. Measles cases in the United States declined dramatically in 2020 after hitting a 28-year high the year before. But since COVID precautions have lifted, cases are once again on the rise, with 49 cases reported in 2021 and 76 cases in 2022, the CDC reports.

“Measles anywhere is a threat everywhere, as the virus can quickly spread to multiple communities and across international borders,” the CDC cautions.

Why measles outbreaks happen
Before the vaccine that protects against measles was licensed back in 1963, the CDC estimates that three to four million people were infected annually, and hundreds of people died from the infection.

Outbreaks of this magnitude don’t happen anymore thanks to the MMR (measles, mumps, rubella) vaccine. Once people are vaccinated against measles, they become immune to it and can’t pass it on to others. As more people have been vaccinated against the disease over the past several decades, it has had fewer opportunities to spread.

Measles is making a comeback, however, as the infection may still spread among U.S. communities with “pockets of unvaccinated people,” the CDC explains. Americans who travel to countries where measles outbreaks are happening can also bring the disease back to the United States.

In Europe, there were roughly 84,000 measles cases in 2018. In the first half of 2019, about 90,000 children and adults in Europe were diagnosed with measles, according to a report from the World Health Organization. In June 2019, federal health officials urged Americans to protect themselves and ensure that they are fully vaccinated at least one month before traveling outside the United States.

Over the past few years, however, COVID contributed to declines in vaccine coverage, less stringent measles surveillance, and disruptions or delays in immunization activities.

But even before the pandemic began, prevailing myths and misconceptions about vaccine safety also played a role. Some people forego immunizations for their children simply for personal reasons, such as their religious views. The fact that most Americans alive today don’t have firsthand knowledge of devastating diseases, like polio and smallpox, may also contribute to lagging vaccination rates in some parts of the country.

In January 2019, an outbreak of measles in Washington state, prompted the governor to declare a public health emergency. A couple months later, there were 72 confirmed cases near Portland, Oregon–a known anti-vaccine “hotspot.” Nearly all those infected were children who had not been immunized against the disease.

On January 29, 2019, New York health officials also confirmed that 64 children from Brooklyn’s Orthodox Jewish community were diagnosed with measles. By April, that tally of measles cases grew to 246 children and 39 adults. The outbreak was triggered when unvaccinated children traveled to Israel where there was a large outbreak of the disease. When the young people returned home, the disease spread to other members of the community.

How to Protect Your Community 
You can protect yourself, your family, and your community by learning about measles and how it’s prevented.

What is measles? Measles (rubeola) is a serious and sometimes fatal respiratory disease that’s caused by a virus. Worldwide, it is still one of the leading causes of death in children.

How does it spread? An infected person can pass the virus, usually by coughing or sneezing, up to four days before and after the trademark red rash appears. Measles droplets from an infected person can linger in the air for hours. Unvaccinated people who inhale contaminated droplets or touch an infected surface and then touches their nose or mouth can become infected.

Who’s at risk? Any child or adult who is not vaccinated is at risk, especially if they travel internationally in countries where measles is still common or if they visit areas in the U.S. where outbreaks have been reported.

What are the signs and symptoms? Measles symptoms occur in stages, beginning with a high fever accompanied by a runny nose, cough, and watery eyes. Tiny white spots may appear in the mouth a couple of days later. An itchy red rash follows in three to five days, starting at the hairline and spreading down toward the feet.

Is getting measles dangerous? Measles is a highly contagious viral infection that can lead to serious complications or even death. There is no cure for the virus or treatment that can shorten the length of the infection. Once a person becomes infected, complications may include pneumonia, severe diarrhea, and even swelling of the brain. A doctor may order fluids for dehydration or, if needed, prescribe antibiotics to treat a secondary bacterial infection—an infection that develops as a complication from the disease.

How can you avoid infection? Early vaccination is key. The CDC recommends all children get two doses of MMR vaccine by age 6. Adults who aren’t immune should get at least one dose.

Article sources open article sources

Centers for Disease Control and Prevention. Nearly 40 million children are dangerously susceptible to growing measles threat. Nov 23, 2022.
Centers for Disease Control and Prevention. Measles Cases and Outbreaks. Dec 2, 2022.
Centers for Disease Control and Prevention. Vaccine for Measles. Nov 5, 2020.
American Academy of Pediatrics. CDC: Travelers to Europe should protect themselves from measles. Jun 17, 2019.
State of Washington: Office of the Governor. Proclamation by the Governor: 19-01. Jan 25, 2019.
Washington State Department of Health. Measles 2019.
Centers for Disease Control and Prevention. Measles (Rubeola). Nov 5, 2020.
Centers for Disease Control and Prevention. Measles (Rubeola): Transmission of Measles. Nov 5, 2020.
Centers for Disease Control and Prevention. Measles (Rubeola): Signs and Symptoms. Nov 5, 2020.
Centers for Disease Control and Prevention. Measles (Rubeola): Complications of Measles. Nov 5, 2020.

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