Ethiopia vaccinates nearly 15 million children against measles despite COVID-19 challenges

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Nearly 15 million children have been vaccinated against measles in Ethiopia in an effort by the health authorities to maintain essential health services, even as they battle to contain the COVID-19 pandemic. 

The nationwide campaign which wrapped up this weekend was conducted under the leadership of the Ethiopian Ministry of Health with support from World Health Organization (WHO), UNICEF, Gavi, the Vaccine Alliance and the United States Centers for Disease Control and Prevention. The vaccination campaign was initially scheduled for April but was suspended due to the pandemic and resumed in July.

The campaign ran for 10 days, which is longer than similar past campaigns to limit crowding and risks of COVID-19 infections. Health workers wearing face masks delivered the measles vaccine in open and well-ventilated areas. Other measures such as physical distancing, handwashing and temperature checks were also implemented in compliance with COVID-19 prevention guidelines.

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Ahead of the immunization drive targeting children aged 9–59 months, vaccinators were trained on the COVID-19 prevention measures, communities informed of the campaign and encouraged to turn up, and vaccination supplies as well as personal protective equipment and sanitizers were shipped.

The campaign’s target was 15 million children and it attained 96% coverage (14.4 million), showing that even with an ongoing COVID-19 pandemic, countries can continue to carry out life-saving mass vaccinations.

“By taking the appropriate measures, we can continue to provide essential services while striving to end this pandemic. Millions of children are at risk of vaccine-preventable diseases and waiting for the end of COVID-19 to restart immunization campaigns is a gamble we cannot afford,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

Fewer than 10 of the 47 countries in the WHO African Region are on track to achieve the 2020 measles elimination target of cutting new infections to fewer than one per 1 million population. The COVID-19 pandemic threatens to set the region back even further. Initial data from the first quarter of 2020 indicates that 1.5 million more African children missed the first dose of measles vaccine compared with the same period last year. Unless vaccination services manage to reach these children in the coming months, the decline adds a significant number of susceptible infants and young children to the existing pool of unvaccinated children across the region, posing huge risks for measles outbreaks. In 2019, 4.5 million children were unvaccinated against measles.

Measles is a highly contagious disease and one of the leading causes of death among young children globally despite the availability of a safe and effective vaccine. An estimated 52 600 people died from measles in 2018 in the African Region, mostly children under the age of five.

Measles outbreaks remain a risk in all African countries where the routine immunization coverage remains below 95% and where periodic supplemental immunization campaigns have been delayed or do not achieve 95% coverage in all districts.

Due to the COVID-19 pandemic, at least nine scheduled measles vaccination campaigns in Africa were or continue to be at risk of being cancelled, which could result in further outbreaks in 2020 and beyond.

WHO has issued guidance on the importance of maintaining safe immunization services. The guidance provides advice on the criticality of urgent catch-up vaccination when COVID-19 movement restrictions are lifted. It also recommends conducting careful risk assessment before implementing preventive mass vaccination, with attention to appropriate protective measures to avoid COVI-19 transmission.

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