A measles outbreak is likely in 2021 due to disrupted vaccination schedules caused by the Covid19 lockdown, according to an article published in The Lancet. The scientists who authored the article urge international action to prevent the possibility of a devastating measles epidemic in the coming years.

“The coming months are likely to see increasing numbers of unimmunized children who are susceptible to measles. Many live in poor, remote communities where health systems are less resilient, and malnutrition and vitamin A deficiency are already increasing,” lead author Kim Mulholland said in a statement.

Mulholland, a professor and a World Health Organization’s SAGE Working Group chair for the measles and rubella vaccine, says that 2020 did not see many measles cases due to Covid19 travel restrictions and control measures. But Covid19’s economic impact led to malnutrition, which worsens measles’ severity. “Children who die from measles are often malnourished, but acute measles pushes many surviving children into malnutrition. Malnutrition, along with measles-associated immune suppression, leads to delayed mortality, while co-existing vitamin A deficiency can also lead to measles-associated blindness.”

Related on The Swaddle:

In Its Race to Fight Covid19, Is India Forgetting Its TB Problem?

Before Covid19, the year 2019 saw a dramatic global increase in measles cases, higher than any surge in the two preceding decades. There were almost 10 million measles cases, which resulted in more than 200,000 deaths according to the World Health Organization (WHO) data — a 50% increase from measles deaths in 2016.

By October 2020, the WHO estimates that around 94 million children in 26 countries will have missed their scheduled vaccine dose.

India is already on the backfoot. As of 2019, 2.3 million children in India have not received their measles vaccines, and India has the fourth-highest number of measles cases registered between 2018-2019 out of 194 countries. Plus, India also ranks very low on the Global Hunger Index, making malnutrition a cause of high concern in the country. “The inadequate vaccination that led to the 2019 measles outbreaks has still not been adequately addressed, and the situation is now exacerbated by service disruptions during the Covid19 pandemic so that high-risk, unimmunized children are clustered together in unreached communities,” Mulholland said in the statement.

The scientists behind The Lancet report state three points for immediate action. They write, “First, urgent action is required to address the immediate risk of measles outbreaks by helping countries to reach unimmunized children through catch-up and campaigns. Second, countries need to prepare for the expected outbreaks. WHO and partners have developed a Strategic Response Plan to assist with measles outbreak prevention, preparedness, and response, and have launched a call to action and funding appeal. Finally, the international community must not lose sight of measles and rubella elimination targets.”

They add, “These are the solutions to end the cycle of inadequate immunization and outbreaks of the past decade. Without concerted efforts now, it is likely that the coming years will see an increase in measles and its severe, frequently fatal, complications.”