![]() It’s extremely easy to reintroduce measles through travel and to spread measles. Whenever we have some rumor that autism is caused by the measles, mumps, and rubella vaccine, and parents in high-income countries stop vaccinating, you start to see measles cases. Vermund: We have to vaccinate against measles, all the kids all the time, and that includes high-income countries. What does that mean for outbreak risk and what are the implications of that for solving the problem? The report listed the 10 countries with the highest number of children with missed first doses, and these countries were fairly spread out, geographically. But now, as children go back to schools and communities come together again, even this country is at risk of measles outbreaks. Because of social distancing, we pushed back the impact of those outbreaks a little bit. There have been increasing outbreaks here. We know that there are pockets of vulnerability in this country. We also should be mindful that controlling the measles virus globally is in the U.S. It’s important to have international attention and investment so countries can mount these catch-up campaigns, especially as COVID-19 restrictions begin to open up. ![]() In certain cases, the WHO, Gavi, and UNICEF can provide support. Omer: It's ultimately the country programs that are responsible, but they need a lot of help and support. What steps need to be taken to get these children vaccinated? When you have a diminution of the number of kids who are protected, you can pretty much count on there being outbreaks because the transmission is more robust and, therefore, the protection is more fragile, and we need a very high proportion of children to be vaccinated to achieve the so-called herd immunity. But the second element that is concerning is that it's more infectious than the other respiratory viruses, including coronavirus. It has a higher death rate and complication rate, and for those reasons alone, we are alarmed. Sten Vermund: Measles, among respiratory viruses, is more serious than most. So, this is concerning, and we need to catch up. ![]() They’re often in the most under-resourced, most underprivileged, and most vulnerable communities. Saad Omer: It's concerning because we know from experience that these missed doses are not uniformly distributed. How concerning is it that such a growing number of children are missing their first dose of the measles vaccine? ![]() This interview has been condensed and edited. In a recent conversation, Sten Vermund, dean of the Yale School of Public Health, and Saad Omer, director of the Yale Institute for Global Health and recent member of the WHO Strategic Advisory Group of Experts’ working group on measles and rubella vaccines, spoke to Yale News about the dangerous implications of this trend and what can be done to reverse it. So this increase in missed vaccinations and lower rates of outbreak surveillance, which also decreased in 2020, put regional measles elimination at risk, public health leaders say. Approximately 95% of a population needs to be vaccinated against measles in order to achieve herd immunity. Measles is a highly contagious disease and high rates of vaccination are required to prevent outbreaks. That is 3 million more than the number of children who missed recommended doses in 2019, representing the largest increase in 20 years. Centers for Disease Control and Prevention (CDC). More than 22 million children worldwide missed their first dose of the measles vaccine in 2020, according to the World Health Organization (WHO) and the U.S.
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