Tag: Rubella

Landmark study highlights power of vaccination

[ad_1]

A major landmark study to be published by The Lancet reveals that global immunization efforts have saved an estimated 154 million lives – or the equivalent of 6 lives every minute of every year – over the past 50 years. The vast majority of lives saved – 101 million – were those of infants.

The study, led by the World Health Organization (WHO), shows that immunization is the single greatest contribution of any health intervention to ensuring babies not only see their first birthdays but continue leading healthy lives into adulthood.

Of the vaccines included in the study, the measles vaccination had the most significant impact on reducing infant mortality, accounting for 60% of the lives saved due to immunization. This vaccine will likely remain the top contributor to preventing deaths in the future.

Over the past 50 years, vaccination against 14 diseases (diphtheria, Haemophilus influenzae type B, hepatitis B, Japanese encephalitis, measles, meningitis A, pertussis, invasive pneumococcal disease, polio, rotavirus, rubella, tetanus, tuberculosis, and yellow fever) has directly contributed to reducing infant deaths by 40% globally, and by more than 50% in the African Region.

“Vaccines are among the most powerful inventions in history, making once-feared diseases preventable,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Thanks to vaccines, smallpox has been eradicated, polio is on the brink, and with the more recent development of vaccines against diseases like malaria and cervical cancer, we are pushing back the frontiers of disease. With continued research, investment and collaboration, we can save millions more lives today and in the next 50 years.”

The study found that for each life saved through immunization, an average of 66 years of full health were gained – with a total of 10.2 billion full health years gained over the five decades. As the result of vaccination against polio more than 20 million people are able to walk today who would otherwise have been paralysed, and the world is on the verge of eradicating polio, once and for all.

These gains in childhood survival highlight the importance of protecting immunization progress in every country of the world and accelerating efforts to reach the 67 million children who missed out on one or more vaccines during the pandemic years.

Monumental efforts to increase access to vaccination over five decades

Released ahead of the 50^th anniversary of the Expanded Programme on Immunization (EPI) to take place in May 2024, the study is the most comprehensive analysis of the programme’s global and regional health impact over the past five decades.

Founded in 1974 by the World Health Assembly, EPI’s original goal was to vaccinate all children against diphtheria, measles, pertussis, polio, tetanus, tuberculosis, as well as smallpox, the only human disease ever eradicated. Today, the programme, now referred to as the Essential Programme on Immunization, includes universal recommendations to vaccinate against 13 diseases, and context-specific recommendations for another 17 diseases, extending the reach of immunization beyond children, to adolescent and adults.

The study highlights that fewer than 5% of infants globally had access to routine immunization when EPI was launched. Today, 84% of infants are protected with 3 doses of the vaccine against diphtheria, tetanus and pertussis (DTP) – the global marker for immunization coverage.

Nearly 94 million of the estimated 154 million lives saved since 1974, were a result of protection by measles vaccines. Yet, there were still 33 million children who missed a measles vaccine dose in 2022: nearly 22 million missed their first dose and an additional 11 million missed their second dose.

Coverage of 95% or greater with 2 doses of measles-containing vaccine is needed to protect communities from outbreaks. Currently, the global coverage rate of the first dose of measles vaccine is 83% and the second dose is 74%, contributing to a very high number of outbreaks across the world.

To increase immunization coverage, UNICEF, as one of the largest buyers of vaccines in the world, procures more than 2 billion doses every year on behalf of countries and partners for reaching almost half of the world’s children. It also works to distribute vaccines to the last mile, ensuring that even remote and underserved communities have access to immunization services.

Thanks to vaccinations, more children now survive and thrive past their fifth birthday than at any other point in history. This massive achievement is a credit to the collective efforts of governments, partners, scientists, healthcare workers, civil society, volunteers and parents themselves, all pulling in the same direction of keeping children safe from deadly diseases. We must build on the momentum and ensure that every child, everywhere, has access to life-saving immunizations.”

Catherine Russell, UNICEF Executive Director

In 2000, Gavi, the Vaccine Alliance, which includes WHO, UNICEF and the Bill & Melinda Gates Foundation (BMGF) as core founding members, was created to expand the impact of EPI and help the poorest countries in the world increase coverage, benefit from new, life-saving vaccines and expand the breadth of protection against an increasing number of vaccine-preventable diseases. This intensified effort in the most vulnerable parts of the world has helped to save more lives and further promote vaccine equity. Today, Gavi has helped protect a whole generation of children and now provides vaccines against 20 infectious diseases, including the HPV vaccine and vaccines for outbreaks of measles, cholera, yellow fever, Ebola and meningitis.

“Gavi was established to build on the partnership and progress made possible by EPI, intensifying focus on protecting the most vulnerable around the world,” said Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance. “In a little over two decades we have seen incredible progress – protecting more than a billion children, helping halve childhood mortality in these countries, and providing billions in economic benefits. Vaccines are truly the best investment we can make in ensuring everyone, no matter where they are born, has an equal right to a healthy future: we must ensure these efforts are fully funded to protect the progress made and help countries address current challenges of their immunization programmes.”

Immunization programmes have become the bedrock of primary health services in communities and countries due to their far reach and wide coverage. They provide not only an opportunity for vaccination but also enable other life-saving care to be provided, including nutritional support, maternal tetanus prevention, illness screenings and bed net distribution to protect families from diseases like malaria.

Since the study only covers the health impact of vaccination against 14 diseases, the number of lives saved due to vaccination is a conservative estimate and not a full account of the life-saving impact of vaccines. Societal, economic or educational impacts to health and well-being over the 50 years have also contributed to further reductions in mortality. Today, there are vaccines to protect against more than 30 life-threatening diseases.

While the HPV vaccine, which protects against cervical cancer in adults, was not included in the study, it is expected to prevent a high number of future deaths as countries work towards increasing immunization targets aimed at eliminating cervical cancer by 2030. New vaccine introductions, such as those for malaria, COVID-19, respiratory syncytial virus (RSV) and meningitis, as well as cholera and Ebola vaccines used during outbreaks, will further save lives in the next 50 years.

Saving millions more is “Humanly Possible”

Global immunization programmes have shown what is humanly possible when many stakeholders, including heads of state, regional and global health agencies, scientists, charities, aid agencies, businesses, and communities work together.

Today, WHO, UNICEF, Gavi, and BMGF are unveiling “Humanly Possible”, a joint campaign, marking the annual World Immunization Week, 24-30 April 2024. The worldwide communication campaign calls on world leaders to advocate, support and fund vaccines and the immunization programmes that deliver these lifesaving products – reaffirming their commitment to public health, while celebrating one of humanity’s greatest achievements. The next 50 years of EPI will require not only reaching the children missing out on vaccines, but protecting grandparents from influenza, mothers from tetanus, adolescents from HPV and everyone from TB, and many other infectious diseases.

“It’s inspiring to see what vaccines have made possible over the last fifty years, thanks to the tireless efforts of governments, global partners and health workers to make them more accessible to more people,” said Dr Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation. “We cannot let this incredible progress falter. By continuing to invest in immunization, we can ensure that every child – and every person – has the chance to live a healthy and productive life.”

Source:

The World Health Organization

[ad_2]

Source link

April 25, 2024
Persistent measles importations challenge U.S. elimination efforts

[ad_1]

A recent Centers for Disease Control and Protection (CDC) report published in the Morbidity and Mortality Weekly Report (MMWR) assessed the status of measles elimination in the United States (U.S.) and reported on the recent increase in cases by analyzing surveillance data from January 2020 to March 2024.

Study: Measles — United States, January 1, 2020–March 28, 2024. Image Credit: sulit.photos/Shutterstock.com

Background

Measles, a highly contagious viral illness, was considered eliminated in the U.S. in 2000 due to high coverage with the measles, mumps, and rubella (MMR) vaccine.

Despite this, the elimination status faced challenges in 2019 following significant outbreaks in under-vaccinated communities in New York, contributing to a notable rise in cases.

Further research is needed to address gaps in vaccine coverage and enhance surveillance systems to prevent future outbreaks and sustain measles elimination.

About the study

Confirmed measles cases are reported to the Centers for Disease Control and Prevention (CDC) by state health departments through the National Notifiable Disease Surveillance System and directly via email or telephone to the National Center for Immunization and Respiratory Diseases.

The Council of State and Territorial Epidemiologists classifies measles cases. Cases are deemed import-associated if they originate internationally, are epidemiologically linked to an imported case, or show viral genetic evidence of an imported measles genotype.

Conversely, cases without an epidemiologic or virologic connection to an imported source are categorized as having an unknown origin.

For analytical purposes, unique sequences are identified as those varying by at least one nucleotide in the N-450 sequence, following the World Health Organization’s (WHO)’s recommendations for describing sequence variants.

Patients who were unvaccinated yet eligible for vaccination were identified based on the criteria set by the Advisory Committee on Immunization Practices.

A surveillance system is considered effective if at least 80% of cases meet three criteria: classification as import-associated, comprehensive reporting on key surveillance indicators, and confirmation through laboratory testing.

Additionally, measles cases are categorized into chains of transmission based on known epidemiologic links. These include isolated cases, two-case chains involving two linked cases, and outbreaks consisting of three or more linked cases.

The analysis of two-case chains and outbreaks also involves assessing the potential for missed cases by examining the time intervals between the onset of measles rashes, with intervals exceeding one maximum incubation period suggesting possible unreported cases.

Study results

From January 1, 2020, to March 28, 2024, the CDC was notified of 338 confirmed measles cases across 30 jurisdictions. A noticeable portion of these cases, particularly 12 of 13 reported before the COVID-19 mitigation measures began in March 2020, marked the early stages of this period.

In the following years, 2021 and 2022 witnessed 170 reported cases, 78% of which were linked to distinct outbreaks. Notably, 47 of the 49 cases in 2021 were among Afghan evacuees at U.S. military bases during Operation Allies Welcome, and 86 of the 121 cases in 2022 stemmed from an outbreak in Central Ohio.

By 2023, 48% of the 58 cases reported were associated with four outbreaks. As of late March 2024, 97 cases had been reported for the year, signifying a significant increase over previous first-quarter averages.

The median age of the affected individuals was three years, ranging from newborns to 64 years old, with 58% of the cases occurring in the 16 months to 19 years age group.

A significant majority, 91% of patients, were either unvaccinated or had an unknown vaccination status, and of these, 84% were eligible for vaccination.

Hospitalization data showed that 46% of the patients were hospitalized, primarily children under five years old, with 92% being unvaccinated or of unknown vaccination status. There were no reported deaths due to measles.

Regarding the origin of the cases, 96% were linked to importation. A detailed breakdown reveals that the majority of the 326 import-related cases involved U.S. residents eligible yet unvaccinated or of unknown vaccination status.

The most frequent origins of these imported cases were from the Eastern Mediterranean and African WHO regions. However, the first quarter of 2024 saw increased European and Southeast Asian cases.

Surveillance quality was notably high, with nearly all cases (98%) including comprehensive data on key indicators. Timeliness of reporting showed that 58% of cases were reported to health departments on or before the day of rash onset.

Laboratory confirmations were achieved in 93% of cases, with a large majority verified through real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing and successful genotyping of most specimens, identifying predominant measles genotypes B3 and D8.

Transmission patterns were categorized into 92 chains, with the majority being isolated cases. However, 20 chains qualified as outbreaks involving three or more cases, and the typical outbreak lasted 20 days, highlighting the rapid transmission potential of measles.

Notably, none of the two-case chains or larger outbreaks experienced a gap exceeding the maximum incubation period.

[ad_2]

Source link

April 16, 2024
Measles outbreak in Illinois underscores critical need for vaccination

[ad_1]

In a recent study published in the Morbidity and Mortality Weekly Report (MMWR), researchers from Illinois, the United States of America (US), reported the incidence of five measles cases among unvaccinated children who resided in the same building but did not socialize with each other.

Notes from the Field: Measles Outbreak — Cook County, Illinois, October–November 2023. Image Credit: adriaticfoto / Shutterstock

Background

Measles is an infectious disease preventable by vaccination and poses a significant health risk. In the US, it is advised that children receive two doses of the measles, mumps, and rubella (MMR) vaccine, typically administered between the ages of 12 and 15 months and again between 4 and 6 years. The present study describes a concerning case of measles outbreak among five unvaccinated children from two families residing in the same building who did not socialize with each other.

The case

On October 5, 2023, Patient A, a 2-year-old immigrant from Yemen, was diagnosed with an unspecified viral illness at the emergency department (ED) of Hospital A, following negative test results for influenza, coronavirus disease 2019 (COVID-19), and respiratory syncytial virus. Patient A had not been administered the MMR vaccine and had symptoms of fever, cough, and coryza. On October 8, Patient A visited Hospital B’s ED due to exacerbated respiratory symptoms and tested positive for rhinovirus/enterovirus. Patient A was then admitted again to Hospital A for respiratory distress.

Notably, Patient A developed a maculopapular rash while hospitalized the next day. On October 10, the family disclosed that they had been in contact with an individual diagnosed with measles before entering the US. Measles was confirmed via real-time reverse transcription-polymerase chain reaction (RT-PCR), and the patient was discharged.

Investigations

Between October 5 and 11, the child was potentially exposed to 247 healthcare workers and 177 patients and kin. This included 13 infants aged under one year, five immunocompromised children, and one unvaccinated child aged over one year. Two of these children were given the MMR vaccine within three days of exposure, while 13 received immune globulin as a precautionary measure.

Patient A’s domestic contacts included two siblings who had not received the MMR vaccine and were found to be susceptible to measles through serologic testing. The siblings were Patient B, aged four years and Patient C, aged nine. The siblings contracted measles during quarantine, with varied symptoms. Although patient B required an ED visit for supportive care, neither child was hospitalized. All the residents of the building were alerted on October 17.

On October 30, Patient D (another child aged two years) visited the ED with symptoms and resided on a different floor of the same building as Patient A. The child had not received the MMR vaccine, as its parents objected based on concerns about the side effects of the vaccine. Measles was confirmed through RT-PCR.

Interestingly, despite living in the same building, the families of both sets of patients had different cultural backgrounds and languages. Both families denied having any contact with each other. While their apartment units did not share ventilation, they shared laundry facilities and building entrances.

On October 31, Patient D’s unvaccinated one-year-old sibling, named Patient E, was tested due to isolated coryza. The child attended a child-care facility on October 30 while symptomatic and confirmed measles through RT-PCR. Post-exposure prophylaxis was administered to susceptible individuals, including immune globulin for one child and an early second dose of MMR vaccine for others. Patient E did not develop a fever until November 6, and a rash appeared on November 9, nine days after the positive test result and notification of the child-care facility.

While testing for measles is typically done when prodromal symptoms occur, such as cough, fever, coryza, or conjunctivitis, the isolated coryza experienced by Patient E may not have been measles-related. As measles testing before fever onset is uncommon, determining the accurate contagious period for this patient was challenging. Patient E did not need hospitalization.

Discussion

Five children contracted measles in this outbreak. They were unvaccinated despite being eligible for the MMR vaccine owing to cultural barriers, limited access to healthcare, and vaccine refusal. Outbreaks have been observed previously among close-knit communities, but the present families were not a part of such networks. Public health responses typically involve tailored approaches, like culturally appropriate education materials and translation services. However, these efforts are expensive and time-consuming. This outbreak highlights measles’ high contagiousness, even among children not in each other’s contact.

Conclusion

In conclusion, the study emphasizes the need for all children and susceptible individuals to receive two doses of the MMR vaccine at appropriate intervals. Clinicians should suspect measles in patients with febrile rash illness and ensure vaccination to prevent future outbreaks.

[ad_2]

Source link

March 18, 2024
Empathetic correction of misinformation can improve attitudes towards vaccination, study shows

[ad_1]

An international study has shown for the first time how empathetic correction of misinformation among vaccine-hesitant patients can significantly improve attitudes towards vaccination – and potentially boost vaccine uptake.

The research, led by the University of Bristol, also found this new style of communication could help build and maintain a positive relationship with health professionals, increasing trust and public confidence. With the UK currently facing a growing measles outbreak, fuelled by declining rates of the Measles, Mumps, and Rubella (MMR) vaccination, the results are timely and present important learnings for vaccine delivery programmes.

Its findings, published today in the journal Health Psychology, found the more than two-thirds (around 69%) of vaccine-hesitant study participants who received empathetic engagement from a healthcare professional preferred this compared with a group who were just told the facts.

Although we expected people to generally respond more positively to an empathetic approach, it was surprising how much greater the preference for this style of communication was among those who expressed concerns about vaccination.

The study highlights how the way misinformation is tackled, especially with vaccine averse groups, can play a vital role in changing perceptions which can be hard to shift.”

Dr Dawn Holford, Lead Author, Senior Research Associate in Psychology

The study, which involved more than 2,500 participants in the UK and US, compared their response to direct, factual communication with a novel dialogue-based technique empathising with their views, while also addressing false or misleading anti-vaccination arguments.

The results showed participants overall preferred the new approach, known as empathetic refutational interviewing – and this was response was strongest for the vaccine-hesitant, who found it more compelling than being presented purely with facts.

The majority of participants (around 64%) who experienced the empathetic refutational interview also indicated they were more open to continuing the conversation with a healthcare professional, and around 12% became more willing to be vaccinated compared to those participants who received the factual approach.

The interview technique comprises a four-step process. First the patient is invited to share their thoughts and concerns about vaccination so that healthcare professionals can understand their motivations and reservations. Then understanding and trust is built by affirming the patient’s feelings and concerns. Thirdly, a tailored explanation is provided to challenge misconceptions, offering a truthful alternative to any misinformed beliefs. Finally, relevant facts about vaccination are provided, such as how they can benefit the individual by guarding against disease as well as collectively protecting others by reducing the spread and building vaccine-induced herd immunity.

Dr Holford said: “The findings actively demonstrate the power of communication, which healthcare professionals can use in their daily roles. Our study shows it is possible to gain trust and change minds if we take people’s concerns seriously and tailor our approach to help them make informed decisions about their health.

“This is hugely encouraging, especially with the growing influence of misinformation and fake news worldwide.”

The research is currently being developed into training tools and programmes to support healthcare professionals in the UK, France, Germany, and Romania.

During the COVID-19 pandemic, misinformation about vaccines fuelled vaccine hesitancy especially among vulnerable groups. In the wake of the pandemic, reduced uptake of various vaccines remains a major public health concern.

The UK Health Security Agency (UKHSA) recently declared a national incident due to a growing outbreak of measles, one of the most contagious viruses, with extra clinics and vaccine buses targeting communities with low vaccination rates. Uptake of the MMR (Measles, Mumps and Rubella) vaccine has fallen worldwide in the wake of the pandemic.

A recent study by the World Health Organisation found the global decline in childhood vaccinations, to protect against devastating but preventable diseases, was the largest sustained drop in around 30 years.

Co-author Stephan Lewandowsky, Chair in Cognitive Psychology at the University of Bristol, has led numerous studies demonstrating the alarming influence of misinformation and during the pandemic developed a unique online guide addressing and correcting the proliferation of misleading myths surrounding COVID-19 vaccines.

Professor Lewandowsky added: “It is important to understand the motivations underlying people’s vaccine hesitancy so we can correct misconceptions without confronting people’s deeply held attitudes head-on. By affirming and empathising with those deeply held attitudes we create a space where people are sufficiently comfortable to process corrective information, so they can make a better informed decision.”

[ad_2]

Source link

March 4, 2024