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Many mass vaccination efforts around the world stopped this spring to prevent the spread of the virus to overcrowded inoculation sites. The consequences are alarming.
By Jan Hoffman and Ruth Maclean
As countries deficient in the global struggle to repel coronaviruses, they unknowingly contribute to new disease outbreaks and death from other diseases, which are prevented without problems through vaccines.
This spring, after the World Health Organization and UNICEF warned that the pandemic could spread as young people flock to vaccination, many countries suspended their vaccination programs. Even in countries that have tried to stop them, vaccine delivery flights have been disrupted by the pandemic. and the fitness staff has gone out of their way to combat it.
Diphtheria is now occurring in Pakistan, Bangladesh and Nepal.
Cholera in South Sudan, Cameroon, Mozambique, Yemen and Bangladesh.
A poliovirus mutation has been reported in more than 30 countries.
And measles abounds all over the world, Bangladesh, Brazil, Cambodia, the Central African Republic, Iraq, Kazakhstan, Nepal, Nigeria and Uzbekistan.
Of the 29 countries that have recently suspended their measles campaigns due to the pandemic, 18 report outbreaks, while 13 other countries are postponing it. According to the Measles and Rubella Initiative, 178 million more people are at risk of not being vaccinated against measles until 2020.
The threat is now “an epidemic in a few months that will kill more young people than Covid,” said Chibuzo Okonta, president of Doctors Without Borders in West and Central Africa.
As the pandemic persists, WHO and other foreign public fitness teams now urge countries to resume vaccination while battling coronavirus.
At stake is the long-term collaboration of a lasting 20-year collaboration that has prevented 35 million deaths in 98 countries from vaccine-preventable diseases and reduced infant mortality by 44%, according to a 2019 study through Vaccine Impact. an organization of public fitness researchers.
“Vaccination is one of the most resilient and basic disease prevention teams in the history of public health,” Dr Tedros Adhanom Ghebreyesus, WHO Executive Director, said in a statement. “Disruption of immunization systems due to the Covid-19 pandemic threatens to reach the bottom of decades of progress against vaccine-preventable diseases such as measles. “
But the obstacles to restarting are considerable. Vaccine stocks are still difficult to find, health personnel are working full-time with Covid-19, infection caused by coronavirus, and a new wave of reluctance to vaccines prevents parents from accessing clinics.
Many countries have still been affected by the total strength of the pandemic, further weakening their ability to cope with outbreaks of other diseases.
“We will have countries that will withdraw from Covid and then face measles. This would further stretch their fitness systems and have serious economic and humanitarian consequences,” said UNICEF Chief of Immunization Dr Robin Nandy, who supplies vaccines for a hundred countries, achieving forty-five, consistent with the percentage of young people under the age of five.
Lack of vaccine administration has serious implications for coverage against coronavirus itself.
At a pre-month global summit, Gavi, the Vaccine Alliance, a fitness association founded through the Bill and Melinda Gates Foundation, announced that it had won $8. 8 billion promises for critical vaccines for young people in middle- and deficient countries, and beginning a crusade to administer Covid-19 vaccines. Fix once they become available.
But as the facilities collapse under the pandemic, “these are the same ones that will be needed to send a Covid vaccine,” Dr. Katherine O’Brien, Director of Immunization, Vaccines and Biological Products at WHO, at a recent webinar on demanding vaccination situations.
Three fitness staff members with portable fridges filled with vaccines and a team of public screamers and note takers recently boarded a canoe of wood motorized by the wide Tshopo River in the Democratic Republic of the Congo.
Although measles is sprouting in the country’s 26 provinces, the pandemic has ended many immunization systems in previous weeks.
The canoe team had to strike a balance between preventing the transmission of a new virus that is just beginning to hit Africa hard and prevent an old known killer, but when the long, narrow canoe reached the riverside communities, the team’s biggest challenge turned out to be the mechanism for vaccinating young people while observing new pandemic protection restrictions. Instead, the team found themselves working hard just to convince the villagers to allow their little ones to empty themselves.
Many parents were convinced that the device was measurable about the vaccine – which is not for measles but, secretly, an experimental vaccine opposed to coronavirus, so they would be guinea pigs involuntary.
In April, French-speaking Africa was outraged through a French television interview in which two researchers argued that vaccines opposed to coronaviruses deserve to be tested in Africa, reviving memories of a long history of such abuses. And in Congo, virologist In the reaction rate to coronavirus, he said the country had agreed to participate in clinical vaccine trials this summer. He later clarified that no vaccine will be tested in Congo until it is tested elsewhere, but harmful rumors had already spread.
The team fooled the parents in the most productive way possible. Although Tshopo’s vaccinators vaccinated 16,000 children, another 2,000 escaped.
This was the year that Congo, Africa’s largest country at the time, was launching a national immunization programme. The urgency may not have been greater. The measles epidemic in the country, which began in 2018, has continued to last: since that month of January alone, there have been more than 60,000 cases and 800 deaths; Ebola has erupted again today, in addition to tuberculosis and cholera, which hit the country. Country.
Vaccines exist for all these diseases, although not available, at the end of 2018 the country introduced a vaccination initiative in nine provinces, was an achievement of coordination and initiative, and in 2019, in the first full year, the percentage of fully vaccinated young people increased from 42 to 62% in Kinshasa, the capital.
This spring, when the program was ready for national deployment, the coronavirus hit and mass vaccination campaigns, which involve summoning lots of young people to sit in combination in the courtyards of schools and markets, seemed to ensure the spread of coronavirus. in clinics, it has become unsustainable in many areas.
The country’s fitness government has to allow vaccines to continue in spaces where measles is affected, but there are no cases of coronavirus, but the pandemic froze foreign flights that would bring medical supplies and several provinces began to run out of polio vaccines. , measles and tuberculosis.
When immunization materials nevertheless arrived in Kinshasa, they may simply not move to the country. Domestic flights have been suspended. Land transport was not feasible due to poor road conditions. Finally, a United Nations peacekeeping project delivered materials to its aircraft.
However, fitness workers, who had no masks, gloves or disinfectant gel, feared infection; many have stopped working, others deviated to be trained for Covid.
The cumulative effect has been deastrous for polio eradication: around 85,000 Congolese young people have not won the vaccine.
But the disease that most fears public health is measles.
The measles virus spreads smoothly through aerosols (small debris or droplets suspended in the air) and is much more contagious than coronavirus, according to experts from the Centers for Disease Control and Prevention.
“If other people enter a room where a user with measles two hours ago and no one has been immunized, 100% of those other people will become infected,” dr. Yvonne Maldonado, pediatric infectious disease specialist at Stanford University.
In the poorest countries, the measles mortality rate for young people under the age of five ranges from 3 to 6 years, in line with one per cent; situations such as malnutrition or an overcrowded refugee camp can increase the mortality rate and children may succumb to headaches such as pneumonia, encephalitis and severe diarrhoea.
In 2018, the last peak year for which global knowledge was compiled, only about 10 million measles cases and 142,300 similar deaths were estimated, and then global immunization systems were stronger.
Prior to the coronavirus pandemic in Ethiopia, 91% of the capital’s young people, Addis Ababa, had won their first visits to the measles vaccination regimen, while 29% in rural areas had won them (to prevent an outbreak of a highly infectious disease such as measles, the optimal policy is 95% or more, with two doses of the vaccine). When the pandemic struck, the country suspended its crusade against measles in April. But the government continues to report many new cases.
“Epidemic pathogens don’t recognize borders,” said Dr. O’Brien of the W. H. O. “Especially measles: measles is measlesArray”
Immunization rates in richer countries also decreased due to the pandemic. Some U. S. states report falls as steep as 70% in the same era last year for measles and other diseases.
Once other people start traveling again, the threat of infection will increase. “It helps me stay awake at night,” Dr. Stephen L said. Cochi, senior advisor to the CDC’s Global Immunization Division. diseases are just a plane flight. “
After OMSet its vaccine partners published the effects of a survey last month showing that 80 million young children under the age of one were at risk of not being vaccinated, some countries, including Ethiopia, the Central African Republic and Nepal, have begun searching to restart their programmes.
Uganda now manufactures motorcycles for fitness employees. In Brazil, some pharmacies offer vaccination while driving. In the Indian state of Bihar, a 50-year-old fitness employee learned to ride a bike in 3 days to bring vaccines to remote families. UNICEF has chartered a flight to deliver vaccines to seven African countries.
Dr. Cochi of the CDC, who provides technical and programmatic assistance to more than 40 countries, said that if such campaigns can be conducted, the pandemic is an open question. “It will be riddled with limitations. We are talking about low-income countries where social estating is not a reality, it is not possible,” he said, mentioning Brazilian favelas and migrant caravans.
He hopes polio campaigns will resume quickly, fearing that the pandemic will delayed a decades-long effort to eliminate the disease.
Dr. Cochi is involved for Pakistan and Afghanistan, where 61 cases of wild poliovirus type 1 have been reported this year, and for Chad, Ghana, Ethiopia and Pakistan, where cases of type 2 poliovirus, mutated from the oral vaccine, have appeared.
Thabani Maphosa, Gavi’s executive leader, who partners with 73 countries to buy vaccines, said at least part of a dozen countries say they can’t have the same percentage of vaccine prices because of the pandemic’s economic history.
If the pandemic goes away in 3 months, Maphosa said, he thinks the foreign network could catch up on vaccines in the next year and a half.
“But our scenarios don’t tell us this is going to happen,” he added.
Jan Hoffman of New York and Ruth Maclean of Dakar, Senegal.
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