Health

Over 20 million children worldwide miss out on measles vaccine annually

About 169 million children worldwide missed out on being vaccinated between 2010 and 2017, according to a UNICEF report.

Canada ranks 7th on list of high-income countries with the most children who missed out on 1st dose

UNICEF says 287,000 Canadian children did not receive the first dose of the measles vaccine between 2010 and 2017. (Geoff Caddick/AFP/Getty Images)

The number of measles cases worldwide in the first three months of 2019 has increased 300 per cent compared to the same period in 2018 to more than 110,000 cases reported worldwide, says a UNICEF report released Thursday.

UNICEF said that an estimated 169 million children worldwide did not receive the first dose of the measles vaccine in the past eight years. Pockets of unvaccinated children allow measles to spread, the agency said, which has caused the current outbreaks around the world, including in Canada.

Children are amongst the most vulnerable to measles. In 2017, youngsters made up the majority of the 110,000 people who died from measles.

UNICEF executive director Henriette Fore said that missing vaccinations lays the foundation for measles cases today. The World Health Organization recommends a 95 per cent vaccination rate to achieve "herd immunity" — a level needed to make sure that communities are safe from infections from measles.

Two doses are necessary for the highest level of protection.

Federal Health Minister Ginette Petitpas Taylor has announced a new project to help improve access to vaccinations and increase coverage for two-year-olds in the Surrey, B.C., area. (Eric Risberg/Associated Press)

"The measles virus will always find unvaccinated children," said Fore. "If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike."

UNICEF says the reasons for not seeking the first dose of the measles vaccine include:

  • Lack of access.
  • Poor health systems.
  • Complacency.
  • Fear or skepticism about vaccines.

Canada was in the top 10 high-income countries with children who did not receive the first dose of the measles vaccine between 2010 and 2017. The United States tops the list with more than 2.5 million children not vaccinated.

Canada ranked seventh. UNICEF said that 287,000 kids in Canada did not receive the first dose during these years.

UNICEF's chief of immunizations Robin Nandy said in high-income countries some people aren't recognizing the seriousness of the situation.

"People forget how deadly this disease is," he said in an interview. "You take a different scenario in sub-Saharan Africa where they are seeing measles all the time — they know people who have died."

In low-income countries, poverty and supply shortages limit access to vaccines, UNICEF said.

Also on Thursday, federal Health Minister Ginette Petitpas Taylor announced a new project with the Fraser Health Authority in British Columbia, which the department said will improve access to vaccinations and increase vaccine coverage for two-year olds in the Surrey region.

The Public Health Agency of Canada said it will focus on improving services for hard-to-reach and low-income families, as well as Indigenous people and newcomers to Canada. They also announced three other projects to improve vaccination rates in Canada.

CBC News reached out to Health Canada about the UNICEF report. They referred journalists to the childhood National Immunization Coverage Survey from 2017, which showed that 90 per cent of all two-year-olds in Canada had received at least one dose of the measles vaccine. 

2nd dose crucial to prevention

The federal government says that two-dose coverage is almost 100 per cent effective. The global coverage for this second dose is about 67 per cent.

Receiving one dose of the measles vaccine does not necessarily mean full protection. While the world's population is growing, the global coverage amount for the first dose of measles vaccines has stayed consistent at 85 per cent. But global coverage for those who also received their second dose dips to 67 per cent.

UNICEF called the situation critical for low- and middle-income countries. Of the top 20 countries with the largest number of unvaccinated children in 2017, nine have yet to introduce a second dose. UNICEF is working with Cameroon, Liberia and Nigeria to implement the second dose in 2019. Nigeria has the highest number of children under one year of age who did not get a first dose: approximately four million.

When just looking at high-income countries, a decrease also occurs from 94 to 91 per cent. Canada's federal government said that two-dose coverage is almost 100 per cent effective. For routine vaccination, it recommends that the first dose be administered at 12 to 15 months of age, and the second between 18 months and before starting school.

This week in California, Dr. Karen Smith, director of the California Department of Public Health, reported an increase in the number of measles cases. She said the state usually sees less than two dozen a year, but has recorded 38 this year as of Thursday. Much of the increase was linked to overseas travel.

Smith said more than 76 per cent of patients were not vaccinated or did not receive the two doses.

With files from CBC's Melissa Kent and The Associated Press