Polio and Measles Could Surge After Disruption of Vaccine Programs

Health Information Lifestyle

The widespread interruption of routine immunization programs around the world during the coronavirus pandemic is putting 80 million children under 1 year old at risk of contracting deadly, vaccine-preventable diseases, according to a report Friday by the World Health Organization, UNICEF and Gavi, the Vaccine Alliance.

The groups surveyed 129 poor and middle-income countries and found that 68 had some degree of disruption of vaccine services through clinics and through large inoculation campaigns.

Measles initiatives, for example, have been suspended in 27 countries, including Chad and Ethiopia, and polio programs are on hold in 38, including Pakistan and the Democratic Republic of Congo.

Many public health experts say they are worried that deaths from diseases including cholera, rotavirus and diphtheria could far outstrip those from Covid-19 itself.

The report highlighted warnings about polio, which had recently been all but eradicated, a hard-won victory that resulted from mass immunization programs that reached millions of children.

Dr. Seth Berkley, chief executive of Gavi, said that developing countries had made big gains in immunizations against numerous diseases in recent years. Before the pandemic hit, he said, more children in more countries had been protected against more vaccine-preventable diseases than ever before.

“Due to Covid-19, this immense progress is now under threat, risking the resurgence of diseases like measles and polio,” he said.

Restarting immunization programs is crucial not just for preventing more outbreaks of life-threatening diseases, he said: “It will also ensure we have the infrastructure we need to roll out an eventual Covid-19 vaccine on a global scale.”

According to health ministers and medical providers in the countries surveyed, there are a number of reasons for the disruptions.

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In late March, up to 80 percent of flights to Africa that deliver vaccines and syringes were canceled. The health care workers who administer vaccines have been afraid to proceed with the supplies they have on hand, because they lack sufficient protective gear. Parents have been afraid to take children to health clinics. Many areas are in lockdown altogether. And thousands of health care workers who might otherwise be engaged in vaccination are being diverted to respond to Covid-19.

But officials are now moving toward a cautious risk-benefit analysis. Noting that Covid-19 has flared inconsistently worldwide, varying not only from country to country but also within national borders, the Global Polio Eradication Initiative, a consortium of international organizations, is urging countries to evaluate their own situations closely and devise alternative, pandemic-safe vaccination strategies as soon as possible.

Because of the pandemic, Nigeria, which had been well on track to be certified as free of wild polio virus, had to cancel two polio vaccine campaigns in targeted areas that would have otherwise immunized a total of 37.6 million children.

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  • Frequently Asked Questions and Advice

    Updated May 20, 2020

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      Over 38 million people have filed for unemployment since March. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Is ‘Covid toe’ a symptom of the disease?

      There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • How can I help?

      Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

The Nigerian campaigns required that health care workers go door-to-door. “We couldn’t expose vaccinators,” explained Dr. Anis Siddique, the head of immunization for UNICEF in Nigeria, about why the programs were suspended.

Before the coronavirus pandemic, measles cases were already rising. In 2017, there were 7,585,900 estimated measles cases and 124,000 estimated deaths, according to the World Health Organization. In 2018, the last year for which international figures have been compiled, there were 9,769,400 estimated measles cases and 142,300 related deaths.

In 2019, the United States reported 1,282 measles cases, its highest in more than 25 years.

“Prior to Covid, measles was moving across the world as people flew,” said Dr. Frank Mahoney, an immunization expert and medical epidemiologist with the International Federation of Red Cross and Red Crescent Societies. “With more and more children becoming susceptible to it, it could be amplified and become a major international problem.”

Henrietta Fore, the executive director of UNICEF, addressed the terrible calculus countries must make in determining how to proceed. “While circumstances may require us to temporarily pause some immunization efforts,” she said, “these immunizations must restart as soon as possible, or we risk exchanging one deadly outbreak for another.”

https://www.nytimes.com/2020/05/22/health/coronavirus-polio-measles-immunizations.html, GO TO SAUBIO DIGITAL FOR MORE ANSWERS AND INFORMATION ON ANY TOPIC

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