Ukraine’s efforts to stop measles outbreak continue as case total increases
Measles continues to spread in Ukraine, with new cases now being reported in all oblasts and Kyiv. These cases are the latest in an expanding outbreak that affected over 3 000 people and claimed the lives of 5 children and adults in 2017.
“WHO and partners have been working closely with the Ministry of Health to protect the country’s population from measles as well as from other serious vaccine-preventable diseases. At least twice as many children were vaccinated on time against measles in 2017 compared to in 2016,”1 says the WHO Representative in Ukraine, Dr Marthe Everard. “This jump in routine immunization coverage represents a great step forward. However, the continuing spread of measles in Ukraine demonstrates that more must be done to vaccinate all those who have fallen behind.”
Achievements in the past year have been substantial in Ukraine
Over the past year, with support from WHO and partners, the Ministry of Health has:
- established a national Measles Task Force and response plan to urgently address the outbreak;
- actively sought out under-vaccinated children up to 10 years old through catch-up campaigns, and offered free vaccination to those under-17 susceptible to the disease;
- developed a comprehensive immunization programme strategy, including a long-term plan to ensure high-quality, safe vaccines are available for every eligible child;
- provided extra training for health workers in identifying and reporting measles cases;
- increased communication to parents to help them understand the critical importance of full vaccination in protecting health and well-being.
Efforts must be sustained and expanded to address all remaining challenges
“Every child or adult who has not has been fully vaccinated is a potential opportunity for measles to take hold and spread. Our joint work to realize the promise of measles elimination in Ukraine is more urgent than ever and it must be sustained”, says Robb Butler, Programme Manager Vaccine-preventable Diseases and Immunization, WHO Regional Office for Europe.
Supplemental immunization of missed children has been less successful than routine immunization, with coverage as low as 41% in local areas most affected by the outbreak.
Measles cases have been reported in all age groups, but vaccination has so far only been available to children younger than 17. It is vitally important that health workers and contacts of measles cases be vaccinated free of charge as a priority regardless of age.
Stockouts at local level continue to prevent some eligible children from receiving the vaccines they need.
Damage to vaccine confidence from the spread of misinformation about vaccines has made some health workers reluctant to recommend vaccination and some parents hesitant to demand it for their children. Restoring the population’s trust in the health system and in vaccination requires a long-term, sustained effort.
The international community, Ministry of Health, health workers, parents and civil society organizations all have a vital role to play in ensuring that the people of Ukraine are protected from the threat of measles and other vaccine-preventable diseases. Unless the large pool of susceptible individuals is drastically reduced through sustained, high routine and ad hoc supplemental immunization, Ukraine will remain vulnerable to large outbreaks and off track to achieve the disease control goals set out in the European Vaccine Action Plan 2015-2020. These include elimination of endemic transmission of measles, which has been achieved by 33 of 53 Member States of the WHO European Region so far.
Measles is a highly contagious vaccine-preventable viral disease that is a major cause of childhood mortality globally. Complications are more common in children under the age of 5 or adults over the age of 20. They include blindness, encephalitis, severe diarrhoea and related dehydration, ear infections and severe respiratory infections such as pneumonia. Severe complications can be fatal.
In the absence of vaccination, about 90% of individuals would be infected before they reached the age of 10. Two doses of measles vaccine provide over 99% protection from the disease and is the standard for all national immunization programmes in the Region. Elimination of measles requires 95% coverage with both doses of the vaccine, together with high-quality disease surveillance to quickly detect any cases.
WHO EpiData, 10/2017
Measles data for the period November 2016 to October 2017, received as of 7 December 2017 http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and...
WHO/UNICEF coverage estimates
Fact sheet – Measles in the WHO European Region http://www.euro.who.int/en/media-centre/sections/fact-sheets/2015/measle...
Ms. Anna Borshchevska
WHO Country Office in Ukraine