You're listening to The Drug Report on ReachMD, hosted by Linda Bernstein, Pharm.D., Clinical Professor on the Volunteer Faculty of the School of Pharmacy, University of California, San Francisco.
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Measles cases and associated deaths are on the rise worldwide according to a November 13, 2020 article in The Morbidity and Mortality Weekly Report entitled, “Progress Toward Regional Measles Elimination – Worldwide, 2000-2019.” The report noted that the number of measles cases (as reported to the World Health Organization and UNICEF) increased 556% from 132,490 in 2016 to 869,770 in 2019, representing the most reported cases since 1996. In 2019, the global increase in cases was driven by large outbreaks in several countries due to a variety of factors including large populations of measles-susceptible children who had not received even the first of the two recommended Measles Containing Vaccines or MCV1; some not receiving the second measles vaccine (MCV2); a decline in vaccine confidence by the public and healthcare professionals, low demand from the public, and challenges with vaccine supply, storage, and handling. This disturbing trend in the measles infection rate marked a significant step backward in progress toward global measles elimination.
During 2000–2019, compared with no measles vaccination, measles vaccination prevented an estimated 25.5 million deaths globally. As outlined in the “Immunization Agenda 2030”, a global immunization strategy for 2021–2030, further progress toward achieving measles elimination goals will require strengthening essential immunization systems to increase 2-dose coverage, identify and close historical immunity gaps through catch-up vaccination to prevent outbreaks, improve surveillance and preparedness for rapidly responding to outbreaks, and leverage measles as a tracer and guide to improving immunization programs.
In 2020, the coronavirus disease 2019 pandemic has produced increased programmatic challenges, leading to fewer children receiving vaccinations and poorer surveillance. Progress toward measles elimination during and after the pandemic will require strategies to integrate catch-up vaccination policies into essential immunization services, assurance of safe provision of services, engagement with communities to regain trust and confidence in the health system, and rapid outbreak response.
A CDC publication entitled, “COVID-19's Impact on Measles Vaccination Coverage”, a Statement by the Measles & Rubella Initiative comprised of the American Red Cross, U.S. Centers for Disease Control and Prevention, UNICEF, United Nations Foundation, and the World Health Organization, dated April 14, 2020, stated:
“As COVID-19 continues to spread globally, over 117 million children in 37 countries may miss out on receiving life-saving measles vaccines. Measles immunization campaigns in 24 countries have already been delayed; more will be postponed.”
On May 8, 2020, the CDC’s report, “Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020,” stated, “The identified declines in routine pediatric vaccine ordering and doses administered might indicate that U.S. children and their communities face increased risks for outbreaks of vaccine-preventable diseases,” and suggested that a decrease in rates of routine childhood vaccinations were due to changes in healthcare access, social distancing, and other COVID-19 mitigation strategies. The report also noted that “parental concerns about potentially exposing their children to COVID-19 during well child visits might contribute to the declines observed.”
Pharmacists can play a key role in combatting measles, if given the opportunity. According to a November 17 publication of the American Pharmacists Association entitled, “Amid concerns about declining childhood vaccination rates, measles surges globally, pharmacists can help,” APhA President Michael D. Hogue, PharmD, FAPhA, FNAP stated, “[This] news out of CDC regarding the global surge in measles cases illustrates why pharmacist involvement in pediatric immunizations during the pandemic is so important.”
U.S. Health and Human Services amended the Public Readiness and Emergency Preparedness Act (PREP Act) to allow all state-licensed pharmacists to immunize children over the age of 3 to “increase access to childhood vaccines and decrease the risk of vaccine-preventable disease outbreaks as children across the United States return to daycare, preschool and school."
Dr. Hogue commented, “Some states have unfortunately decided to restrict access to care by excluding pharmacists as “Vaccines for Children providers.” Vaccines for Children Program or VFC, is federally funded and helps provide vaccines to children whose parents or guardians may not be able to afford them. Dr. Hogue calls upon all state VFC programs to eliminate unnecessary barriers to access to care so we can avoid the global measles outbreak from taking hold in this country. He stated the pharmacist is eager to help prevent unnecessary disease outbreaks through prevention services like vaccinations.
For The Drug Report, I’m Dr. Linda Bernstein.
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