More than 22mn infants across the globe didn’t get their first measles vaccine dose in 2020, nearly 3mn more than in 2019, according to the World Health Organisation and the US Centers for Disease Control and Prevention.
This marks the largest increase in two decades and creates very dangerous conditions for outbreaks to occur.  
Even in countries with high vaccination rates, anti-vaccine sentiment has led to outbreaks in some communities. In 2019, for example, the US saw the highest number of preventable measles cases since 1992, CDC noted.
Measles, one of the most contagious viruses in the world, is “almost entirely preventable” through the two vaccine doses, the WHO and CDC said.
But only 70% of kids received their second dose last year, which is well below the 95% threshold needed to protect communities, the organisations said.
However, measles surveillance also deteriorated with the lowest number of specimens sent for laboratory testing in over a decade.
Weak measles monitoring, testing and reporting for measles jeopardise countries’ ability to prevent outbreaks of this highly infectious disease.
Major measles outbreaks occurred in some 26 countries and accounted for 84% of all reported cases in 2020.
“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support Covid-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, CDC’s Global Immunisation Director.  
“We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent­­ deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases.”
First-dose coverage fell in 2020, and only 70% of children received their second dose measles vaccine, well below the 95% coverage needed to protect communities from the spread of the measles virus.
Adding to the worsening of immunity gaps worldwide, 24 measles vaccination campaigns in 23 countries, originally planned for 2020, were postponed because of the Covid-19 pandemic — leaving more than 93mn people at risk for the disease.
These supplemental campaigns are needed where people have missed out on measles-containing vaccines through routine immunisation programmes.
“While reported measles cases dropped in 2020, evidence suggests we are likely seeing the calm before the storm as the risk of outbreaks continues to grow around the world,” said Dr Kate O’Brien, Director, WHO’s Department of Immunisation, Vaccines and Biologicals.
“It’s critical that countries vaccinate as quickly as possible against Covid-19, but this requires new resources so that it does not come at the cost of essential immunisation programmes. Routine immunisation must be protected and strengthened; otherwise, we risk trading one deadly disease for another.”
Measles is one of the world’s most contagious human viruses but is almost entirely preventable through vaccination. In the last 20 years, the measles vaccine is estimated to have averted more than 30mn deaths globally.
Estimated deaths from measles dropped from around 1,070,000 in 2000 to 60,700 in 2020. The estimated number of measles cases in 2020 was 7.5mn globally.  
Health experts’ demand strengthening of immunisation and surveillance systems to reduce growing measles risks.
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