While the World Health Organisation has raised the alarm about an increase in measles outbreaks globally, South Africa is confident the risks locally are minimal.

UNICEF and the WHO  reported cases of measles increased by 79 percent globally in January and February 2022. The organisations warned this could cause an increase in the spread of vaccine-preventable diseases and could trigger larger outbreaks.

Almost 17 338 measles cases were reported worldwide in January and February 2022, compared to 9665 during the first two months of 2021. According to WHO, the countries with the largest measles outbreaks in the past year include Somalia, Yemen, Nigeria, Afghanistan and Ethiopia.

South Africa has not experienced the same drop in vaccination coverage as other African countries, said Dr Lesley Bamford, the Department of Health’s Chief Director for the Child Health Programme.

Vaccine hesitancy poses a risk

But Dr Bamford said there is an ongoing drifting risk of experiencing measles outbreaks. South Africa last experienced a measles outbreak in 2017.

“In order to be confident that we don’t experience another one, we need to ensure that 95% of children are vaccinated against measles and receive two doses of the measles vaccine. If we don’t achieve those levels in South Africa, there is always a risk that the number of susceptible children will rise,” said Dr Bamford.

Measles is a very infectious disease that is spread through respiratory contact and children present with fever, a cough, rash, red eyes and conjunctivitis. Complications such as pneumonia, diarrhoea, middle ear infection and exacerbated malnutrition can also develop.

The increase in vaccine hesitancy across South Africa since the arrival of COVID-19 fuels concerns. Dr Bamford said people need to remember that vaccines have saved millions of lives.

“Vaccination has been probably the single most important advance in public health in the past 200 years. Smallpox which used to kill many millions of people has been eradicated through vaccination.” 

Johannesburg Paediatrician Dr Enrico  Maraschin agrees that immunisation programs are vital to protect communities at large rather than one individual. To adequately protect a community, one needs to achieve herd immunity. 

“Your child’s immunity will have an effect on the next child. Chicken-pox can lead to pneumonia, mumps can lead to deafness, Streptococcus Pneumonia and Haemophilus influenza type b can result in permanent brain damage and ultimately death”.

He said parents often feel that their child is not at any serious risk of the diseases that vaccines protect against and that the recommended vaccine schedule is too aggressive for babies and small children. 

“With the exception of clean water, no other intervention has been as successful in preventing illness and death in young children”.

Dr Bamford said the vaccine does cause mild side-effects like fever, mild rash and redness at the injection site but it is extremely safe and effective.

Illness not an excuse to skip vaccination

A common misconception around childhood vaccination is that children should not be vaccinated if they have illnesses. Parents delay vaccination if a child is very ill or admitted to hospital. 

“If a child is well enough to go home, then they are well enough to be vaccinated. Should children with pre-existing conditions be vaccinated? Yes, it’s even more important to protect children with conditions, for example children with HIV.”

Dr Maraschin said parents must keep in mind the risks associated with vaccine preventable diseases. 

“Globally measles remains one of the leading causes of death in young children. This shows that the illness is still in our environment and will cause harm if not contained by the vaccination programs”, he said.

He said schools must ask learners for their immunisation cards when enrolling them. If children are missing vaccinations then parents should be asked to get these done.

Healthcare practitioners should also check the immunisation records of each child they see and suggest a catch-up program where necessary”, he said.

Risk being monitored

DoH spokesperson Foster Mohale said the country has not yet recorded a recent increase in measles cases.

“The figures announced by UNICEF and WHO are global figures. Although immunisation rates dropped during the hard lockdown, all districts implemented catch up campaigns and rates quickly returned to pre-pandemic levels”, he said.

Mohale admitted these levels are lower than they should be – as a result the risk of a measles outbreak remains and is being carefully monitored. 

“All parents and caregivers are encouraged to ensure that their children have received all the necessary vaccines which includes two doses of measles vaccine (at 6 and 12 months).”

Measles doses are provided free at all public sector clinics and can be given as catch up doses later than the recommended age if the child missed the dose(s). – Health-e News