Cases are exploding around the world, vaccination is declining.

We are not talking about Covid-19, but about so-called “classic” diseases such as measles.

So classic that we sometimes forget their dangerousness.

However, in the first two months of 2022, reported cases of this extremely contagious viral infection jumped 80% worldwide, warned on Wednesday April 27, the World Health Organization (WHO) and the 'UNICEF.

In question, a significant delay in the vaccination of children during the Covid-19 pandemic raising fears today of the appearance of serious epidemics of measles which could, according to UN organizations, affect "millions of children" in 2022.

In the last twelve months, 21 measles outbreaks have been recorded, mainly in Africa and the Eastern Mediterranean region.

Among the most affected countries are Somalia, Yemen, Nigeria, Afghanistan and Ethiopia.

In France, vaccination against measles is compulsory (MMR vaccine - measles, mumps, rubella), yet injections fell by 10% in 2021. A decline, which began at the start of the health crisis linked to Covid-19, which is explained by several factors and could lead to local epidemic outbreaks.

A shift in pediatric vaccinations from confinement

Apart from vaccination, there is no way to effectively prevent measles, recalls Mircea Sofonea, lecturer in epidemiology and evolution of infectious diseases at the University of Montpellier.

"Measles is considered the most contagious respiratory virus, with a basic reproduction number (average number of secondary infected per contagious person) estimated between 12 and 18", specifies the epidemiologist.

Thus, vaccination must concern a very high fraction of the population (95%), and must be carried out in the first years of life, because it is before five years (and then after twenty years) that the risks are greatest. important.

At the start of the health crisis linked to Covid-19, confinement and the fear of being contaminated by this new virus contributed to discouraging patients from going to their doctor, which led to a general drop in vaccination, explains Mircea Sofonea.

"There was a form of delay in pediatric vaccinations from that moment," he says, specifying that this phenomenon is far from being specific to France.  

Also, according to him, if the campaign for the booster dose against Covid-19 and the vaccination against seasonal flu, in the fall of 2021, were carried out with care, the same was not true for vaccination. against other diseases, including measles.

"There was a very important focus on Covid-19, which explains this shift and this drop in vaccination" against other diseases.

However, "measles is the first of the diseases which will make this vaccination gap visible", he continues.

"As soon as there is a drop, there is an epidemic resumption which is observed", develops Mircea Sofonea.

A phenomenon already observed at the local level, notably in the Netherlands where a drop in vaccination coverage in orthodox Protestant anti-vaccine communities has led to a local drop in herd immunity, and therefore to recurrent epidemic outbreaks of measles.

"This is what we are seeing today on a global scale", adds the epidemiologist, "because in each country, you have had a drop in vaccination which, suddenly, raises the potential contagiousness of measles".

The MMR, affected by distrust of vaccines?

In France, 10% less vaccination in 2021. This is not much compared to other countries, but all the same, specifies Mircea Sofonea, “measles still represents a risk insofar as we have seen severe cases and significant circulation in recent years: the measles situation in France has never really been resolved, and it is still at risk".

After the confinements and the fear of being contaminated by the coronavirus, the vaccination campaign against Covid-19 may also have played a role in this drop in vaccinations against measles.

Skepticism, even rejection, of the Covid-19 vaccine (even more so when it was a question of injecting it into children) may have fueled mistrust of other vaccines intended to younger people.

"France, compared to other countries such as Portugal or Spain, does not have as proactive a policy as its European neighbors with regard to pediatric anti-SARS-CoV-2 vaccination", explains Mircea. Sofonea, which refers to lower levels of vaccination coverage.

“At the time of the end-of-year celebrations, instead of highlighting vaccination for children, we ended up with a school prevention protocol: this created mistrust vis-à-vis pediatric vaccination. , which is a shame because these two vaccines have nothing to do”, recalls the epidemiologist.

"MMR works extremely well against measles and is harmless; the SARS-CoV-2 vaccine is not more dangerous but is new,

The fact remains that today, the delay in making appointments for vaccination against measles temporarily creates "a call for air for measles which circulates quietly", explains Mircea Sofonea.

Faced with this phenomenon, the virus may begin to spread locally.

"It's worrying," he concludes, "because measles is a disease that can kill in the absence of treatment: between 1 and 2% lethality, which corresponds to a higher estimate than that of Initial Covid-19."

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