Parents have been urged to protect their children against measles, amid rising vaccine hesitancy, to curb the threat of waning herd immunity that could lead more children to be struck down by preventable disease.
The UAE government launched a national measles inoculation campaign on Thursday, which aims to provide a dose of the MMR vaccine to all children aged one to seven, regardless of previous inoculations or infections. The National Supplementary Measles Immunisation Campaign 2024 has been given the theme: Protect Yourself, Protect Your Community.
A highly effective, safe vaccine has been in circulation for more than 60 years, offering protection from measles for millions of children. But after the Covid-19 pandemic there has been a shift towards doubt over vaccine safety, fuelled by misinformation circulated on social media, threatneing global targets to eradicate preventable diseases.
Dr Farida Al Hosani, member of the WHO Pandemic Influenza Preparedness Framework Advisory Group, said child immunisation plans were vital. “We’ve noticed in recent years, especially post-Covid, there has been a drop in vaccine coverage rates, especially measles,” she said.
“It's usually the last vaccine for children, and sometimes mothers forget about it, or there is some hesitancy about it. There is also some misconception that it might be related to autism, which is proven to be not true. It is an extremely safe vaccine, and prevents the spread of measles in the community.”
Global outbreaks
Outbreaks of measles have been reported across the US and European nations, with the US Centres for Disease Control and Prevention (CDC) and World Health Organisation reporting 9 million cases of the highly contagious disease in 2022 and 136,200 deaths, mostly in children.
In 2023, Europe saw a 30-fold increase in measles cases compared to 2022. More than 30,000 cases were recorded from January to October in 2023, while there were just 941 cases in all of 2022, the WHO said.
“Misinformation is playing a major role in creating fear in the community,” said Dr Al Hosani, who is an adjunct associate professor at UAE University. “A lot of information we see on social media from unreliable sources is playing a big role in this increase in vaccine hesitancy, in different communities.
“We have seen countries in Europe have pockets of measles outbreaks in children. We saw it in the recent years in the United States, and it's the same in our region.
“I would advise any mother moving to live here to visit their paediatrician and ensure her children are up-to-date based on our schedule here. Booster campaigns done for measles are safe, and will improve their immunity.”
National campaign
A campaign partnership between Emirates Health Services, Abu Dhabi Public Health Centre, and Dubai Health Authority, aims to strengthen immunity and protect public health by providing an additional booster dose of the MMR vaccine for children under the national measles elimination programme. The global goal is to eradicate the disease by 2030.
Vaccine hesitancy was a key topic of the three-day Healthcare Future Summit held in Dubai.
Experts said adult vaccination programmes should be considered as important as childhood immunisation, as populations begin to live longer into old age.
Prof Michael Moore, a former Australian minister of health and past president of the World Federation of Public Health Associations, said while lessons had been learnt on public communication during Covid-19, the pandemic had left behind a legacy of doubt.
“All of us involved in vaccines are concerned about misinformation,” he said. “What we're trying to do is control the narrative and make sure that the misinformation is contained.
“That requires a transparent engagement, particularly with social media companies. There is no reason why governments, in particular, can't engage with social media companies to ensure they apply their algorithms that ensure misinformation is not circulated.
“Then we need to continue to co-ordinate policies to increase resilience in the information environment.”
Creating a comprehensive adult vaccination schedule emerged as a consistent and fundamental theme throughout the summit, but clear challenges remain in light of widening, unverified doubt around tried and tested vaccines.
While implementing a widespread adult vaccination schedule to tackle debilitating conditions such as shingles and influenza could prove challenging, clear rewards are to be had.
Adult vaccines
A unified adult vaccination schedule could advance public health by reducing vaccine-preventable diseases, cutting healthcare costs, and enhancing quality of life across communities, experts said.
“Vaccine hesitancy is a growing challenge that threatens to reverse the progress that has been made in tackling vaccine preventable diseases,” said Dr Hamad Eid Al Romaihi, director of heath protection and communicable diseases control, Ministry of Health Qatar.
“It can also reverse and extend the deadline for reaching the target for elimination and the eradication of diseases such as polio and measles.
"One of the main concern with the vaccine hesitancy is insufficient herd immunity. When that happens there is an increase in outbreaks which affect not only a local health system, but also has an impact on global health systems.”
In 2014, immunisation experts at the WHO defined vaccine hesitancy as a delay in acceptance or refusal of vaccine, despite the availability of vaccination services.
Vaccine hesitancy is not a binary choice of accepting or using vaccines that exist, but reflects different degrees of underlying uncertainty.
Some individuals totally refuse the vaccine, others delay them awaiting more information and also believe they are not at immediate risk.
Research by the King Saud bin Abdulaziz University for Health Sciences, Riyadh in 2021 found vaccine hesitancy in GCC countries ranged from 11 to 71 per cent.
Differences in rates were noted for vaccine type, with Covid-19 vaccine having the highest reported hesitancy at 70.6 per cent.
Healthcare workers were among the main sources of information and recommendations about vaccination, but up to 68 per cent of them were vaccine-hesitant.
The majority of healthcare workers had never received any training on addressing vaccine hesitancy among patients, researchers found.
“Another challenge is hesitancy among healthcare workers in this region; if they themselves are hesitant they will not recommend vaccines for their patients,” said Dr Al Romaihi.
“It's important to address any hesitancy among healthcare workers and offer them special training programmes.”
