COVID-19 is a Deadly Threat to Children
by Natasha Crowcroft, Director of the University of Toronto’s Centre for Vaccine Preventable Diseases; Professor, University of Toronto’s Dalla Lana School of Public Health and David Morley C.M., President and CEO, UNICEF Canada
With the world anxiously awaiting a vaccine for COVID-19, the importance of vaccinations has not received such global attention in recent times. While the focus on stopping the spread of COVID-19 is a paramount priority, we must continue to deliver healthcare to the world’s most vulnerable to ensure we don’t inadvertently cause negative consequences in other areas.
As physical distancing measures become stricter to limit the spread of the coronavirus, we must ensure that children are not left defenceless against deadly infectious diseases because they miss routine vaccinations.
The pandemic is pushing already struggling health systems in many countries past the breaking point. Without a coordinated international effort to strengthen health systems, more than 117 million children in 37 countries are at risk of not receiving immunizations against measles. An estimated 140,000 people died from measles in 2018, mostly children and babies. All those deaths were preventable.
Children living in countries with protracted humanitarian emergencies need even more support.
About 1 in 4 children are living in areas affected by conflict. Mobilizing vaccination programs in emergencies is especially difficult. Health systems have long stopped working, with warring groups killing health workers and destroying already depleted facilities.
During the recent Ebola outbreak in the war-torn Democratic Republic of Congo, more than 5,300 children under 5 died from measles – more than double the total number of Ebola deaths. At the same time, more than 30,000 people contracted cholera.
We have been here before. Emergencies have always posed major threats to public health – destroyed health systems in Syria set the stage for polio to re-appeared 18 years after it was eliminated. But never before have we seen disruption on the global scale of COVID-19.
The global community also needs a strategy on how to resume the production of routine vaccines now that major producers, including key suppliers in India, have been forced to greatly reduce or cease operations. Plus, capacity will likely be diverted to scaling up COVID-19 vaccine production when and if candidates are ready for mass use.
As we mark World Immunization Week (April 24-30), it is essential to understand that vaccines are the key reason child mortality rates have been cut in half since 1990. The focus on reducing child mortality was driven by the ratification of the UN Convention on the Rights of the Child (CRC).
The CRC compels governments in every country and at all levels to safeguard the health and survival of their most vulnerable. This means ensuring newborns, children and mothers — including those in emergency settings and the most marginalized — have continued access to primary essential healthcare services like immunization.
In countries where immunization programs have stopped completely because of coronavirus, governments should prioritize restarting them as soon as possible and identifying children who missed vaccine doses. Without action, we risk a resurgence of diseases such as polio, whooping cough, cholera and measles, and preventable deaths of newborns and children from pneumonia and diarrheal disease.
There are plenty of successes to embrace. Thanks to vaccines, maternal and neonatal tetanus — extremely fatal in newborns — has been eliminated in all but 12 countries as of July 2019. Only two countries have recorded infections of wild poliovirus last year. Measles immunizations have saved an estimated 23.2 million children since 2000.
Yet, 13 million children globally are not receiving any vaccines. Most live in remote rural areas, urban shanty towns and conflict zones. Some of the measures to respond to COVID-19 will slow the spread of vaccine-preventable diseases, but only for a short window. We know they will be back.
While everyone in Canada has been understandably been focused on keeping themselves and their loved ones safe and protected during the pandemic, we must ensure that we do whatever it takes to keep every child safe and healthy.
For the world’s poorest nations, sustained access to healthcare services and immunizations for children and mothers will be a matter of life and death.
The world is grappling with a new reality. This is not the first epidemic and it will not be the last. It is also an opportunity to embrace vaccines with renewed determination.