VoICE Immunization Evidence: Conflict and Humanitarian emergencies
Conflict and migration can lead to outbreaks, including in previously controlled or eliminated diseases, and jeopardized disease control efforts.
The ongoing conflict in Syria has caused the breakdown of immunization services, leading to outbreaks of vaccine preventable diseases in the region and the re-emergence of polio in Syria for the first time in 15 years. The potential for polio to re-emerge in neighboring areas with low coverage of inactivated polio vaccine (IPV) threatens the success of global efforts to eradicate polio.
Lam E., Diaz M., Maina A.G., and Brennan M. 2016. Displaced populations due to humanitarian emergencies and its impact on global eradication and elimination of vaccine-preventable diseases. Conflict and Health. 2016; 10:27.
Researchers investigating the causes of a measles outbreak in Burkina Faso that occurred despite a recent mass vaccination campaign found that migration to and from Cote d’Ivoire was a major risk factor for children. Unvaccinated children who developed measles were 8.5x more likely to have recently traveled to Cote d’Ivoire than unvaccinated children who had not traveled across the border. Children returning to Burkina Faso after a period of time in Cote d’Ivoire were less likely to have been vaccinated due to low routine coverage of measles vaccines in Cote d’Ivoire. Conversely, unvaccinated children from Burkina Faso who traveled to Cote d’Ivoire and returned were more likely to be exposed to measles and thus had a higher rate of disease than children who never visited Cote d’Ivoire.
Yameogo, K.R., Perry, R.T., Yameogo, A., et al. 2005. Migration as a risk factor for measles after a mass vaccination campaign, Burkina Faso, 2002. International Journal of Epidemiology. 34(3).
Large measles outbreaks occurred in Lebanon and Jordan, following an influx of Syrian refuges migrating to escape conflict. In Lebanon, the measles incidence increased 200-fold in one year following high migration. There were 2.1 measles cases per million population in Lebanon in 2012; this increased to 411 cases per million in 2013.
Teleb N. and Hajjej R. 2017. Vaccine preventable diseases and immunization during humanitarian emergencies: challenges and lessons learned from the Eastern Mediterranean Region. East Mediterr Health J.. 22(11):775-777.