A 2015 study projected that the crippling of immunization programs resulting from the 2014 Ebola epidemic in Guinea, Liberia, and Sierra Leone could double the number of people at risk of a measles outbreak, and could cause up to 16,000 measles deaths, surpassing the number of deaths caused by Ebola itself.
Global Issues
A single case of measles can incur more than $140,000 in costs
The US state of Iowa incurred more than US$140,000 in direct costs of outbreak containment stemming from a single case of measles in an unvaccinated student infected overseas. Swift containment procedure limited the outbreak to 3 additional cases but included significant and costly steps including tracking down contacts of the infected student, establishing a measles information hotline, testing exposed medical staff for immunity, conducting measles vaccination clinics, and putting quarantines into effect.
Although even small outbreaks of highly contagious diseases can be exceedingly costly to contain, the value of containment to society is very high. Traditional economic evaluations of outbreaks which include just the costs of illness to individuals should be expanded to include the costs and value of containing the outbreak required to protect society.
Meningitis epidemics in Burkina Faso caused major disruptions in healthcare services and increased misdiagnoses
Meningococcal meningitis epidemics in Burkina Faso “… disrupted all health services from national to operational levels,…” according to a 2011 study. Impacts included a shortage of available hospital beds and medicines, a reduction or delay in routine lab analyses for other diseases, longer wait times, and an increase in misdiagnoses by overtaxed health workers.
Rotavirus vaccine in conflict areas saves lives and is cost-effective, even with low coverage rates
A two-dose schedule of rotavirus vaccine was estimated to be cost-effective in Somalia, where more than 20 years of civil conflict have significantly damaged the health system and vaccine coverage is exceedingly low. Researchers estimate that in 2012, routine use of rotavirus vaccine, even at low coverage rates, would have averted nearly 25% of deaths due to rotavirus diarrhea in Somali children under one year of age.
Vaccine-preventable illnesses cause greatest burden of mortality for children affected by armed conflict
Children under 5 years of age bear the greatest burden of indirect conflict-associated mortality (indirect mortality results from disruption of health services including immunization, food insecurity, and high risk living conditions such as those found in refugee camps). The leading causes of child death in these circumstances include respiratory infections, diarrhea, measles, malaria, and malnutrition.
Migration can increase measles risk for unvaccinated children
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.
Vaccine-preventable illnesses are the leading causes of death during humanitarian emergencies
Respiratory infections and diarrhea are the leading causes of death during humanitarian emergencies according to a 2016 review of vaccine-preventable diseases and the use of immunizations during complex humanitarian emergencies.
Universal immunization programs have been shown to improve the height and weight measurement markers associated with malnutrition
Malnutrition is a leading contributor to morbidity and mortality during humanitarian emergencies, and a cyclical relationship exists between malnutrition and infectious diseases. Universal immunization programs have been shown to improve the height and weight measurement markers associated with malnutrition.
The pneumococcal conjugate vaccine was associated with a decline in antibiotic-resistant pneumococcal cases in South Africa
This study from South Africa demonstrates significant declines in invasive pneumococcal disease cases caused by bacteria that are resistant to one or more antibiotics. In fact, the rate of infections resistant to two different antibiotics declined nearly twice as much as infections that could be treated with antibiotics.
Correctional facilities can provide access to health services for incarcerated adolescents at risk of hepatitis B
Studies have indicated that the prevalence of risky behaviors associated with Sexually Transmitted Infections (STIs) and HIV is high among incarcerated adolescents. In the US, most adolescents sentenced to serve time in correctional facilities are offered preventive vaccination against hepatitis B. Medical clinics in correctional facilities provide an ideal environment for adolescents in high risk settings to obtain access to preventive health services. In certain cases, these facilities even overcome barriers such as parental consent by making these adolescents wards of the state and followed by which preventive services are obtained by the state providing consent.