Don't let coronavirus derail urgent vaccinations, PAHO warns

First day of the measles vaccination campaign in Rio de Janeiro, Brazil. Photo by: REUTERS / Tania Rego via EBC / Latin America News Agency

WASHINGTON — Vaccine-preventable diseases such as measles could spread further in Latin America and the Caribbean if countries do not maintain immunizations during the COVID-19 pandemic, the Pan American Health Organization warned Tuesday.

Dr. Carissa Etienne, director at PAHO, said the region is already fighting outbreaks of measles in three countries — Argentina, Brazil, and Mexico — following the disease’s return to Latin America and the Caribbean after being eradicated from the region in 2016.

Will vaccines reach low-income countries during a global pandemic?

As researchers work to develop vaccines for the novel coronavirus, the potential for large global demand could create challenges for access in low-income countries, says Seth Berkley, CEO at Gavi, the Vaccine Alliance.

“Efforts to control measles must continue safely amid the COVID-19 pandemic or we risk erasing more than 20 years of progress,” Etienne said at a PAHO media briefing Tuesday. “This is true for other diseases and a top priority for PAHO, as many countries have been struggling to maintain high coverage of key vaccines even before the pandemic. Globally, COVID-19 has already impacted immunization programs.”

She said that disruptions to vaccine supply chains and primary care services, as well as restrictions on vaccine distribution by health care workers, are alarming signs that regular immunization schedules will not be able to proceed as needed. To prevent overwhelming the health care system with hospitalizations during COVID-19 pandemic, vulnerable groups such as health care workers and older populations must be prioritized for vaccinations against other respiratory illnesses, she said.

“We recommend that governments prioritize those vaccines that are most urgent. This includes vaccines for diseases that have an imminent risk of expanding in that area, such as measles, and vaccines that protect from other respiratory infections, such as flu and pneumococcus,” Etienne said. “If we don't immunize now, many more people are going to get sick from preventable disease in the coming months and years.”

“Efforts to control measles must continue safely amid the COVID-19 pandemic or we risk erasing more than 20 years of progress.”

— Dr. Carissa Etienne, director, PAHO

There were more than 1 million cases of COVID-19 in the Americas as of Monday, Etienne said, with more than 60,000 deaths. Increased testing capacities have confirmed what PAHO has long suspected, she said: Infection rates are higher than what health authorities had been previously able to report. All countries in the region have diagnosed cases, and a growing number are seeing community transmission.

As the Southern Hemisphere moves into winter, Etienne said countries are using “creative” approaches to ensure vaccine coverage for seasonal influenza despite the COVID-19 pandemic. Bolivia is immunizing people in nursing homes and jails, and Brazil is targeting older adults at pharmacies.

PAHO issued detailed guidance to help countries plan which vaccines should be prioritized during this time of strain on health systems, weighing potential risks against the burden that COVID-19 is placing on health care facilities. The region is expected to immunize almost 100 million people with the flu vaccine this season, Etienne said.

Vaccine coverage rates in Latin America and the Caribbean are close to 95%, Etienne said, and the region has eliminated smallpox, polio, and four other diseases.

“History has shown us that if we allow large gaps in immunization coverage, vaccine-preventable diseases like polio and measles can reemerge,” Etienne said. “This region has shown great capacity to ensure people are vaccinated. We must maintain this capacity now but also to ensure the readiness to deliver the vaccine for COVID-19.”