The COVID-19 pandemic has pushed vaccination coverage for the highly contagious disease to its lowest level since 2008.

Measles is “imminently threatened” to spread in various parts of the world after the COVID-19 pandemic led many children to miss their routine vaccinations, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) said have warned.

Millions of children are now susceptible to measles, one of the world’s most contagious diseases, public health authorities said in a joint report on Wednesday.

The disease is almost completely preventable by vaccination, but at least 95 percent vaccination coverage is needed to prevent outbreaks.

A record number of nearly 40 million children missed a dose of measles vaccine in 2021 due to difficulties caused by the COVID pandemic, the report said.

Continued declines in vaccination, weak disease surveillance and delayed response plans due to COVID-19, alongside ongoing outbreaks in more than 20 countries, mean that “measles is an imminent threat in every region of the world,” it warned.

Officials said there were about 9 million measles infections and 128,000 deaths worldwide by 2021.

The WHO and CDC reported that only about 81 percent of children received their first dose of the measles vaccine, while 71 percent received their second dose, marking the lowest global coverage rate of the first measles dose since 2008.

“The record number of under-immunized children susceptible to measles demonstrates the severe damage to immunization systems that have taken place during the COVID-19 pandemic,” CDC Director Dr. Rochelle Walensky said in a statement.

Measles is usually spread through direct contact or airborne and causes symptoms, among other things fever, muscle aches and a skin rash on the face and upper neck. Most measles-related deaths are caused by complications such as brain swelling and dehydration. The WHO says serious complications are most serious in children under five and adults over 30.

While the number of measles cases has not yet risen dramatically compared to previous years, now is the time to act, WHO measles chief Patrick O’Connor told Reuters news agency.

“We are at a crossroads,” he said. “It’s going to be a very challenging 12-24 months to mitigate this.”

More than 95 percent of measles deaths occur in developing countries, especially in Africa and Asia. There is no specific treatment for the disease, but the two-dose vaccine against the virus is about 97 percent effective in preventing serious illness and death.

In July, the United Nations said there were 25 million children missed routine immunizations against diseases, including diphtheria, largely because the coronavirus pandemic had disrupted routine health services or fueled misinformation about vaccines.

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