Visualizing global progress in reducing the burden of measles

Children worldwide are still dying from measles, a disease that is easily and cheaply preventable by vaccine. This is a child in Guinea. --Flickr, Julien Harneis

Many of us have the luxury of not knowing what life was like prior to the start of mass vaccination.

Talking to my grandmother about her childhood helps me understand how much I take for granted, however. Growing up in rural Virginia in the 1930s, she saw the impact of vaccine-preventable diseases firsthand.

“When my sister Jane was 10,” my grandmother tells me, “she came down with whooping cough. She had terrible coughing fits so bad she could hardly breathe, and she had to miss months of school.” Jane survived, but others were not so lucky.

A lot of progress has been made against measles, but many around the world remain unlucky when it comes to this deadly and disabling disease. And bad luck, when it comes to infectious disease, travels.

Prior to the introduction of nationwide vaccine programs, diseases such as whooping cough, measles, and polio were a common part of everyday life. In the 1940s, prior to the introduction of the measles vaccine, 3 to 4 million people contracted the virus and 400 to 500 died from it annually in the US according to the Centers for Disease control (CDC). In 2010, measles deaths in the US amounted to just 18.

At the global level, child deaths from measles declined by 80% between 1990 and 2010 (see screen grab). A new paper looking at progress in reducing child mortality and attainment of Millennium Development Goal 4 found that vaccines, new drugs, and other health innovations saved 4.2 million children’s lives in 2013 alone.

Leading causes of death in 1990 and 2010 and percent change, global

Measles IHMEMany developing countries are making great strides against vaccine-preventable diseases as they increase vaccination coverage. For example, Rwanda managed to reduce child deaths from measles by 79% between 1990 and 2010 (see screen grab below). According to estimates from the WHO and UNICEF, the country increased its measles vaccination coverage from 83% in 1990 to 95% in 2010.

Leading causes of death in 1990 and 2010 and percent change, Rwanda

Measles 2As a whole, Sub-Saharan Africa also made dramatic progress during these two decades, decreasing deaths from measles among children under 5 by 87% over the period as illustrated in the next screen grab. This progress is largely attributable to increases in vaccination coverage.

Deaths from measles among children under 5 years, 1990-2010, sub-Saharan Africa

Measles3Despite all the progress made worldwide, the threat of vaccine-preventable diseases is ever present, even in countries where most people have never seen a case of measles.

In late April, the CDC reported the largest measles outbreak since 1996 in the US. Thirty-four of the 129 cases originally contracted it in other countries and brought it into the US. Most of the individuals who became infected in the US were unvaccinated or unaware of their vaccination status.

To stop the spread of measles—an extremely contagious disease—over 90% of people need to be vaccinated. Not all states in the US have achieved this level of vaccine coverage. According to the Washington State Department of Health, just 85% of people are vaccinated. Washington had one of the highest vaccine opt-out rates, but those rates are starting to decline since the state began requiring a doctor’s signature if parents choose not to vaccinate their children, as reported by the New York Times. High vaccination opt-out rates remain problematic in states where laws make it relatively easy for parents to do so.

To boost and maintain progress against vaccine-preventable diseases, constant vigilance and investment in vaccination programs are sorely needed. Ideally, everyone would live in a country where vaccine-preventable diseases are a distant memory.

Katie Leach-Kemon, a weekly contributor of global health visual information posts for Humanosphere, is a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

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Katie Leach-Kemon

Katherine (Katie) Leach-Kemon is a policy translation specialist at the Institute for Health Metrics and Evaluation (IHME). Katie specializes in two of IHME's research areas, the Global Burden of Disease and health financing. Katie has helped produce IHME's Financing Global Health report since it was first published in 2009. She received an MPH from the University of Washington and served as a Peace Corps volunteer in Niger. Her work has been published in The Lancet, Health Affairs, and the Journal of the American Medical Association. You can follow her on Twitter @kleachkemon.