Preparing For TB, Polio, Measles, and COVID-19 Outbreaks
The European Centre for Disease Prevention and Control (ECDC) agency recently issued a public health notice regarding the prevention and control of infectious diseases related to visitors from Ukraine.
On March 8, 2022, the ECDC reported a large number of people from Ukraine are entering the European Union (EU) countries Hungary, Poland, Romania, Slovakia. Unfortunately, many of those people, mainly women and children, are under-vaccinated against infectious diseases.
The ECDC stated, ‘Ensuring continuity of routine vaccinations and addressing gaps in prior vaccination histories is an essential element of the public health support for displaced people.’
‘In this context, ensuring vaccination coverage against poliomyelitis, measles, tuberculosis, and COVID-19 should be a priority.’
According to ECDC data, the current under-vaccinations status is as follows:
- According to the 2021 annual tuberculosis (TB) surveillance and monitoring in Europe, based on 2019 data, Ukraine reported the second-highest number of TB cases (28,539), with an incidence of 65 cases per 100,000 and a mortality rate of 7.3 deaths per 100,000. And Ukraine is one of 10 countries globally with the highest burden of multi-drug resistant TB. Ukraine has been deploying the BCG vaccine for many years.
- In Ukraine, there is still considerable vulnerability to poliovirus, particularly for young children, primarily due to insufficient vaccination coverage. Overall vaccination coverage for polio was 80% in 2021, and this level of coverage has not been exceeded in recent years. As a result, the U.S. CDC issued an Alert - Level 2 travel advisory regarding polio outbreak concerns in December 2021. Both injectable and oral polio vaccines are used in Ukraine.
- Vulnerability to measles is also a serious concern, as the overall vaccination coverage for two doses of measles-containing vaccine was 81.9% in 2020, which is insufficient to prevent outbreaks.
- Since the start of the COVID-19 pandemic in 2020, and as of March 2, 2022, a total of 106,239 COVID-19 related fatalities have been recorded in Ukraine. Six COVID-19 vaccines are approved for use in Ukraine: Spikevax, Comirnaty, COVID-19 Vaccine Janssen, Vaxzevria, Covishield, and CoronaVac. Data as of February 2022 show that uptake of a primary COVID-19 vaccination series in the total population was 35%, which is substantially lower than the EU/EEA average of 71.7%. To alert international travelers of their health risks, the CDC issued a Level 4: Very High Level of COVID-19 in Ukraine in October 2021.
Furthermore, Table #1 shows the number of cases of relevant vaccine-preventable diseases in the last four years and the corresponding vaccination coverage in Ukraine.
And Table #2 provides an overview of the vaccinations to be offered in the absence of documented evidence of prior immunization. Where possible, combination vaccines should be used to facilitate vaccination.
The ECDC stated a ‘Priority should be given to protection against easily transmitted infectious diseases possibly associated with serious outcomes, such as COVID-19, measles, and poliomyelitis.’
This ECDC report presents the ‘5Cs’ model as a framework for designing appropriate strategies to facilitate vaccination acceptance and uptake. The 5Cs are Confidence, Constraints, Complacency, Calculation, and Collective responsibility.
These under-vaccination concerns could also apply to the U.S.
The U.S. CDC confirmed on March 1, 2022, that, based on a request from the U.S. Department of State and consistent with the determination made by the Secretary of Homeland Security, it would extend the exercise of its enforcement discretion regarding certain aspects of its Global Travel During the COVID-19 Pandemic.
According to this exercise of enforcement discretion, covered persons will not be required to provide proof of a negative COVID-19 test result before boarding a flight to the United States or complete the attestation at Section 1 of the Combined Passenger Disclosure and Attestation to the United States of America form.
This exercise of enforcement discretion is limited to specific groups of individuals, to the extent, they were physically present in Ukraine as of February 10, 2022, and will expire on April 1, 2022, subject to any further extensions, consistent with the action of the Secretary of Homeland Security.
The CDC added ‘Travelers may further be subject to additional public health measures as may be required by state and local health authorities at their arrival location in the U.S.’
Additional travel vaccination news is posted at Vax-Before-Travel.
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Note: This news article is an aggregation for various reports and has been edited to present for mobile readers.