MEASLES IN UKRAINE. DYNAMICS OF INCIDENCE AND PERSPECTIVES OF STRUGGLE

Abstract

SUMMARY. Between 2000 and 2021, measles vaccine prevention (according to WHO calculations) prevented 56 million deaths in the world. At the same time, in 2021, 128,000 people died from measles, mainly children under the age of 5. Measles continues to be an actual infection, accompanied by periodic epidemic outbreaks of varying intensity.

In Ukraine, in the post-vaccination period, the highest increase in the incidence of measles was registered in 2018–2019 (125.5–135.7 per 100,000 population). At the same time, its level was several times lower than the morbidity rates observed in the inter-epidemic periods before the introduction of vaccination. In 2016, coverage rates for the 1st and 2nd vaccinations against measles, mumps, and rubella (MMR-1 and MMR-2, respectively) were the lowest ever since the beginning of vaccine prevention (45.5 % and 30.2 %, respectively). This state of vaccination coverage preceded the epidemic in 2018–2019. At the beginning of the last outbreak in Ukraine (2017), 49.0 % of cases were children aged 1–9 years, 27.0 % were adults, and in 2019 – 29.0 % and 47.0 %, respectively. Thus, children in the age group that should be maximally protected according to the vaccination schedule played the role of a trigger in the spread of measles among the population. In 2021, the share of children covered by MMR-1 and MMR-2 in the administrative regions of Ukraine ranged from 78.2 to 97.5 % and from 77.0 to 99.1 %, respectively. These indicators were quite low in the western regions both in 2021 (respectively 79.9–86.3 and 77.0–88.0 %) and in 2022 (respectively 67.0–86.6 and 54.9–83.7 %), where the intensity of migration processes in 2022 in connection with the aggression of the Russian Federation was the most pronounced. In general, the state of measles vaccine prevention in Ukraine can be assessed as unsatisfactory. During 2020, 2021, 2022 and 2023 (9 months), 264 cases of measles (0.6 per 100,000 population), 16 (0.04), 11 (0.03), 46 (0.11) were registered, respectively.

Such low indicators in 2021 and 2022, although they were observed against the background of a cyclical decrease in the incidence of measles, can be explained by quarantine measures against COVID-19, which reduced the activity of the transmission mechanism of the pathogen, and the beginning of military operations in connection with the aggression of the russian federation? which affected the diagnosis and registration of cases. It is also necessary to take into account the fact that in 2022, due to migration abroad, the number of children, including those susceptible to measles, decreased. Currently, Ukraine is gradually entering the period of a new cyclical rise in the incidence of measles, but based on a long-term analysis of the dynamics of the incidence, it can be predicted that its intensity will be much lower.