COVID-19 Pandemic Exacerbates Measles Crisis in Zambia

Strategic Insights -

The COVID-19 pandemic had a profound impact on childhood routine immunization programs in Zambia, resulting in increased measles mortalities and complications. Research published in Tropical Medicine and Health found that the likelihood of measles-related deaths and complications in children was significantly higher due to high rates of unvaccinated children, late diagnosis, and poor case management. The study aimed to examine the effect of the COVID-19 pandemic on measles mortality and its predictors among patients seen at health facilities in Zambia.

Key Takeaways:

  • The COVID-19 pandemic resulted in a 220% increase in monthly measles mortality in Zambia, from 0.06 per 100,000 before the pandemic to 0.23 during the pandemic.
  • The study found that predictors of mortality were younger age category (0-4), testing positive for measles IgM, rush, and female sex, which increased the odds of dying.
  • Being vaccinated reduced the odds of dying, with an adjusted odds ratio of 0.06 (95% CI 0.01-0.42).
  • Evidence for the COVID-19 effect was strongly associated with increased measles mortality (RR, 1.02; 95% CI 1.00, 1.04; 0.017) with a trend step change of 81% (RR, 1.81; 95% CI 1.14-2.87).
  • Measles dose 2 vaccination trends increased by about 0.3% during the COVID-19 pandemic due to the Supplementary Immunization Activity (SIA).
  • The research concluded that prioritizing vaccine coverage, enhancing diagnostic and treatment capacities, and addressing gender and healthcare access disparities are essential components of interventions aimed at lowering mortality.

Statistics:

  • 3429 measles cases were reported during the study period, with 1261 having complete metadata and included in the analysis.
  • The median age was 3 years (IQR, 1-7).
  • 54 (4.3%) of the enrolled patients died.
  • 205 (21.0%) were IgM positive, and 207 (16.9%) were vaccinated.
  • Measles mortality increased by 220% during the pandemic.
  • The study found a dramatic drop of about 42% in measles dose 2 vaccination trends during the pandemic.

Sources:

  • Tropical Medicine and Health. Attention to COVID 19 pandemic resulted in increased measles cases and deaths in Zambia. 2025, 53(1):1-17.
  • NewsRx. Study Findings on COVID-19 Reported by Researchers at Zambia National Public Health Institute (Attention to COVID 19 pandemic resulted in increased measles cases and deaths in Zambia). Vaccine Weekly. May 14, 2025; p 419.