The threat of a measles outbreak is growing due to a significant decline in vaccination rates among children worldwide, according to joint report released Wednesday by the U.S. Centers for Disease Control and Prevention, and the World Health Organization.

For the last few decades, measles has remained relatively contained due to the double-dose vaccination that is 97% effective. The measles vaccination rates have steadily dropped since the start of the COVID-19 pandemic, the report found, with nearly 40 million children missing one or both of the doses in 2021, a record high according to the CDC and WHO.

Because of the pandemic, 61 million measles vaccine doses were postponed or missed in 18 countries in 2021, the report found.

"This decline is a significant setback in global progress towards achieving and maintaining measles elimination and leaves millions of children susceptible to infection," the two agencies said in a news release.

In 2021, there were about 9 million measles cases and 128,000 measles deaths worldwide, according to the CDC and WHO. Twenty-two countries experienced "large and disruptive outbreaks" — a trend that has continued into 2022, according to the report.

The report found that, based on the latest data, only 81% of children worldwide are receiving a first dose, and only 71% are receiving a second dose. This marks the "lowest global coverage rates" since 2008, the CDC and WHO found.

"The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programs were badly disrupted," WHO Director-General Dr Tedros Adhanom Ghebreyesus said in a statement.

Now, the two agencies are advising officials across the world to get their immunization systems back on track to prevent more missed vaccinations.

"Measles outbreaks illustrate weaknesses in immunization programs," CDC Director Dr. Rochelle P. Walensky said in a statement. "Public health officials can use outbreak response to identify communities at risk, understand causes of under-vaccination, and help deliver locally tailored solutions to ensure vaccinations are available to all."

The best way to contain the deadly virus is for all stakeholders to put their resources into immunization surveillance systems, the report stressed.

Through the Immunization Agenda 2030 global strategy — which aims to give vaccine access to everyone worldwide — the WHO and CDC hope all children can be immunized, and outbreaks can be detected and responded to quickly.

"We have a short window of opportunity to urgently make up for lost ground in measles vaccination and protect every child," said Ephrem Tekle Lemango, immunization chief for UNICEF, said in a statement. "The time for decisive action is now."

Last week, health officials in central Ohio reported they were investigating a measles outbreak at several childcare facilities. 18 cases were under investigation, officials said at the time. All of the cases were in unvaccinated children, and 17 of the 18 infected children are under the age of five.

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