Tackling the Measles Epidemic in Kazakhstan

USAID and UNICEF Partner to Raise Awareness about the Dangers of Vaccine Misinformation

Vaccines are one of modern medicine’s most significant achievements and arguably the most effective tool in the fight against disease. However, vaccine misinformation remains a barrier to protecting individuals and communities from preventable diseases. Many parents, like Alexei and Nastya, know this all too well.

Little Varya was three years old when Alexei and Nastya adopted her from an orphanage.

The couple had long dreamed of children, and when they saw Varya, it was love at first sight. Neither the arduous adoption process nor Varya’s chronic illness would stop them from becoming a family.

Her chronic illness left Varya immunocompromised, and because of this, they had been incorrectly advised that she not get some childhood vaccinations, including the measles vaccine. Alexei and Nastya did not push for it. Like so many other families, they were also wary of vaccines, having received misinformation that the potential of an adverse vaccine reaction outweighed the vaccine’s benefits. 

“I was afraid,” Nastya says. “I didn’t know how a vaccine would work with Varya’s diagnosis, how it would affect her body.”

In February 2019, Varya noticed red dots on her legs as she got ready for school. Nastya and Alexei immediately rushed Varya to the hospital. Varya was diagnosed and treated for an allergic reaction. But when Varya’s temperature rose to 40 degrees Celsius, an infectious disease specialist was called in. It was hemorrhagic vasculitis, and the cause - measles. Varya was quickly transferred to an infectious disease hospital. 

Over the next ten days, Varya fell gravely ill. “I will never forget that time…,” Nastya recalls. “Varya was burning with a fever, crying from pain at night.” Nastya felt helpless.  

She struggled to swallow and became emaciated, weighing only 17 kilograms. There was also an emotional toll on Nastya, who felt helpless in easing her daughter’s pain.  

Fortunately, over time, Varya pulled through, but she still suffers long-term effects from measles. The prolonged high-grade fever impaired her cognitive abilities, which now impacts her ability to do her school work.

Varya spent a total of six and a half weeks in the hospital. During her stay, the hospital was full of children and adults - all with measles. Nastya still gets emotional when she thinks about Varya’s battle with measles. “When you see your child suffer so much, how would you feel about it? I have no words,” Nastya says. 

In 2019, Kazakhstan experienced a measles outbreak of 13,326 cases. Of the 9,409 measles cases registered among children 0 to 14 years old, 7,802 (83%) were not vaccinated. Many were babies, too young for the measles vaccine. However 22% of the unvaccinated were due to vaccine refusal, and 30% were due to medical contraindications (both real and perceived). Unfortunately, nineteen children and two adults died from the disease. 

A 2020 UNICEF study found that vaccine misinformation leading to false contraindications, medical exemptions, and vaccine refusal, were among the leading causes of missed opportunities to vaccinate against measles in Kazakhstan. The analysis was part of a USAID-funded UNICEF Kazakhstan Measles Outbreak Prevention Program. The program provided technical support to analyze the causes of the measles outbreak, study parents’ views on vaccination and awareness campaigns, and recommendations for improving the supply of vaccines and the capacity of health care workers for immunization.

The USAID-UNICEF partnership equips health care workers, families, and individuals with the knowledge and tools to combat vaccine misinformation and hesitancy. To date, over 700 healthcare providers and managers in the South, East, and West Kazakhstan regions have been trained on World Health Organization (WHO) immunization and vaccine guidelines and standards. Last month, UNICEF launched EGU.kz– a USAID-supported, evidence-based website dedicated to educating the public on routine childhood vaccinations and dispelling common vaccine myths in Kazakhstan. The interactive website was viewed 10,819 times in its first week.

Almost two years have passed, and Varya is now immunized and protected against many preventable diseases. She has not experienced a single adverse reaction to any of her prescribed vaccines. Nationally, the number of annual measles cases has dropped since the outbreak, with only 3,270 measles cases registered in 2020, of which 2,265 were children under 14 years of age. 

“We sincerely thank USAID for partnering in such an important program,” said the UNICEF Representative in Kazakhstan, Arthur van Diesen. “We believe that this program will help save and preserve the lives and health of Kazakhstani children and families.”