The United Nations Children’s Fund on Wednesday said that 2.9 million children in India under the age of one were not administered the first dose of the measles vaccine between 2010 and 2017, the second-highest in the world.

In Nigeria, four million children missed out on the dose during this period. In the United States, over 2.5 million children were not administered the first dose, Unicef said. For Pakistan and Indonesia, the figure was 1.2 million, and for Ethiopia, 1.1 million.

The report comes amid growing concerns about the impact of anti-vaccination campaigns.

Measles is the world’s most contagious viral disease. According to the World Health Organization, the virus remains an important cause of death among young children globally. When more than five cases of measles are reported in a place in a short span of time, it is considered an outbreak.

“The ground for the global measles outbreaks we are witnessing today was laid years ago,” Unicef Executive Director Henrietta Fore said after the report was released. “The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike.”

Unicef said that 1,10,000 cases of measles were reported worldwide from January to March 2019, which is 300% higher compared to the corresponding months in 2018. This finding had been corroborated by the World Health Organization in a report earlier this month. In 2017, 1,10,000 children died of the disease, a 22% increase from 2016, it said.

Global coverage of the first dose of measles vaccine stood at 85% in 2017, and had remained the same for a decade, Unicef said. The organisation said the reasons for the lack of improvement were poor access to the vaccine, poor health systems, complacency and fear or skepticism about the vaccine.

“Worldwide coverage levels of the second dose of the measles vaccines are even more alarming,” the report said. “Of the top 20 countries with the largest number of unvaccinated children in 2017, 9 have not introduced the second dose. Twenty-countries in sub-Saharan Africa have not introduced the necessary second dose in the national vaccination schedule.”

Global coverage of the second dose stands at 67%, Unicef said. In developed countries, coverage of the first dose is at 94%, and of the second at 91%.

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