Kenya has restarted its vaccination programme in an effort to tackle the re-emergence of measles, which has surged in the country during the Covid restrictions. A 10-day campaign against highly contagious measles and rubella has begun to target 4 million children aged nine months to five years in 22 of Kenya’s 47 counties where outbreaks are highest. Measles is the “third most common cause of deaths among children from vaccine-preventable diseases”, the health ministry said. In 2020, only 85% of children in the east African country had received the first dose of the vaccine and less than 50% had had the second. The exercise will involve 16,000 health workers at 5,061 vaccination centres. An assessment conducted in Kenya with the support of the World Health Organization showed a big rise in the number of unvaccinated children. “The unprecedented increase in the number of unvaccinated children, accumulation of susceptible children to more than 2.1 million and the ongoing Covid-19 pandemic has aided outbreaks,” the ministry said. According to the WHO, it takes at least 95% of the combined MCV1 and MCV2 vaccine coverage to prevent outbreaks. Across sub-Saharan Africa, however, the level of first doses being administered has stagnated at 69% since 2013. “Only seven countries in the region achieved 95% measles-containing vaccine coverage in 2019,” the WHO said. Kenya’s 4 million children are among 16.6 million in Africa who missed supplemental vaccination against measles between January 2020 and April 2021, according to the WHO. In April, the WHO reported of major outbreaks of measles in eight African countries that affected “tens of thousands” as efforts to contain Covid took centre stage. “Children under five years can die from measles complications and if the virus circulation is not stopped, their risk of exposure increases daily. We know that vaccination is by far the best way to keep these children safe,” said Maniza Zaman, Unicef representative in Kenya. The WHO also reported that the “quality of measles surveillance in Africa fell to the lowest level in seven years in 2020, with just 11 countries meeting their target”. Dr Matshidiso Moeti, WHO regional director for Africa, said: “Recent outbreaks of measles, but also yellow fever, cholera and meningitis, all point to worrying gaps in immunisation coverage and surveillance in Africa. As we fight Covid-19, we cannot leave anyone dangerously exposed to preventable diseases. I urge all countries to double down on essential health services, including life-saving vaccination campaigns.” According to the US Centers for Disease Control and Prevention, the number of global measles cases more than quadrupled to the highest in 23 years, from 132,490 in 2016 to 869,770 in 2019. Mortality rates almost doubled, with 207,500 reported deaths.