COVID-19, seasonal influenza and measles: potential triple burden and the role of flu and MMR vaccines

Policy interventions aimed at reducing person-to-person transmission of SARS-CoV-2 (such as hand hygiene, physical distancing and wearing face coverings) were implemented globally to minimise healthcare burden, and to allow more time for an effective treatment and successful vaccine. After months of ‘lockdown’, many countries started to ease these measures recently only to see a surge in COVID-19 cases and deaths. During the winter of 2020–2021, we face the prospect of a dual burden of a COVID-19 pandemic and a seasonal influenza epidemic.3 However, what’s not being currently discussed is that the burden on healthcare could be further compounded by a potential surge of measles and rubella cases. This is due to: (1) a declining trend in Measles-Mumps-Rubella vaccine coverage accompanied by an increasing trend in Measles-Mumps-Rubella cases since 2016;4 and (2) disruption and suspension of Measles-Mumps-Rubella vaccination campaigns in 23 countries to cope with the COVID-19 pandemic.