Measles related pneumonia in unimmunized children: a deadly combination

Abstract

Background: Despite the availability of an effective vaccine, measles is a significant cause of vaccine-preventable childhood morbidity and mortality in developing countries. The most common and life-threatening complication of measles is pneumonia and the vast majority of measles deaths are due to pneumonia, especially in poorly immunized children. Clarifying children's vaccination status may be useful to identify susceptible groups and increase preventive measures for measles related pneumonia. Objective: To determine frequency of unvaccinated children presenting with measles related pneumonia. Methodology: This study was a cross-sectional study carried out at Department of Pediatrics, Fauji Foundation Hospital, Rawalpindi from March 2026 to June 2026. Children aged 1–5 years with DMP were enrolled by non-probability consecutive sampling technique resulting in 255 children. The following data were collected on a structured proforma: demographic data, nutritional status, place of residence, parental education, socioeconomic status, and vaccination history. All data were analyzed on SPSS version 22.0. Data for the categorical variables were summarized as frequencies and percentages, and for the quantitative variables as means and standard deviations. The Chi-square test was used to assess the associations and a p value of ≤0.05 was considered statistically significant. Results: The mean age of 255 children with measles-related pneumonia was 3.2±1.1 years. There were 146 (57.3%) males and 109 (42.7%) females. Among the children, 153 (60.0%) were at least one dose of vaccine and 102 (40.0%) were unvaccinated against measles. Children in low socioeconomic families, malnourished children, children from rural areas and children whose mothers had lower education levels were significantly more likely to be unvaccinated (p<0.05). Conclusions: The proportion of children with pneumonia who presented with measles was high and many were not vaccinated. Improving the quality of routine immunization services and vaccine coverage, especially in hard-to-reach groups, must be achieved to stop avoidable childhood deaths and to lower severe measles complications.