Over 20 million children worldwide miss out on measles vaccine annually

• Lack of access.
• Poor health systems.
• Complacency.
• Fear or skepticism about vaccines.

Canada was in the top 10 high-income countries with children who didnot receive the first dose of the measles vaccine between 2010 and 2017. The United States tops the list with more than 2.5 million children not vaccinated.

Canada ranked seventh. UNICEF said that 287,000 kids in Canada did not receive the first dose during these years.

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UNICEF's chief of immunizations Robin Nandy said in high-income countries somepeople aren't recognizing the seriousness of the situation.

"People forget how deadly this disease is," he said in an interview. "You take a different scenario in sub-Saharan Africa where they are seeing measles all the time they know people who have died."

In low-income countries, poverty andsupply shortageslimit access to vaccines, UNICEF said.

Also on Thursday, federal Health Minister Ginette Petitpas Taylor announced a new project with the Fraser Health Authority in British Columbia, which the department said will improve access to vaccinations and increase vaccine coverage for two-year olds in the Surrey region.

The Public Health Agency of Canada said it will focus on improving services for hard-to-reach and low-income families, as well as Indigenous people and newcomers to Canada. Theyalso announced three other projects to improve vaccination rates in Canada.

CBCNews reached out to Health Canada about the UNICEF report. They referred journalists to thechildhood National Immunization Coverage Surveyfrom 2017, which showed that 90 per cent of all two-year-olds in Canada had received at least one dose of the measles vaccine.

2nd dose crucial to prevention

Receiving one dose of the measles vaccine does not necessarily mean full protection. While the world's population is growing, the global coverage amount for the first dose of measles vaccines has stayed consistent at 85 per cent. But global coverage for those who also received their second dose dips to 67 per cent.

UNICEF called the situation critical for low- and middle-income countries. Of the top 20 countries with the largest number of unvaccinated children in 2017, nine have yet to introduce a second dose. UNICEF is working with Cameroon, Liberia and Nigeria to implement the second dose in 2019. Nigeria has the highest number of children under one year of age who did not get a first dose: approximately fourmillion.

When just looking at high-income countries, a decrease also occurs from 94 to 91 per cent. Canada's federal government said that two-dose coverageis almost 100 per cent effective. For routine vaccination, it recommends that the first dose be administered at 12 to 15 months of age, and the second between 18 months and before starting school.

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This week in California, Dr. Karen Smith, director of the California Department of Public Health, reported an increase in the number of measles cases. She said the state usuallysees less than two dozen a year, but has recorded 38 this year as of Thursday. Much of the increase was linked to overseas travel.

Smith said more than 76 per cent of patients were not vaccinated or did not receive the two doses.