The Unfinished Measles Immunization Agenda

The Journal of Infectious Diseases

There are compelling epidemiological, economic, and ethical arguments for setting a global measles eradication goal. The 6 chairpersons of Regional Verification Commissions for Measles and Rubella elimination advocate that the time for courageously accelerating efforts to ensure a world where no child dies of measles, is NOW!

JAMA, 2008

2017

Journal of Infectious Diseases, 2011

Journal of Infectious Diseases, 2011

Measles is considered to be an important cause of morbidity and mortality in children, in developing nations. After poliomyelitis, measles is the next candidate disease for eradication. The feasibility of measles eradication has been studied and approved by an expert panel, convened by WHO. Pan American Health Organisation evolved the strategy for measles eradication which includes initial “catch up campaign” followed by “keep up” and “follow up” campaigns. Region of the Americas has achieved elimination of measles by adopting this strategy. To reduce measles mortality in South East Asia region, The Strategic Advisory Group of Experts (SAGE) has drafted recommendations, stating all children should receive two doses of measles vaccine. In spite of biological and technical feasibility, measles eradication faces ample challenges. Competing priorities like ongoing polio eradication, introduction of new vaccines under Universal Immunisation Program and other ongoing health initiatives, pose major challenges. Limited resources and injectable vaccine requiring trained workforce to administer, are other considerations. Wars, political and social unrest, as well as population displacement and migration, create hindrance in achieving and maintaining, good vaccine coverage, which is essential for eradication. Hence, measles eradication seems to be very challenging. Each and every part of the world should comply with the efforts for eradication; only then, global transmission of the disease can be terminated.

MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control, 1998

A meeting concerning advances in measles control and elimination, the third in a series, was held in Atlanta during August 1997. The meeting was cosponsored by CDC, the Pan American Health Organization, the World Health Organization, and the United Nations Children's Fund. Meeting participants concluded that substantial progress has been made toward controlling measles. Measles transmission has been interrupted in several countries, reinforcing the view that measles eradication is technically feasible using existing vaccines and intervention strategies. However, measles still accounts for 10% of global mortality from all causes among children aged <5 years (i.e., approximately 1 million deaths annually). Progress toward measles control varies substantially among countries and regions. Intensified efforts are necessary to implement appropriate control and elimination strategies, including supplementary vaccination campaigns, expansion of routine vaccination services, and surve...

Bulletin of the World Health Organization, 1998

In 1994, the Ministers of Health from the Region of the Americas targeted measles for eradication from the Western Hemisphere by the year 2000. To achieve this goal, the Pan American Health Organization (PAHO) developed an enhanced measles eradication strategy. First, a one-time-only "catch-up" measles vaccination campaign is conducted among children aged 9 months to 14 years. Efforts are then made to vaccinate through routine health services ("keep-up") at least 95% of each newborn cohort at 12 months of age. Finally, to assure high population immunity among preschool-aged children, indiscriminate "follow-up" measles vaccination campaigns are conducted approximately every 4 years. These vaccination activities are accompanied by improvements in measles surveillance, including the laboratory testing of suspected measles cases. The implementation of the PAHO strategy has resulted in a marked reduction in measles incidence in all countries of the Americas....

Morbidity and Mortality Weekly Report, 2022

All six World Health Organization (WHO) regions have committed to eliminating measles.* The Immunization Agenda 2021-2030 (IA2030) † aims to achieve the regional targets as a core indicator of impact and positions measles as the tracer of a health system's ability to deliver essential childhood vaccines. IA2030 highlights the importance of ensuring rigorous measles surveillance systems to document immunity gaps and achieve 95% coverage with 2 timely doses of measles-containing vaccine (MCV) among children. This report describes progress toward measles elimination during 2000-2021 and updates a previous report (1). During 2000-2021, estimated global coverage with a first MCV dose (MCV1) increased from 72% to a peak of 86% in 2019, but decreased during the COVID-19 pandemic to 83% in 2020 and to 81% in 2021, the lowest MCV1 coverage recorded since 2008. All countries conducted measles surveillance, but only 47 (35%) of 135 countries reporting discarded cases § achieved the sensitivity indicator target of two or more discarded cases per 100,000 population in 2021, indicating surveillance system underperformance in certain countries. Annual reported measles incidence decreased 88% during 2000-2016, from 145 to 18 cases per 1 million population, then rebounded to 120 in 2019 during a global resurgence (2), before declining to 21 in 2020 and to 17 in 2021. Large and disruptive outbreaks were reported in 22 countries. During 2000-2021, the annual number of estimated measles deaths decreased 83%, * Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographic area for ≥12 months in the presence of a high-quality surveillance system that meets the targets of key performance indicators. † https://www.who.int/teams/immunization-vaccines-and-biologicals/strategies/ia2030 § A discarded measles case is defined as a suspected case that has been investigated and determined to be neither measles nor rubella by using either 1) laboratory testing in a proficient laboratory, or 2) epidemiologic linkage to a laboratoryconfirmed outbreak of a communicable disease that is not measles or rubella. The discarded case rate is used to measure the sensitivity of measles surveillance.

African Journal of …, 2009

; intervention methods may no longer be needed. It represents the sum of successful elimination efforts in all countries. Indeed, measles transmission has been interrupted in several countries, reinforcing the view that measles eradication is technically feasible using existing vaccines, laboratory techniques and intervention strategies. However, measles still accounts for 10% of global mortality from all causes among children aged less than 5 years (That is, approximately 1 million deaths annually). Vaccination proper coverage is key indicator of campaign success and to predict control on measles. In Nigeria where there is perennial, low routine vaccination coverage and where the quality of the mass immunization campaign is not high enough, large and persistent measles outbreaks continue to occur with high morbidity and mortality. Immunization and vaccination remains one of the most cost effective strategies to prevent infectious diseases. However, the most effective and efficient way to protect the health of children is by immunization before the risk of disease arises. Vaccination has succeeded in eradicating small pox in the world, soon would be achieved with polio and measles will be next to reach the same degree of disease control (viz, worldwide eradication) as has occurred with smallpox. The efficacy of vaccination and immunization in reducing the incidences of several diseases is clearly shown by the success story of measles control in developed countries of the world. However, intensified efforts are necessary to implement appropriate control and elimination strategies, including supplementary vaccination campaigns, expansion of routine vaccination services, and surveillance.