Assessment of Routine Measles Vaccine Effectiveness Among Children Referring to Tertiary Fever Hospital in Egypt

Abstract

Background: Measles is one of the leading causes of childhood morbidity and mortality in the world despite the availability of a relatively inexpensive, safe, and effective vaccine. Objectives: The study aimed to evaluate measles vaccine effectiveness as one of the fundamental actions to eliminate measles infection. The specific objectives were to estimate the measles vaccine effectiveness at the level of under 12-year-old children population using the Egyptian surveillance data for cases seeking medical care at Embaba Fever Hospital between March 2017 and February 2018 and to determine the trend of measles virus infection during the same period. Methods: This hospital-based cross-sectional analytical study was conducted at Embaba Fever Hospital in Giza Governorate for the evaluation of measles vaccine effectiveness. In total, 466 patients were enrolled in the study and investigated clinically and laboratory to confirm the diagnosis of measles. Results: Of the 466 children, 69 (14.8%) tested positive for measles IgM antibodies. Children in the 1 - 4 year age group had the highest positivity rate to measles antibodies (43.5%), followed by the age group of ≥ 5 years (29%) and the age group of < 1 year (27.5%). The overall estimated vaccine effectiveness was 80.7% (95% CI: 63.7 - 90.8%) for the one-dose measles-mumps-rubella (MMR) and 91.8% (95% CI: 88.0 - 94.5%) for the two-dose vaccine. Conclusions: Measles infection is still high among vaccinated and unvaccinated children in Egypt. Therefore, it is suggested that a sustainable plan be developed for achieving high vaccination coverage among children younger than five years of age.