Abstract
Measles elimination has been identified as a public health priority in Europe for a long time but has not yet been achieved. The World Health Organization (WHO) recommends identification of susceptible sub-populations to target supplementary immunization activities. We used three different sources of information: retrospective samples investigated for measles IgG between 1997 and 2016, vaccine coverage data from the existing electronic registry for birth cohorts 2015 to 1999, and surveillance data from 2009 until 20 July 2019. We calculated susceptibility by birth cohort using seroprevalence data, adjusting vaccine coverage data with reported effectiveness (93% for the first and 97% for the second dose, respectively), and compared it with measles incidence data, aggregated by birth cohorts and districts. Susceptibility levels for persons 10–41 years (birth cohorts 2007–1976) were 10.4% and thus far above the recommended values of WHO (5%). Older birth cohorts were sufficiently protected. Districts with the highest susceptibility estimates corresponded with districts with the highest incidence rates. Birth cohorts with susceptibility levels > 10% showed a 4.7 increased relative risk of having had more than one measles case. We conclude that retrospective serosurveys are a cheap and useful approach in identifying susceptible sub-populations, especially for older birth cohorts whose coverage data remain scarce.
Highlights
Measles elimination in the World Health Organization (WHO) Region for Europe was already planned for 2010 but has not yet been achieved [1,2]
In order to identify sub-populations that are most at risk for measles, we assessed the population immunity using three different sources of information: The results of an analysis of the measles containing vaccines (MCV) coverage data extracted from the regional electronic vaccination registry, the results from an ad-hoc retrospective serosurvey conducted in 2017 and the most recent surveillance data from the electronic reporting system EMS [17]
We found that the WHO recommended susceptibility thresholds of maximum 15% in children months–4 years, 10% in persons 5–9 years, and 5% in persons >10 years were not achieved
Summary
Measles elimination in the WHO Region for Europe was already planned for 2010 but has not yet been achieved [1,2]. The number of reported measles cases in the region increased 15 times between (the year with the lowest number of cases recorded) and 2018 [3]. Several issues have contributed to this phenomenon, one of them being vaccine hesitancy- a factor identified as one of the 10 key health threats in 2019 [4]. Susceptibility levels below 5% in children 10 years and older, below 10% in children age five to nine years, and below 15% in children 24 months to 4 years are needed to eliminate measles [6]. In Austria, mandatory reporting of suspected measles cases has been implemented in 2006 [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
