National and Global Options for Managing the Risks of Measles and Rubella

Kimberly M Thompson

doi:10.4172/2157-7560.1000165

Abstract

Countries currently choose from several different measles and rubella containing vaccine options and use a wide range of vaccination schedules as they control the transmission of measles only or measles and rubella viruses within their borders and cooperate and coordinate to achieve regional and/or global goals. This paper discusses the current national options that countries use or could use for national measles and/or rubella control or elimination and existing associated regional goals to characterize the expected current global path and identify alternative paths. With highly effective, relatively inexpensive, and safe vaccines available we can potentially end indigenous measles and rubella virus transmission. The Pan American Health Organization eliminated endemic transmission of both measles and rubella, which demonstrated the possibility of global eradication, and four other regions of the World Health Organization are now pursuing targets for regional elimination. We discuss the choice of a global strategy of control compared to eradication to highlight the choices, opportunities, issues, and challenges that will ultimately determine the magnitude of human and financial costs of measles and rubella globally over the next several decades and beyond.

Highlights

The introduction and widespread use of measles- and rubellacontaining vaccines (MCVs and RCVs, respectively) significantly reduces the burden of these diseases nationally, regionally, and globally
National use of measles and rubella vaccines began with developed countries rapidly adopting the vaccines to control and eliminate indigenous transmission of measles and rubella
A recent analysis found that resurgence of measles in Africa in the late 2000s and delayed implementation of accelerated measles immunization efforts in India led to missing the global goal of 90% reduced mortality by 2010, compared to the 2000 levels [21]

Summary

Introduction

The introduction and widespread use of measles- and rubellacontaining vaccines (MCVs and RCVs, respectively) significantly reduces the burden of these diseases nationally, regionally, and globally. National use of measles and rubella vaccines began with developed countries rapidly adopting the vaccines to control and eliminate indigenous transmission of measles and rubella. A major outbreak of rubella in the early 1960s led to an estimated approximately 20,000 infants born in the US with Congenital Rubella Syndrome (CRS). This outbreak motivated broad adoption of rubella vaccination in combination with measles immunization, which led to apparent interruption of transmission in 1996 [2] with confirmed interruption of endemic rubella by 2001 [3]. Canada and many developed European countries rapidly and significantly reduced their burdens of measles and rubella following the introduction of vaccines [1]. Middleand low-income countries gradually started to increase their population immunity levels for measles by adding a second routine dose of measles vaccine (MCV2), conducting preventive supplemental immunization activities (SIAs), and/or more recently by responding to outbreaks with vaccination campaigns

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