The Use of Rapid Coverage Monitoring in the National Rubella Vaccination Campaign, Haiti 2007–2008

Abstract

Prior to introduction of rubella vaccine in Haiti's national immunization program, the Haitian government conducted a nationwide rubella-measles immunization campaign targeting persons 1-19 years of age to accelerate elimination of rubella and congenital rubella syndrome, while strengthening measles elimination. The national immunization campaign was conducted in phases by geographic region and combined multiple interventions to reach high coverage in all districts. We analyzed reported data on number of doses administered and results of rapid monitoring by "commune" (district) to evaluate coverage for each vaccine and intervention in target populations. We reviewed measles and rubella surveillance data from Haiti's national surveillance system. Immunization registers recorded 4.7 million doses of measles-rubella (MR) vaccine administered to persons 1-19 years of age, reaching 80.2% of the estimated population of 1-4 year-olds and surpassing the target among 5-19 year-olds. In addition, 1 million children under 5 years of age received oral polio vaccine and vitamin A supplements, 1.5 million school children received deworming treatment nationwide, and over 500000 women 15-49 years old in 2 major population centers received diphtheria-tetanus vaccine. Based on administrative data, 102 (76.7%) of 133 communes attained 95% or greater coverage with MR vaccine among persons 1-19 years of age. Rapid monitoring in 118 communes indicated that coverage targets were reached in 52.5%. From 2007 to 2010, no confirmed cases of measles or rubella were reported from Haiti. The experience in Haiti suggests that rubella and congenital rubella syndrome can be eliminated through mass vaccination in countries with weak national immunization programs. However, high routine immunization coverage and improved surveillance are urgently needed to maintain measles and rubella elimination.