What will it take to end human suffering from measles?

Abstract

In The Lancet Infectious Diseases, Filippo Trentini and colleagues 1 Trentini F Poletti P Merler S Melegaro A Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. Lancet Infect Dis. 2017; (published online Aug 11.)http://dx.doi.org/10.1016/S1473-3099(17)30421-8 PubMed Google Scholar presented the results of a comprehensive modelling analysis that examined the transmission of measles in nine countries with diverse demographic and vaccination histories. The results emphasised that to achieve and maintain measles elimination, countries will need to focus immunisation efforts on reaching different age groups and improving immunisation coverage. 1 Trentini F Poletti P Merler S Melegaro A Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. Lancet Infect Dis. 2017; (published online Aug 11.)http://dx.doi.org/10.1016/S1473-3099(17)30421-8 PubMed Google Scholar Specifically, in low-income (and high-fertility) countries, susceptibility remains concentrated in early childhood, and periodic Supplementary Immunization Activities continue to contribute substantially to population immunity. 1 Trentini F Poletti P Merler S Melegaro A Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. Lancet Infect Dis. 2017; (published online Aug 11.)http://dx.doi.org/10.1016/S1473-3099(17)30421-8 PubMed Google Scholar The authors suggest that these countries need to increase immunisation coverage, which could occur by improving the performance in routine immunisation delivered as part of the national Expanded Programme on Immunization or making Supplementary Immunization Activities more frequent, regular, and also of higher quality. 1 Trentini F Poletti P Merler S Melegaro A Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. Lancet Infect Dis. 2017; (published online Aug 11.)http://dx.doi.org/10.1016/S1473-3099(17)30421-8 PubMed Google Scholar By contrast, in relatively high-income (and low-fertility) countries, the relatively high immunisation rates and low levels of transmission allow unvaccinated individuals to remain susceptible at older ages. This observation led the authors to suggest the need for Supplementary Immunization Activities that target adolescents and adults in countries in which the susceptibility in these age groups will otherwise sustain measles circulation. 1 Trentini F Poletti P Merler S Melegaro A Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. Lancet Infect Dis. 2017; (published online Aug 11.)http://dx.doi.org/10.1016/S1473-3099(17)30421-8 PubMed Google Scholar Measles immunity gaps and the progress towards elimination: a multi-country modelling analysisFuture vaccination strategies in high-fertility countries should focus on increasing childhood immunisation rates, either by raising first-dose coverage or by making erratic SIAs more frequent and regular. Immunisation campaigns targeting adolescents and adults are required in low-fertility countries, where the susceptibility in these age groups will otherwise sustain measles circulation. Full-Text PDF