Effect Of Measles Vaccination Research Articles

Measles in the elimination period: the epidemic situation in Voronezh region

Vaccine-preventable diseases, one of which is measles, do not lose their importance and still remain a threat to public health. There is a deterioration in the epidemic situation regarding measles, both in the world and in the Russian Federation. The purpose of the study was to characterize the manifestations of the measles epidemic process in the Voronezh region for the period 1940–2023. The study of morbidity was carried out on the basis of data from Rosstat Form 2, 146 maps of the epidemiological investigation of a case of measles in the Voronezh region for the period 2011–2023 with the calculation of basic statistical indicators. The general availability of effective measles vaccination led to a decrease in the incidence, which by the beginning of the 21st century had become sporadic. However, from 2011 to 2023, there is an upward trend in incidence: rates increased from 0.27 cases (95 % CI 0.06–0.48) to 2.14 per 100 thousand population (95 % CI: 1.54–2,74); the risk group were children (average age 5.70 ± 0.24 years). From 2011 to 2015 imported cases predominated; since 2016 local cases predominated. For 2011–2023 146 cases (81 outbreaks) of measles were registered; among those who fell ill, the majority were not vaccinated against this infection or did not know about their vaccination status. Seroprotection level for the period 2011–2023 averaged 94.09±0.41 %; in certain years, there was an insufficient level of the immune layer in indicator groups of the population 16–17 years old and older. Thus, the pronounced activation of the measles epidemic process in the Voronezh region in recent years is due to a decrease in the immune layer.

Effects of Measles Vaccine and Its Associated Risk Factors Among Children Presenting in a Tertiary Care Hospital, Rawalpindi/Islamabad

Objectives: To identify risk factors associated with the development of measles among children under 12 years of age in a tertiary care hospital in Rawalpindi/Islamabad and to determine the effectiveness of measles vaccination in the study population. Methods: A retrospective case control study was done from January 2022 to January 2023 at the Department of Pediatrics, Holy Family Hospital (HFH), Rawalpindi & PAEC General Hospital, Islamabad. Total 600 children were included in the study. The hospital data record had children under the age of 12 with measles. Case controls were enrolled without measles at the same hospital, matched for age and sex. Study outcomes were analyzed by multivariant regression test adjusted with age and sex. Results: The average age of the children was 32.24±14.58 months. Mothers with low education were mostly have measles [OR: 4.1, 95% CI: 1.9-6.5, for primary schooling and OR: 1.1, 95% CI: 0.7-2.0, for matriculation]. Children with measles were mostly not breastfed during the first 2 years of life [OR: 0.8, 95% CI: 0.5-1.4]. Cases were also more likely to have never been vaccinated [OR: 8.2, 95% CI: 5.5-15.0] and never vaccinated other children at home [OR: 6.5, 95% CI: 4.5-10.0]. Conclusion: The study concluded that breastfeeding and proper weaning practices are necessary to eradicate measles.

A measles-vectored vaccine candidate expressing prefusion-stabilized SARS-CoV-2 spike protein brought to phase I/II clinical trials: protection of African green monkeys from COVID-19 disease.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged at the end of 2019 and is responsible for the largest human pandemic in 100 years. Thirty-four vaccines are currently approved for use worldwide, and approximately 67% of the world population has received a complete primary series of one, yet countries are dealing with new waves of infections, variant viruses continue to emerge, and breakthrough infections are frequent secondary to waning immunity. Here, we evaluate a measles virus (MV)-vectored vaccine expressing a stabilized prefusion SARS-CoV-2 spike (S) protein (MV-ATU3-S2PΔF2A; V591) with demonstrated immunogenicity in mouse models (see companion article [J. Brunet, Z. Choucha, M. Gransagne, H. Tabbal, M.-W. Ku et al., J Virol 98:e01693-23, 2024, https://doi.org/10.1128/jvi.01693-23]) in an established African green monkey model of disease. Animals were vaccinated with V591 or the control vaccine (an equivalent MV-vectored vaccine with an irrelevant antigen) intramuscularly using a prime/boost schedule, followed by challenge with an early pandemic isolate of SARS-CoV-2 at 56 days post-vaccination. Pre-challenge, only V591-vaccinated animals developed S-specific antibodies that had virus-neutralizing activity as well as S-specific T cells. Following the challenge, V591-vaccinated animals had lower infectious virus and viral (v) RNA loads in mucosal secretions and stopped shedding virus in these secretions earlier. vRNA loads were lower in these animals in respiratory and gastrointestinal tract tissues at necropsy. This correlated with a lower disease burden in the lungs as quantified by PET/CT at early and late time points post-challenge and by pathological analysis at necropsy.IMPORTANCESevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the largest human pandemic in 100 years. Even though vaccines are currently available, countries are dealing with new waves of infections, variant viruses continue to emerge, breakthrough infections are frequent, and vaccine hesitancy persists. This study uses a safe and effective measles vaccine as a platform for vaccination against SARS-CoV-2. The candidate vaccine was used to vaccinate African green monkeys (AGMs). All vaccinated AGMs developed robust antigen-specific immune responses. After challenge, these AGMs produced less virus in mucosal secretions, for a shorter period, and had a reduced disease burden in the lungs compared to control animals. At necropsy, lower levels of viral RNA were detected in tissue samples from vaccinated animals, and the lungs of these animals lacked the histologic hallmarks of SARS-CoV-2 disease observed exclusively in the control AGMs.

Program eliminacije morbila u Evropi

The use of a safe and effective measles vaccine in national immunization programs has resulted in a reduction in the number of deaths from the disease, although measles remains one of the leading causes of death in children under 5 years of age in underdeveloped and developing countries. After the successful eradication of smallpox, as well as the results achieved in the eradication of poliomyelitis at the global level, the process of measles elimination was initiated using the previously known strategies. In both American regions of the World Health Organization (WHO), the elimination of measles has been successfully verified, while in the WHO European Region, up to 2020, elimination has been verified in 29 out of 53 countries. The main challenges in the process of measles elimination are reaching and maintaining high immunization coverage, reaching and maintaining the values of surveillance indicators, implementing additional immunization of unvaccinated and incompletely vaccinated persons, solving serious problems such as the occurrence of measles epidemics in vulnerable groups, endemic maintenance of the disease, re-establishment virus transmission, determination of chains of transmission, genotyping of agents, impact of measures to control the COVID-19 pandemic. Bearing in mind the mentioned problems, the WHO has decided to postpone the elimination of measles in the WHO European Region to the year 2030.

Evaluating effective measles vaccine coverage in the Malaysian population accounting for between-dose correlation and vaccine efficacy

BackgroundMalaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of MCV1 and MCV2, Malaysia continues to report high measles incidence. This study suggests a novel indicator for investigating population immunity against measles in the Malaysian population.MethodsWe define effective vaccine coverage (EVC) of measles as the proportion of a population vaccinated with measles-containing vaccine (MCV) and effectively protected against measles infection. A quantitative evaluation of EVC throughout the life course of Malaysian birth cohorts was conducted accounting for both vaccine efficacy (VE) and between-dose correlation (BdC). Measles vaccination coverage was sourced from WHO-UNICEF estimates of Malaysia’s routine immunisation coverage and supplementary immunisation activities (SIAs). United Nations World population estimates and projections (UNWPP) provided birth cohort sizes stratified by age and year. A step wise joint Bernoulli distribution was used to proportionate the Malaysian population born between 1982, the first year of Malaysia’s measles vaccination programme, and 2021, into individuals who received zero dose, one dose and multiple doses of MCV. VE estimates by age and doses received are then adopted to derive EVC. A sensitivity analysis was conducted using 1000 random combinations of BdC and VE parameters.ResultsThis study suggests that no birth cohort in the Malaysian population has achieved > 95% population immunity (EVC) conferred through measles vaccination since the measles immunisation programme began in Malaysia.ConclusionThe persistence of measles in Malaysia is due to pockets of insufficient vaccination coverage against measles in the population. Monitoring BdC through immunisation surveillance systems may allow for the identification of susceptible subpopulations (primarily zero-dose MCV individuals) and increase the coverage of individuals who are vaccinated with multiple doses of MCV. This study provides a tool for assessment of national-level population immunity of measles conferred through vaccination and does not consider subnational heterogeneity or vaccine waning. This tool can be readily applied to other regions and vaccine-preventable diseases.

Two-dose measles vaccine effectiveness remains high over time: A French observational study, 2017–2019

BackgroundFrom 2008 to 2019, France has experienced a resurgence of measles epidemics. Surveillance data have shown that the proportion of cases vaccinated with two doses of measles-containing vaccine (MCV) increased with age, raising concerns about the duration of vaccine protection. Our objectives were to investigate age-stratified vaccine effectiveness (VE) for the second dose of MCV (MCV2) and to quantify protection levels over time. MethodsWe analyzed data on measles cases aged 2–31 years, reported via mandatory notification to the French measles surveillance system from October 2017 to September 2019. We estimated an age-stratified VE for MCV2 using the screening method, which compares the vaccination status of cases with that of the general population. We improved this method by accounting for natural immunity, exploring four scenarios with four possible levels of natural immunity in the population. In addition, we quantified the decay rate of protection over time, by fitting an exponential decay model among individuals vaccinated in early life. ResultsIn the baseline analysis (absence of natural immunity), VE estimates were high in all age groups and decreased with age, from 99.6 % (95 % confidence interval: 99.3–99.8) in 2–5 years old to 91.4 % (85.1–95.0) in 26–31 years old. Accounting for natural immunity increased VE in the older age group to 93.2–99.2 % depending on the scenario. We estimated that VE was slowly decreasing over time, with an exponential decay rate of 0.0022/year (0.0017–0.0028), leading to VE of 96.7 % (96.0–97.4) 16 years after MCV2 vaccination. This decline was most compatible with scenario 2, a scenario of 4.4 % naturally immunized, non-vaccinated individuals in the 26–31 years old. ConclusionOur study confirms the continued high effectiveness of two doses of MCV with only slight degradation, decades after immunization. These findings support the importance of achieving a very high vaccination coverage with 2 doses of MCV.

Health effects of routine measles vaccination and supplementary immunisation activities in 14 high-burden countries: a Dynamic Measles Immunization Calculation Engine (DynaMICE) modelling study

WHO recommends at least 95% population coverage with two doses of measles-containing vaccine (MCV). Most countries worldwide use routine services to offer a first dose of measles-containing vaccine (MCV1) and later, a second dose of measles-containing vaccine (MCV2). Many countries worldwide conduct supplementary immunisation activities (SIAs), offering vaccination to all people in a specific age range irrespective of previous vaccination history. We aimed to estimate the relative effects of each dose and delivery route in 14 countries with high measles burden. We used an age-structured compartmental dynamic model, the Dynamic Measles Immunization Calculation Engine (DynaMICE), to assess the effects of different vaccination strategies on measles susceptibility and burden during 2000-20 in 14 countries with high measles incidence (containing 53% of the global birth cohort and 78% of the global measles burden). Country-specific routine MCV1 and MCV2 coverage data during 1980-2020 were obtained from the WHO and UNICEF Estimates of National Immunization Coverage database for all modelled countries and SIA data were obtained from the WHO summary of measles and rubella SIAs. We estimated the incremental health effects of different vaccination strategies using prevented cases of measles and deaths from measles and their efficiency using the incremental number needed to vaccinate (NNV) to prevent an additional measles case. Compared with no vaccination, MCV1 implementation was estimated to have prevented 824 million cases of measles and 9·6 million deaths from measles, with a median NNV of 1·41 (IQR 1·35-1·44). Adding routine MCV2 to MCV1 was estimated to have prevented 108 million cases and 404 270 deaths, whereas adding SIAs to MCV1 was estimated to have prevented 256 million cases and 4·4 million deaths. Despite larger incremental effects, adding SIAs to MCV1 (median incremental NNV 6·02, 5·30-7·68) showed reduced efficiency compared with adding routine MCV2 (5·41, 4·76-6·11). Vaccination strategies, including non-selective SIAs, reach a greater proportion of children who are unvaccinated and reduce measles burden more than MCV2 alone, but efficiency is lower because of the wide age range targeted by SIAs. This analysis provides information to help improve the health effects and efficiency of measles vaccination strategies. The interplay between MCV1, MCV2, and SIAs should be considered when planning future measles vaccination strategies. Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation.

Measles clinical presentation, hospitalization and vaccination status among children in a community-wide outbreak.

In 2018-2019, a measles outbreak emerged in Israel (4158 notified cases). We aimed to evaluate the measles characteristics and the vaccination status among children during the outbreak. We performed a cross-sectional study of measles cases in children under 18years, residing in the Jerusalem district (2254 notified measles cases, June 2018-May 2019). The variables included: clinical symptoms (fever, rash, cough, coryza, conjunctivitis), hospitalizations and child's vaccination status. The national measles vaccination schedule includes two vaccine doses (at ages 12months and 6years). Children, under 18years, comprised 79% (1782/2254) of the notified measles cases. The hospitalization rate was 6.6%. There was one fatality. The measles vaccination status was analyzed by age groups. Infants under 12months (n=425) were excluded. Children aged 1-5years (n=785) and 6-17years (n=572) were expected to receive 1 and 2 measles vaccine doses, respectively. Most (88%) children (1-17years) were unvaccinated, 138 received 1 measles vaccine dose and 24 received 2 doses. Of children aged 1-5years 106 (13.5%) received 1 vaccine dose and were compared to unvaccinated children. Vaccinated children showed lower rates of clinical symptoms and lower risk for hospitalization compared to unvaccinated children (Odds ratio: OR=4.8, 95%CI 1.12-20.2). Vaccine effectiveness of 79% was estimated for one measles vaccine dose against hospitalization. Data on vaccine effectiveness reflect how well vaccines protect children against infection and morbidity. We evaluated the real-world effectiveness of measles vaccine, in an outbreak setting, and showed reduced morbidity in once-vaccinated children.

Comparative study on the effectiveness of intralesional Measles, Mumps, and Rubella vaccine and intralesional vitamin D3 injection in the treatment of verruca

Background: Human papillomavirus (HPV) is the causative agent of verruca and is contagious, recurrent, and recalcitrant due to defects in cell-mediated immunity. No single mode of treatment is completely effective. The most commonly used treatment options are destructive and lead to scarring. The emerging new modality of treatment is immunotherapy, which acts by enhancing cell-mediated immunity (CMI) against HPV to clear treated as well as remote warts. Objectives: The objective was to compare the efficacy of intralesional Measles, Mumps, and Rubella (MMR) vaccine and intralesional vitamin D3 in cutaneous warts. Materials and Methods: A randomized, hospital-based, single-blind study on forty patients divided into two groups (groups A and B), comprising twenty patients each, was conducted. In group A, intralesional MMR vaccine 0.5 mL was injected into the base of warts. In group B, intralesional vitamin D3 0.5 mL was injected into the base of warts after achieving local anesthesia. Sessions were performed in two-week intervals for a maximum number of five sessions. The patients were followed for sixteen weeks. Results: In group A (MMR vaccine), a complete response was seen in 75% (15/20) of the patients, a moderate response in 15% (3/20), a partial response in 5% (1/20), and no response in 5% (1/20). In group B (vitamin D3), a complete response was seen in 65% (13/20) of the patients, a moderate response in 15% (3/20), a partial response in 10% (2/20), and no response in 10% (2/20). No recurrence was noticed after follow-up in either of the two groups. Conclusion: Immunotherapy is an option that is easy, safe, cost-effective, and well-tolerated with minimal side effects. Key words: Verruca; Intralesional MMR; Intralesional vitamin D3; Immunotherapy

Evaluating Effective Measles Vaccine Coverage in the Malaysian Population Accounting for Between-Dose Correlation and Vaccine Efficacy

Evaluating Effective Measles Vaccine Coverage in the Malaysian Population Accounting for Between-Dose Correlation and Vaccine Efficacy

Incentivized self-vaccination for global measles eradication

Measles–we've become inured to its cruel, insidious impact as it kills over 100,000 children yearly because of suboptimal vaccination coverage. It does not have to be this way. A familiar, safe, exceptionally effective measles vaccine saves lives and permanent, global measles eradication is within reach. But now we need to be clever and courageously explore new strategies to save lives. Firstly, let us enable people to vaccinate themselves, not with a needle and syringe, but with a quick inhaled puff of dry powder vaccine. Secondly, let us provide micro-payments using digital currency to incentivize those who vaccinate themselves. Thirdly, let us leverage learnings from how our social networks guide our behaviors to further encourage self-vaccination. Fourthly, let us inspire friendly regional competition among communities vying for the highest proportion of citizens who show measles neutralizing antibodies in spot saliva samples. With global cooperation and relentless determination, we eradicated smallpox. Next up? Measles.

Measles incidence in South Africa: a six-year review, 2015—2020

In 2012 the World Health Organization (WHO) aimed to eliminate measles in five regions by 2020. This retrospective descriptive study reviewed measles surveillance data in South Africa for the period 2015—2020 to document the epidemiology of measles and the progress made towards meeting the 2020 measles elimination goal.A total of 22,578 specimens were tested over the period 2015—2020 yielding 401 (1.8%) confirmed measles cases, 321 (1.4%) compatible and 21,856 (96.8%) discarded cases. The most affected age group was 0–4 year olds. At the provincial level, South Africa achieved adequate surveillance, defined as more than two cases of febrile rash notified annually per 100 000 popoulation, except for KwaZulu-Natal and Limpopo in 2020, probably due to COVID-19 lockdown restrictions. Of confirmed cases, only 26% were vaccinated, 3% were too young to receive vaccines, 5% were not vaccinated, and 65% had unknown vaccination status. Measles vaccine effectiveness amongst 1–4 year olds was 80%. Using the standard case definition, South Africa achieved the measles elimination target of less than one case per one million nationally in years 2015, 2016 and 2020. The years 2017 to 2019 had incidence rates exceeding one per million nationally. Using a narrow case definition, that excluded positive rubella cases, improved the indicators with only the year 2017 having an incidence rate of more than one per million.South Africa displays intermittent measles outbreaks approximately six-yearly interspersed by inter-epidemic periods in which the country meets measles elimination targets. Intense effort is needed to increase the vaccine coverage to avoid periodic outbreaks. Enhanced molecular testing of each case will be required as measles incidence declines regionally.

Characteristics and Genomic Diversity of Measles Virus From Measles Cases With Known Vaccination Status in Shanghai, China.

Although the highly effective measles vaccine has dramatically reduced the incidence of measles, measles, and outbreaks continue to occur in individuals who received the measles vaccine because of immunization failure. In this study, patients who have definite records of immunization were enrolled based on measles surveillance in Shanghai, China, from 2009 to 2017, and genomic characteristics regarding viruses retrieved from these cases provided insights into immunization failure. A total of 147 complete genomes of measles virus (MV) were obtained from the laboratory-confirmed cases through Illumina MiSeq. Epidemiological, and genetic characteristics of the MV were focused on information about age, gender, immunization record, variation, and evolution of the whole genome. Furthermore, systematic genomics using phylogeny and selection pressure approaches were analyzed. Our analysis based on the whole genome of 147 isolates revealed 4 clusters: 2 for the genotype H1 (clusters named H1-A, including 73 isolates; H1-B, including 72 isolates) and the other 2 for D8 and B3, respectively. Estimated nucleotide substitution rates of genotype H1 MV derived using genome and individual genes are lower than other genotypes. Our study contributes to global measles epidemiology and proves that whole-genome sequencing was a useful tool for more refined genomic characterization. The conclusion indicates that vaccination may have an effect on virus evolution. However, no major impact was found on the antigenicity in Shanghai isolates.

Effect of early two-dose measles vaccination on childhood mortality and modification by maternal measles antibody in Guinea-Bissau, West Africa: A single-centre open-label randomised controlled trial.

SummaryBackgroundEarly 2-dose measles vaccine (MV) at 4 and 9 months of age vs. the WHO strategy of MV at 9 months of age reduced all-cause child mortality in a previous trial. We aimed to test two hypotheses: 1) a 2-dose strategy reduces child mortality between 4 and 60 months of age by 30%; 2) receiving early MV at 4 months in the presence versus absence of maternal measles antibodies (MatAb) reduces child mortality by 35%.MethodsSingle-centre open-label community-based randomised controlled trial in Guinea-Bissau, with 2:1 block-randomisation by sex to a 2-dose (4 + 9 months) vs. 1-dose (9 months) MV strategy. Healthy children were eligible 4 weeks after the 3rd diphtheria-tetanus-pertussis-containing vaccine. Before randomisation a blood sample was collected to determine MatAb level. The primary outcome was all-cause mortality. Hazard ratios (HR) were derived from Cox regression in the per protocol population. We tested for interactions with national campaigns with oral polio vaccine (C-OPV). Trial registration: NCT01486355.FindingsBetween August 2011-April 17th 2015, 6,636 children were enroled, 6,598[n2-dose=4,397; n1-dose=2,201] were included in the analysis of the primary outcome, The HR(2-dose/1-dose) between 4 and 60 months was 1.38 (95%CI: 0.92–2.06) [deaths: n2-dose=90; n1-dose=33]. Before the 9-month MV and the HR(1-dose/no dose) was 0.94 (0.45–1.96) [deaths: n2-dose=21; n1-dose=11]. The HR(2-dose/1-dose) was 0.81 (0.29–2.22) for children, who received no C-OPV [deaths/children: n2-dose=10/2,801; n1-dose=6/1,365], and 4.73 (1.44–15.6) for children, who received C-OPV before and after enrolment (p for interaction=0.027) [deaths/children: n2-dose=27/1,602; n1-dose=3/837]. In the 2-dose group receiving early MV at 4 months, mortality was 50% (20–68%) lower for those vaccinated in the presence of MatAb vs. the absence of MatAb [deaths/children: nMatAb=51/3,132; nnoMatAb=31/1,028].InterpretationThe main result contrasts with previous findings but may, though based on a small number of events, be explained by frequent OPV campaigns that reduced the mortality rate, but apparently interacted negatively with early MV. The beneficial non-specific effects of MV in the presence of MatAb should be investigated further.Funding10.13039/501100000781ERC, Danish National Research Foundation, the Danish Council for Development Research, Ministry of Foreign Affairs, Novo Nordisk Foundation, European Union and the Lundbeck Foundation.

The Long-Term Effects of Measles Vaccination on Earnings and Employment

The measles vaccine was introduced in 1963. Take-up of the vaccine in the United States occurred quickly and universally, leading to reductions in morbidity and mortality. New biological evidence on how the measles virus interacts with our immune system indicates the impact of the measles vaccine may be underestimated. Using a difference-in-difference identification strategy, I find evidence the measles vaccine increased earnings and employment. Long-term follow-up of adults finds an increase in income of 1. 1 percent and positive effects on employment. This increase in income is not from an increase in hours worked but rather from greater productivity. (JEL I12, I18, J22, J24, J31)

Analysis of Factors Hindering the Measles Elimination among Children at a Tertiary Care Hospital in South India

Introduction: Measles is a highly infectious acute viral disease that can lead to serious complications and death. Effective immunisation coverage for measles will play a pivotal role in its elimination strategy. So, the global commitment, strengthening of health infrastructure and effective vaccine coverage are essential to achieve a world that will be free of measles. Aim: To assess the factors associated with the occurrence of measles and to determine the factors responsible for non compliance to measles vaccination. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Niloufer Hospital, Hyderabad, India, during the period from October 2019 to March 2020 among the children clinical diagnosed with measles. The patients were evaluated for fever, rash, respiratory and other clinical symptoms associated with measles. History of measles vaccination and vitamin A administration were taken. Blood samples of patients were collected and measles specific IgM antibody detection test was done by Enzyme-linked Immunosorbent Assay (ELISA). Data was statistically analysed and presented as numbers and percentages were calculated. Results: Among 129 children, clinically diagnosed of measles, the predominant age group children effected was 1-6 years 68 (52.71%). Overall, 38 (29.5%) were vaccinated and 85 (65.9%) were unvaccinated during routine immunisation schedule. Measles-Containing Vaccine (MCV) coverage during Supplementary Immunisation Activities (SIAs) was also very limited (19.3%). Out of 129 cases, 121 (93.7%) were confirmed positive by measles IgM ELISA, 5 (3.8%) samples gave equivocal results and 3 (2.3%) were negative for the test. Conclusion: Inspite of the availability of effective and inexpensive measles vaccine for decades, vaccination coverage remains inadequate across the globe. So, effective implementation of vaccine services and monitoring of its surveillance system are needed for eradication of measles.

Effect of measles prevalence and vaccination coverage on other disease burden: evidence of measles immune amnesia in 46 African countries

ABSTRACT Background Measles is highly infectious that leads to a high disease burden among the vulnerable population, especially in developing countries, despite the availability of highly effective measles vaccine. Immune amnesia, the resetting of the immune systems of infected patients, has been observed in developed countries. This paper is the first to use various African countries to evaluate the extent of immune amnesia. Methods We used two panel datasets from 46 African countries between 1990 and 2018 among children, one is the disease prevalence from Global Burden of Disease, and another is on the measles vaccination coverage from WHO/UNICEF Joint Reporting Form. We used panel regression to estimate the effect of measles prevalence or measles vaccination coverage on other disease prevalence (diarrhea, lower respiratory infection, malaria, meningitis, and tuberculosis). Results We found the strong evidence that the increase in the measles prevalence led to an increase in other disease prevalence and mortality. We also found that the increase in the measles vaccination coverage decreased the prevalence of and the mortality due to other diseases. Discussion and Conclusion Measles vaccination can have a large impact on children’s health because not only does it reduce the prevalence of measles cases and deaths but also could it potentially reduce the prevalence of and deaths due to other diseases.

Assessment of Factors Associated with Low Measles Vaccine Effectiveness in Honkolo-Wabe District, Ethiopia

Background:-Measles is an acute illness and the most contagious childhood diseases. Almost all non-immune children contract this respiratory disease if exposed to the virus. The disease characterized by prodarmal fever, conjunctivitis, coryza and presence of Koplik spots. Prior to the introduction of vaccination programs, measles affected almost every child in the world. The expected sero conversion was estimated to 80-85% when 0.5ml live attenuated measles vaccine correctly administered subcutaneously at 9 months and more than 95% after 12months. This study was aimed to describe vaccine effectiveness and assess factors contributing to low measles vaccine effectiveness in Honkolo-Wabe district, Ethiopia. Methods:-Community based unmatched case-control study, involving 51 children who had previous measles illness were randomly selected and 153 controls were selected from the community three for each case in July, 2014. Vaccination status and other risk factors for the study children were ascertained through by interviewing mothers /care giver and observing the cold chain management. Epi-info version 7 was used for data analysis. Results:-Measles vaccine effectiveness was estimated at 70.9% [95% CI=65-79%]. Age of measles vaccine given, poor health seeking behavior of the community, number of dose and inappropriate vaccine transportation from district health office to health post, administration of reconstituted vaccine after 6hrs by HEW were identified as the contributing factors for low measles vaccine effectiveness in Honkolo-Wabe district. Contacting with laboratory confirmed or epidemiological linked measles cases statically significant regard to measles [OR=23.77, 95% CI=9.17-64.25]. Of the study participants 19.6%, 44.6% and 3.9% were received one, two and three doses of measles vaccine respectively. About 3.9%, 45.1% and 12.3% of the participants were received first dose of measles vaccination before, at 9month and after nine month respectively. However 18.6% of the study participants were not received 2nd does. Only 35.3% of the participants were received their second doses after 12month their birth. Conclusions:-Measles vaccine effectiveness was low. Age of children, number of dose, inappropriate vaccine transportation and utilization of reconstituted vaccine after 6hrs were contributing factors for low measles vaccine effectiveness. Regular monitoring and ensure of all birth cohort have received at least 2 doses of measles vaccine at 9month of their birth and above. Improve cold chain management at health post and use reconstituted vaccine within 6 hours.

Epidemiology of measles cases, vaccine effectiveness, and performance towards measles elimination in The Gambia.

IntroductionIn 2011, member states of the World Health Organization (WHO) Africa Regional Office (AFRO) resolved to eliminate Measles by 2020. Our study aims to assess The Gambia’s progress towards the set AFRO measles elimination target and highlight surveillance and immunisation gaps to better inform future measles prevention strategies.Material and methodsA retrospective review of measles surveillance data for the period 2011–2019, was extracted from The Gambia case-based measles surveillance database. WHO—UNICEF national coverage estimates were used for estimating national level MCV coverage. Measles post campaign coverage survey coverage estimates were used to estimate national measles campaign coverage.ResultsOne hundred and twenty-five of the 863 reported suspected cases were laboratory confirmed as measles cases. More than half (53.6%) of the confirmed cases have unknown vaccination status, 24% of cases were vaccinated, 52.8% of cases occurred among males, and 72.8% cases were among urban residents. The incidence of measles cases per million population was lowest (0) in 2011–2012 and highest in 2015 and 2016 (31 and 23 respectively). The indicator for surveillance sensitivity was met in all years except in 2016 and 2019. Children aged 5–9 years (Incidence Rate Ratio—IRR = 0.6) and residents of Central River region (IRR = 0.21) had lower measles risk whilst unvaccinated (Adjusted IRR = 5.95) and those with unknown vaccination status (IRR 2.21) had higher measles risk. Vaccine effectiveness was 89.5%.ConclusionThe Gambia’s quest to attain measles elimination status by 2020 has registered significant success but it is unlikely that all target indicators will be met. Vaccination has been very effective in preventing cases. There is variation in measles risk by health region, and it will be important to take it into account when designing prevention and control strategies. The quality of case investigations should be improved to enhance the quality of surveillance for decision making.

Correlation between measles immunization coverage and overall morbidity and mortality for COVID-19: an epidemiological study.

We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization’s (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho). There was a significant positive correlation between the vaccine coverage (%) and new cases per one million populations (rho = 0.24; p-value = 0.025); however, this correlation was absent in deaths per one million populations (rho = 0.17; p-value = 0.124). On further analysis of the effect of first reported year of vaccination policy, there was no significant correlation with both of total cases per one million populations (rho = 0.11; p-value = 0.327) and deaths per one million populations (rho = −0.02; p-value = 0.829). Claims regarding the possible protective effect of measles vaccination seem to be doubtful.