Measles Vaccine Research Articles

Machine learning algorithms for prediction of measles one vaccination dropout among 12–23 months children in Ethiopia

IntroductionDespite the availability of a safe and effective measles vaccine in Ethiopia, the country has experienced recurrent and significant measles outbreaks, with a nearly fivefold increase in confirmed cases from...

Pediatric Rash Illness Outbreak with Initial Positive Measles Immunoglobulin M Antibody Test Results - American Samoa, March-July 2023.

On April 24, 2023, the American Samoa Department of Health (ASDoH) declared a public health emergency amid concern about a possible measles outbreak given low 2-dose vaccination coverage at the time. ASDoH had received two positive measles immunoglobulin (Ig) M test results after Flag Day festivities 1 week earlier from vaccinated children. ASDoH performed active case finding, took actions to mitigate transmission, and requested technical assistance from CDC. ASDoH implemented a vaccination campaign to improve suboptimal coverage. Confirmatory molecular testing of specimens from these initial persons under investigation (PUIs) was not possible, but subsequent testing of specimens from additional PUIs by Hawaii State Laboratories Division and CDC ruled out measles. In settings with low measles prevalence, measles antibody testing results have low positive predictive value and can lead to difficulties with interpreting results. Testing for additional pathogens revealed a variety of viruses known to cause common childhood viral exanthems. Both molecular and serologic testing should be performed for all suspected measles cases. To decrease the probability of false-positive IgM results, testing should be reserved for cases that meet the Council of State and Territorial Epidemiologists measles case definition, especially those in persons with no evidence of immunity and with a history of recent international travel. In addition, maintaining high measles vaccination coverage can prevent future outbreaks.

Progress Toward Measles Elimination - Worldwide, 2000-2023.

Measles vaccination effectively prevents measles, a highly contagious disease that can cause severe complications and death and requires high population immunity to interrupt transmission. This report describes measles elimination progress during 2000-2023. During 2000-2023, an estimated 60.3 million measles deaths were averted by vaccination. However, despite commitment from all six World Health Organization regions to eliminate measles, no region has successfully achieved and maintained measles elimination as of the end of 2023. During the COVID-19 pandemic, estimated global coverage with the first dose of measles-containing vaccine (MCV1) declined to 81%, the lowest level since 2008. MCV1 coverage improved to 83% in 2022 but was unchanged in 2023. From 2022 to 2023, estimated measles cases increased 20% worldwide, from 8,645,000 to 10,341,000; the number of countries experiencing large or disruptive outbreaks increased from 36 to 57. Estimated measles deaths decreased 8%, from 116,800 in 2022 to 107,500 in 2023, primarily because an increased number of cases occurred in countries with lower risk for death. The stagnation in MCV1 coverage means millions of children remain unprotected, leading to increases in cases and outbreaks. Coverage with measles-containing vaccine (MCV) is lower, and measles incidence is higher, in low-income countries and countries experiencing fragile, conflict-affected, and vulnerable settings, which exacerbate inequities. Urgent and targeted efforts are needed to ensure that all children receive 2 MCV doses and that surveillance is strengthened to hasten progress toward measles elimination.

Securing long-term immunity: The possible necessity of supplementary measles vaccination.

The global initiative to eliminate measles, spearheaded by the World Health Organization, has yet to achieve its intended goals. In Turkey, despite robust vaccination strategies, recent increases in measles cases have been attributed to vaccine hesitancy and irregular migration. This study evaluates measles serology within a pediatric population to determine the impact of vaccination regimens on immunity. A retrospective study at Ankara Bilkent City Hospital analyzed serum measles IgG levels in children aged 1-18 years from January 2020 to August 2023. Exclusions were applied for individuals with positive IgM results, incomplete vaccinations, and immunocompromised conditions. Patients were categorized based on their M-M-R®II vaccine status into those having received either one or two doses. Seropositivity was assessed using the ELISA method. Of the 686 children, 30.2% received a single dose, and 69.8% received two doses of the MMR vaccine. Overall, 70.7% exhibited positive IgG levels. No significant differences were found in IgG levels between those who received one dose and those who received two doses. However, a decline in IgG levels was observed with age, particularly notable in adolescents aged 14-18 years. The study reveals seropositivity rates lower than expected, highlighting challenges in achieving WHO targets. This suggests a potential need for booster doses during adolescence to maintain protective antibody levels. The findings emphasize the importance of continued surveillance and research to adapt vaccination strategies effectively and prevent measles outbreaks, particularly considering the decline in antibody levels and diverse vaccination histories across populations.

Lessons from Recent Measles Post-Campaign Coverage Surveys Worldwide

Background: Measles elimination strategies include supplementary immunization activities (SIAs) to rapidly fill immunity gaps. Post-campaign coverage surveys (PCCSs) are recommended to assess SIA coverage. We characterized selected PCCSs performed following recent SIAs, highlighting specific challenges and strengths, and provide recommendations for improvement. Methods: We extracted national SIA data from the global measles/MR SIA database for the period of 2020–2023 and reviewed PCCS reports available at the World Health Organization headquarters. We extracted selected information on PCCS implementation, including information about the implementer, sampling, and main results. Results: Only 15 of 66 countries (23%) with a national-level SIA performed since 2020 had a PCCS report available. We reviewed those reports, plus six more, following three 2019 SIAs with a delayed PCCS and two PCCSs following large subnational SIAs (Kenya 2021 and Yemen 2023). All 24 PCCS reports available were from Gavi-eligible countries, with 15 from South Saharan Africa (Cameroon, the Democratic Republic of the Congo, and Ethiopia had two PCCSs). Eleven (45.8%) PCCSs were conducted within three months of the end of the SIA. All included sampling information and most had percentage of participation. Description of the interviewers’ profiles varied but was limited. PCCS coverage was lower than administrative data in all but two instances. All PCCSs collected data on previous measles vaccination status that would allow exploring indicators on the SIA reaching previously measles zero-dose children. Of the 12 PCCSs reporting coverage among previously measles zero-dose children, nine reported coverage among this group of more than 50% (range: 12% and 91.6%). Conclusion: Even though a PCCS following an SIA is recommended and a requirement in Gavi-supported countries, most SIAs are not followed by a PCCS and, when performed, the timeliness of survey implementation needs improvement. Recent PCCSs were independently conducted and reports included basic survey information, but analysis and presentation of survey results vary particularly for measles zero-dose-related indicators. More guidance and technical support on how to implement PCCSs, including standardization of reports and more in-depth PCCS analyses, may help improve reporting and use of available PCCS data.

Detection of live attenuated measles virus in the respiratory tract following subcutaneous MMR Vaccination

Abstract The live attenuated measles vaccine is extremely effective in preventing measles and induces mucosal immunity in the respiratory tract, however the mechanism is not known. We show that live attenuated measles virus (LAMV) RNA is frequently detected in the respiratory tract 7-21 days after subcutaneous measles-mumps-rubella (MMR) vaccination in healthy children (n = 5/20) and macaques (n = 6/8). Replicating LAMV was isolated from the lungs of 2 macaques, with no evidence of transmission to unvaccinated individuals. These observations suggest that LAMV in the respiratory tract may play a role in the development of robust mucosal immunity following MMR vaccination.

Long-term dynamics of measles virus-specific neutralizing antibodies in children vaccinated before 12 months of age.

Measles is a highly contagious disease presenting a significant risk for unvaccinated infants and adults. Measles vaccination under the age of 12 months provides early protection, but has also been associated with blunting of antibody responses to subsequent measles vaccinations and assumed to have lower vaccine effectiveness. Our study included children who received an early measles, mumps and rubella (MMR) vaccination between 6 and 12 months of age (n=79, given in addition to the regular MMR vaccination schedule at 14 months and 9 years) and a group without additional early vaccination (n=44). We evaluated measles virus (MeV)-specific neutralizing antibodies before vaccination at 14 months and up to 6 years thereafter using a plaque reduction neutralization test according to the standard set by the WHO. We show a significant association between age of first MMR and MeV-specific neutralizing antibody levels later in life. Although most children who received early vaccination seroconverted after the first dose, children vaccinated before 8·5 months of age exhibited a markedly faster antibody decay and lost their protective neutralizing antibody levels over 6 years. Routine vaccination of infants under 8·5 months of age may lead to blunted MeV-specific antibody responses to subsequent MMR vaccination. Early MMR vaccination should only be considered during measles outbreaks or in other situations of increased risk of MeV infection.

Assessment of humoral immunity to the measles virus in healthcare workers

BACKGROUND: measles is an anthroponotic viral disease characterized by high contagiousness. In the early 2000s in the Russian Federation, the infection was on the verge of elimination, but outbreaks in 2003, 2014, 2019 and the rise in incidence since 2022 refutes this situation. Cleanup vaccination of risk groups and revaccination of persons vaccinated once are ongoing. It is relevant to determine antibodies in blood serum in the vaccinated population and in persons with an unknown vaccination and post-infection history. AIM: of the study is to present the results of a study of humoral immunity to the measles virus in healthcare workers vaccinated against measles and with an unknown vaccination and post-infectious history. MATERIALS AND METHODS: the study was conducted in Kazan, Republic of Tatarstan. The study involved employees of a skin and venereal disease clinic, children's clinics, and a blood center in the amount of 133 people (including 2 men), who were vaccinated and revaccinated with live measles vaccine, after which a sufficient amount of time had passed for the formation of an immune response - 3-4 weeks, as well as 40 female employees with an unknown vaccination and post-infection history. Specific IgG to the measles virus was determined in the test blood sera using the enzyme immunoassay method using the Vector-Best kit (Novosibirsk, Russia). Statistical analysis was carried out using the StatTech v.4.1.9 program (developed by Stattech LLC, Russia). RESULTS. The study was conducted in Kazan, Republic of Tatarstan. The study involved employees of a skin and venereal disease clinic, children's clinics, and a blood center in the amount of 133 people (including 2 men), who were vaccinated and revaccinated with live measles vaccine, after which a sufficient amount of time had passed for the formation of an immune response - 3-4 weeks, as well as 40 female employees with an unknown vaccination and post-infection history. Specific IgG to the measles virus was determined in the test blood sera using the enzyme immunoassay method using the Vector-Best kit (Novosibirsk, Russia). Statistical analysis was carried out using the StatTech v.4.1.9 program (developed by Stattech LLC, Russia). CONCLUSIONS. The ongoing outbreaks of measles in 2003, 2014, 2019, 2022-2023 require constant monitoring of the epidemiological situation with the study of the post-vaccination immune response in vaccinated people and the post-infection response in people with an unknown history of measles

Trends of the second measles vaccine (MCV2) over time after its launch as part of routine immunization in Nigeria: a brief research report.

Nigeria has one of the highest measles burdens and the lowest vaccination coverage in the world. Geographical disparity in the coverage has also been persistent. Between 2019 and 2021, the Nigerian government introduced the second Measles vaccine (MCV2) into routine immunization (RI). This study evaluated the trends of the MCV2 coverage over time across geographical zones. The monthly data on the MCV2 coverage from District Health Information Software (DHIS2) for all the health facilities in Nigeria were aggregated by the geopolitical zone, and the trend of the MCV2 coverage was analyzed over time. The MCV2 coverage in each zone was approximately 20% when the MCV2 program was launched. The MCV2 coverage was higher in the northern zones (35-42%) than in the southern zones (22-31%) 1 year after the launch. Similarly, at 2.5 years, the MCV2 coverage ranged from 38 to 46% in northern zones, while in southern zones, it ranged from 23 to 37%. The introduction of MCV2 as part of the RI schedule potentially narrows down the health inequity in Nigeria.

5.I. Scientific session: Epidemiological insights into vaccine hesitancy in Europe: building bridges and overcoming barriers

Abstract Vaccine hesitancy remains a pivotal challenge in public health, undermining immunization efforts and the containment of infectious diseases across Europe. This scientific session aims to dissect the complex nature of vaccine hesitancy, uncovering epidemiological trends and barriers to vaccine acceptance, particularly in diverse demographic contexts. The objective is to facilitate a comprehensive understanding among public health stakeholders and to foster actionable strategies through enriched dialogue and interaction. This session will delve into recent studies and projects that highlight the variability of vaccine hesitancy within Europe. First, an exploration of COVID-19 vaccine acceptance will reveal how sociodemographic factors influence vaccine-related behaviors across 20 European nations. This will be complemented by an analysis of targeted interventions designed to enhance vaccine uptake among migrant populations, drawing lessons from the RIVER-EU project. Additionally, a focus on national efforts to combat measles vaccine hesitancy will provide a case study on the challenges and successes in altering public health narratives. Based on the feedback received on last year’s session, the format is intended not only to provide a platform to present empirical evidence and insights but also to encourage a participatory environment where attendees can exchange ideas and propose innovative solutions. For this reason, the session will engage the audience through an interactive discussion period at the end of each of the three presentations, stimulating thought-provoking dialogues that could lead to effective and innovative public health practices. Fostering international and interdisciplinary collaboration in the field of vaccine hesitancy is key for continued monitoring and reporting on the vaccine hesitancy phenomenon and inspiring actionable solutions. Key messages • Sociodemographic factors are associated with vaccine hesitancy across Europe indicating the potential for targeted strategies. • A platform to share insights and inspire actionable public health solutions to combat vaccine hesitancy amomg European public health professionals is needed.

Measles cluster in Northern Portugal: enhancing surveillance strengths

Abstract Although measles was declared eliminated in Portugal in 2015, outbreaks persist, despite high vaccination coverage. The last outbreak in the northern region was in 2017. Portugal has a Surveillance System implemented for mandatory communicable diseases (SINAVE) integrating clinical, epidemiological and laboratory data. In 2021, WHO expressed concern about the low sensitivity of measles surveillance and urged Portugal to strengthen its surveillance practices. Our study aims to describe a measles cluster in northern Portugal during the first trimester of 2024. Data from measles cases from the first trimester of 2024 were collected from SINAVE. Contact tracing and Public Health (PH) intervention data was sent by Local Public Health Authorities through a survey designed for that purpose. A total of 70 suspected cases were reported and investigated: 6 cases were laboratory confirmed and 64 were discarded. The confirmed cases had a mean age of 28 years (all adults), with 50% female. The mean notification time was 0,3 days. The index case was imported (Mauritania) and unvaccinated, leading to 2 secondary cases. Five cases had 2 doses of a measles vaccine, with 1 case being a health professional. Additionally, 1 case was imported from France. For 2 cases the source of infection could not be unequivocally identified and no travel history during incubation period. A total of 851 contacts of confirmed cases were identified. Although sustainable transmission is not evident in our region, measles is being introduced through migration and tourism. Despite clinical awareness, strengthening early case detection is essential to enforce effective control measures. PH teams have been working tirelessly to trace clusters origins, gathering large number of contacts and adapting strategies for sustained control. In a globalized world, ensuring surveillance sensitivity is paramount. Integrating other data sources in surveillance routine is crucial for upholding Measles-Free Status compliance. Key messages • Measles must take centre stage on our agenda. • Reinforcing surveillance, integrating additional data sources, is crucial for heightened sensitivity and prompt response.

Unveiling the dimension of regional disparities: Assessing the disruption of immunisation services by COVID-19 in Bangladesh.

The coronavirus disease 2019 (COVID-19) pandemic disrupted essential health care services worldwide, including those related to immunisation. National data from Bangladesh shows that child immunisation may have been adversely affected by the pandemic but regional evidence is limited. We therefore aimed to explore the regional differences in the indirect effects of COVID-19 on child immunisation in Bangladesh. We extracted data from the District Health Information Software (DHIS2) spanning the period from January 2017 to December 2021. We examined three essential immunisation indicators: Bacille Calmette-Guérin (BCG), pentavalent third dose, and measles vaccinations. We examined both the yearly and monthly trends to explore fluctuations in the number of immunisations to pinpoint specific periods of service utilisation regression. Segmented regression with Poisson distribution was implemented given the count-based outcome. We reported incidence rate ratios (IRRs) with 95% confidence intervals (CIs) in different regions in 2020 and 2021 compared to the reference period (2017-19). We initially observed a notable decline in vaccine administration in April 2020 compared to the pre-pandemic period of 2017-19 with a drop of approximately 53% for BCG vaccines, 55% for pentavalent third doses, and 51% for measles vaccines followed by May 2020. The second half of 2020 saw an increase in vaccination numbers. There were noticeable regional disparities, with Sylhet (IRR = 0.75; 95% CI = 0.67-0.84 for pentavalent administration, IRR = 0.79; 95% CI = 0.71-0.88 for measles administration) and Chattogram (IRR = 0.77; 95% CI = 0.72-0.83 for BCG administration) experiencing the most significant reductions in 2020. In April 2020, Dhaka also experienced the largest decline of 67% in measles vaccination. In 2021, most divisions experienced a rebound in BCG and pentavalent administration, exceeding 2019 levels, except for Chittagong, where numbers continued to decline, falling below the 2019 figure. Our findings highlight the impact of the COVID-19 pandemic on childhood immunisation across regions in Bangladesh. Sylhet, Chattogram, and Dhaka divisions experienced the most significant reductions in immunisation services during 2020. This underscores the importance of targeted interventions and regional strategies to mitigate the indirect effects of future challenges on essential health care services, particularly childhood immunisation, in Bangladesh.

The efficacy of cryotherapy compared to the other modalities for the management of palmoplantar warts: a systematic review and network meta-analysis

There are several treatment modalities for Palmoplantar Warts (PPW) introduced, but none have been proven to be significantly effective in all patients. The study aims to assess the efficacy and safety of cryotherapy compared to other modalities for PPW. Searches were conducted in Medline, Embase, Scopus, and CENTRAL databases, along with additional reference and citation tracking from included studies. Randomized Controlled Trials (RCTs) comparing various treatments for PPW were included. Two independent pairs extracted the data from the included studies. Outcomes assessed included cure rates, pain scores, recurrence rates, and adverse events. Network meta-analysis using Netmeta in R software was utilized, with treatments ranked by p-scores. A total of 27 RCTs that enrolled 2,539 participants were deemed eligible. As per p-scores, needling yielded the highest odd for the cure rate (p=1.00), followed by intralesional injection of the Measles, Mumps, and Rubella (MMR) vaccine (p=0.90). For the pain score, 76% topical monochloroacetic acid (p=0.13) showed the lowest mean pain score, while cryotherapy yielded the highest score (p=0.90). Furthermore, cryotherapy showed the highest odds for recurrence rate (p=0.75), followed by intralesional injection of Candida antigen (p=0.61). 0.05% intralesional bleomycin (p=0.93) was the highest agent for adverse events rate, followed by cryotherapy (p=0.61). Needling was the most effective in achieving a cure rate. Cryotherapy has the highest odds for pain score and recurrence rate, while 0.05% intralesional bleomycin has the highest adverse events profile.

Yellow Fever Vaccine-Associated Neurotropic Disease: A Case Report Of A 9-Month Old Infant And Review Of Literature

Introduction Yellow fever vaccine-associated neurotropic disease (YEL-AND) is a rare and serious complication following vaccination with the 17D live attenuated yellow fever vaccine. Cases of YEL-AND present as acute inflammatory demyelinating polyneuropathy, acute disseminated encephalomyelitis, and meningoencephalitis and encephalitis. To date, only a few cases have been reported in the literature in children. Methods/Subject We present the case of a 9-month-old male who developed YEL-AND. He suffered "3 episodes of unprovoked generalized tonicclonic seizure," the first occurring within 2 hours of receiving a dose of the Yellow Fever vaccine, Measles, and Meningococcal vaccines. He was lethargic for 28 hours and had intermittent inconsolable cries for 48 hours, low-grade fever, and loss of motor milestones (sitting and standing). Available laboratory investigations and neuroimaging ruled out other possible causes. He was treated with anticonvulsants and IV Methylprednisolone and made a significant recovery and was discharged on the sixth day and has remained stable on follow-up. His clinical presentation, neuroimaging, and challenges in his management are discussed in this case report. Conclusion The licensed Yellow fever vaccines are safe, effective for the prevention of Yellow fever, and highly recommended, however, it is not completely devoid of serious adverse reactions. This case highlights a possibility of a very early onset of YEL-AND in children and should be suspected in individuals with a temporal relationship of symptom onset to vaccination.

Trends of Diphtheria–Tetanus–Pertussis and Measles Vaccine Coverage Preceding and during the COVID-19 Pandemic: An Analysis of the WHO European Region from 2000 to 2022

Available data highlights the significant impact of the COVID-19 pandemic on global vaccination trends. Despite this, comprehensive evaluations of these changes at the European level are still scarce. This study examines coverage for diphtheria, tetanus, and pertussis (DTP) and measles-containing vaccines (MCV) in the WHO European Region from 2000 to 2022. Vaccination coverage data, defined as the percentage of surviving infants who received the first and third doses of DTP (DTP1 and DTP3) and the first and second doses of MCV (MCV1 and MCV2), were extracted from UNICEF databases. Joinpoint regression analysis was employed to identify joinpoints in the time series and to estimate Annual Percent Changes (APCs) and Average Annual Percent Changes (AAPCs) over predefined timeframes. The coverages for DTP1 and MCV1 exhibit a similar trend, overall characterized by four joinpoints, one of which is in 2019. In contrast, the coverage for DTP3 does not show a significant temporal trend and lacks joinpoints, while the vaccination coverage for MCV2 shows a steadily increasing trend, with three identified joinpoints. A comparative analysis with the pre-pandemic period reveals a significant increase in the number of countries characterized by a decreasing trend during the pandemic period for all considered vaccination coverages, as indicated by the negative AAPC values. These results highlight the effect of the pandemic on childhood vaccination coverage. Compared to a mere descriptive analysis, the temporal analysis of trends using joinpoint regression provides significant opportunities to identify variations in vaccination coverages and pinpoint areas for intervention in future vaccination strategies.

Barriers to child vaccination: The role of international sanctions

International sanctions are often imposed with the aim of influencing the political behavior of target states, but they may have unintended consequences on public health. This study empirically examines the impact of international sanctions on child immunization rates in developing countries. Utilizing panel data from 76 developing countries between 2000 and 2019, the analysis explores how different types of sanctions, including those from the US, EU, and UN, as well as economic and unilateral sanctions, affect the immunization rates for DPT, Hepatitis B, and Measles vaccines. The findings indicate that sanctions, particularly those imposed by the US and EU, significantly reduce vaccination rates, with economic and unilateral sanctions showing the most substantial negative impact. Additionally, the study highlights the moderating role of health spending, revealing that increased healthcare investment can mitigate some of the adverse effects of sanctions. Poorer developing countries are disproportionately affected compared to their more affluent counterparts. The results underscore the need for policymakers to consider the broader public health implications of sanctions and for international efforts to ensure that essential medical resources remain accessible in sanctioned countries. This study contributes to the literature by providing comprehensive empirical evidence on the detrimental effects of international sanctions on child immunization, advocating for a balanced approach that protects public health while achieving geopolitical objectives.

Update on Epidemiologic Trends in Causes of Childhood Blindness and Severe Visual Impairment in East Africa.

The initiative 2030 In Sight and the International Agency for the Prevention of Blindness have developed a plan to mitigate the global burden of preventable sight loss. One priority of this initiative is obtaining population eye health data. East Africa is a region that has historically been plagued by high rates of vision loss, and it is imperative to understand what causes are at play. Two large cross-sectional studies were previously published in 1995 and 2009, reporting the causes of childhood blindness (BL) and severe visual impairment (SVI) in East Africa. An update regarding more recent causes is warranted to better understand the trends of childhood BL/SVI in this region. A search strategy was developed a priori to identify relevant terms and align them with a standardized definition of East Africa. This strategy was then employed across PubMed, Google Scholar, and Scopus, with the yield of the overall search depicted in a Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 flow diagram. In the articles gathered by the search, causes of BL/SVI were typically categorized by anatomy and etiology. Eight articles met the criteria, with data from 6 countries, consisting of 534 cases of childhood BL/SVI. Common anatomic locations identified included the cornea, lens, and whole globe. Among the most common etiologies were corneal scarring/opacity and cataract. Systemic etiologies and disease associations included measles, toxoplasmosis, and prematurity. Presumptive infectious disease and hereditary conditions were also identified as a category, but specific identification of etiologies and genetic diagnosis was largely unavailable. BL/SVI due to the cornea was among the common anatomic sites of disease in our study. The identification of measles as an associated systemic etiology requires further understanding in the context of increased vaccination programs. Multiple articles acknowledged that cataract has become the predominant cause of BL/SVI owing to increased measles vaccination and vitamin A supplementation. Additional research should be conducted to gain a complete understanding of childhood BL/SVI in East Africa, and responses at regional and national levels are likely necessary to address treatable causes of vision impairment.

Factors Associated With Appropriateness of Vaccination Age Coverage For Measles Vaccine In Kufa District, Najaf Governorate, Iraq

Measles is one of the diseases that can be effectively managed with vaccination. Herd immunity is a concept that describes the situation where a large proportion of a population is vaccinated, resulting in high coverage rates. Measles infections persist at high levels in specific areas despite the general vaccination rates. Administering the vaccination at the recommended age is crucial for attaining protection and reducing the transmission of vaccine-preventable illnesses . Cross –sectional study was conducted from 1st of OCT .2023 until 25th of JAN. 2024 among mothers with their child aged 12-23 month. The purpose of this study was to assess age-appropriate measles vaccination coverage and associated factors. Collected data using pre-tested questionnaires also data on measles vaccination were taken from vaccination card.This study analyzed 388 mothers, revealing that the majority of father age were between 20-34y, with 41.2% having primary education. Mother age found to be 258(66.5%) between 20-34y .225(57.9%) of father occupation were free job and 334(86.1%) were house wife by occupation, the sex of child 201(51.8%) were found to be female .68.61% were vaccinated with measles vaccine on time, (29.38%) were delayed and (1.80%) were found to be unvaccinated. The education level, number of children in the family and child order are significantly associated with measles vaccination status of child. As we revealed that the proportion of individuals receiving the vaccine within the designated timeframe is below 70%. We should focus on enhancing on time of routine children immunization. This can be achieved by reinforcing existing techniques, developing new approaches, and emphasizing the media's role in promoting the significance of timely vaccine administration.

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.

Factors influencing the first dose of measles vaccination uptake in 42 low- and middle-income countries

ObjectivesVaccination against measles still stands as a highly impactful public health strategy for mitigating childhood morbidity and mortality. Relatively poor immunization coverage among children has been observed in low and middle-income countries (LMICs). Our study intended to determine socio-demographic factors associated with the 1st dose of measles vaccination among South Asian (SA) and SubSaharan African (SSA) countries children. Study designThis was a cross-sectional study. MethodsThis study utilized demographic and health survey data from 42 low-and middle-income countries (LMICs) in SA and SSA. The children's dataset yielded 255,775 children between the ages of 12 and 59 months. The independent predictors were determined by using crude and adjusted odds ratios with 95% confidence intervals (CI). ResultsThe prevalence of first-dose measles-immunized children was 55.5% for the selected LMICs. The multivariable analysis for combined regions (SA and SSA) showed that parents with a higher level of education, rich wealth quintile, mothers with media access, mothers with more than four antenatal care (ANC) visits and baby postnatal check-up (PNC) within two months were significantly associated with the first dose of measles vaccination among children. ConclusionThe first dose measles immunization coverage in the selected LMICs was considerably low. To boost the uptake of childhood measles vaccination, public health interventions particularly need to focus on children born to uneducated parents, poor families, and those who have not used health services (ANC and PNC). Financial funding is crucial for establishing mobile vaccination clinics to improve immunization rates among the impoverished.