Exploring the time to intervene with a reactive mass vaccination campaign in measles epidemics

The current WHO policy during measles outbreaks focuses on case management rather than reactive vaccination campaigns in urban areas of resource-poor countries having low vaccine coverage. Vaccination campaigns may be costly, or not timely enough to impact significantly on morbidity and mortality. We explored the time available for intervention during two recent epidemics. Our analysis suggests that the spread of measles in African urban settings may not be as fast as expected. Examining measles epidemic spread in Kinshasa (DRC), and Niamey (Niger) reveals a progression of smaller epidemics. Intervening with a mass campaign or in areas where cases have not yet been reported could slow the epidemic spread. The results of this preliminary analysis illustrate the importance of revisiting outbreak response plans.

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Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw064 ◽

2016 ◽

Vol 3 (2) ◽

Cited By ~ 15

Author(s):

Craig M. Hales ◽

Eliaser Johnson ◽

Louisa Helgenberger ◽

Mark J. Papania ◽

Maribeth Larzelere ◽

...

Keyword(s):

Confidence Interval ◽

Vaccination Campaign ◽

Vaccine Effectiveness ◽

Mass Vaccination ◽

Cold Chain ◽

Primary Case ◽

Federated States Of Micronesia ◽

Measles Outbreak ◽

Mass Vaccination Campaign ◽

Vaccination Campaigns

Abstract Background. A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods. We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results. Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions. Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.

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Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

10.21203/rs.3.rs-34385/v2 ◽

2020 ◽

Author(s):

Anne Eudes Jean Baptiste ◽

John Wagai ◽

Richard Ray Luce ◽

Balcha Girma Masresha ◽

Don Klinkenberg ◽

...

Keyword(s):

Vaccination Campaign ◽

Screening Method ◽

Population Level ◽

Vaccine Effectiveness ◽

Sensitivity Analyses ◽

Outbreak Response ◽

Internally Displaced ◽

Complex Emergency ◽

Campaign Coverage ◽

Measles Outbreaks

Abstract Background: From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impactMethods: We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey (PCCS) after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. . Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4 (95%CI: 97.8 – 98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

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Vaccination opportunities in multiple sclerosis patients treated with cladribine tablets

Current Neuropharmacology ◽

10.2174/1570159x20666211217160451 ◽

2021 ◽

Vol 20 ◽

Author(s):

Lucia Moiola ◽

Agostino Riva ◽

Ferdinando Nicoletti ◽

Antonio Uccelli ◽

Marco Salvetti ◽

...

Keyword(s):

Multiple Sclerosis ◽

Immune System ◽

Mechanism Of Action ◽

Vaccination Campaign ◽

Humoral Response ◽

Focused Attention ◽

Vulnerable Patients ◽

Mass Vaccination Campaign ◽

Multiple Sclerosis Patients ◽

Vaccination Campaigns

: The COVID-19 pandemic and the mass vaccination campaign highlighted the situation of the most vulnerable patients. In this work, we focused attention on patients who have Multiple Sclerosis (MS), particularly in treatment with cladribine tablets, trying to understand if and when it is possible to administer the vaccine successfully. Considering the innovative topic, we reviewed the existing literature with an analysis of the experiences also related to other vaccinations, including influenza and VZV, and very recent data from countries with vaccination campaigns already advanced. Overall, we have taken into account the mechanism of action, the pharmacokinetic/pharmacodynamic of cladribine and the changes in the immune system after its administration, together with the preliminary data about the humoral response to influenza, VZV and SARS-CoV-2 vaccinations in cladribine treated patients. In conclusion, data showed that the use of cladribine tablets seems to permit flexibility regarding vaccination timing and we suggest that vaccination in those patients should be safe and effective.

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MONITORING OF MEASLES RUBELLA VACCINATION SESSIONS AT SCHOOLS IN PUNE CITY

10.36106/gjra/4703836 ◽

2021 ◽

pp. 34-35

Author(s):

Sana Ra q Khuroo ◽

Varsha Mahesh Vaidya ◽

A P S Narula

Keyword(s):

Urban Areas ◽

Healthcare Workers ◽

Vaccination Campaign ◽

Cross Sectional Study ◽

Cold Chain ◽

Cross Sectional ◽

Who Checklist ◽

Vaccination Campaigns ◽

Rubella Vaccination ◽

Injection Practices

Introduction: India with the support of WHO launched one of the world's largest vaccination campaigns against measles and rubella on 5 February 2017. The campaign was launched to vaccinate children in the age group of 9 months to 15 years with measles and rubella vaccine. In Maharashtra state the campaign started from 27th November 2018. All eligible children were vaccinated at the following session sites: Schools, Health sub-centers, Anganwadi centers, xed outreach sessions and mobile posts in villages and urban areas, Government health facilities will vaccinate on all days of campaign. Aim and objectives: To monitor vaccination injection practices, cold chain maintenance and safe needle disposal at measles rubella vaccination sessions at schools in Pune city. Material and methods: Study was a cross sectional study. 5 schools in each 5 Wards (Bibewadi, Kondwa, Hadapsar, Wanowri, and Dhankawadi) out of the 15 wards of Pune Municipal Corporation were MR vaccination campaign session will take place will be studied in 2nd week of the campaign. After obtaining permission from the WHO surveillance medical ofcer The above mentioned sites were visited on vaccination day. A structured Performa based on WHO checklist were lled on observation of all the sites selected. Results: 92% of the vaccinators have attended training sessions, 16% of the vaccinators were wearing gloves, Swabbing of the skin done by 52% , 80% of the vaccinators were administering vaccine through subcutaneous route, cold chain were maintained to 100% perfection and Safe needle disposal practices were maintained to 100%. Conclusion: Need for better training to healthcare workers about safe practices and proper implementation of vaccination campaign.

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Measles outbreak in complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019

BMC Public Health ◽

10.1186/s12889-021-10436-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anne Eudes Jean Baptiste ◽

John Wagai ◽

Richard Luce ◽

Balcha Masresha ◽

Don Klinkenberg ◽

...

Keyword(s):

Vaccination Campaign ◽

Screening Method ◽

Population Level ◽

Vaccine Effectiveness ◽

Sensitivity Analyses ◽

Outbreak Response ◽

Internally Displaced ◽

Health Authorities ◽

Campaign Coverage ◽

Measles Outbreaks

Abstract Background From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impact. Methods We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. Results Of the total 15,237 reported measles cases, 2002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4% (95%CI: 97.8–98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6–90.1). Conclusion The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergencies affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

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Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

10.21203/rs.3.rs-34385/v3 ◽

2021 ◽

Author(s):

Anne Eudes Jean Baptiste ◽

John Wagai ◽

Richard Ray Luce ◽

Balcha Girma Masresha ◽

Don Klinkenberg ◽

...

Keyword(s):

Vaccination Campaign ◽

Screening Method ◽

Population Level ◽

Vaccine Effectiveness ◽

Sensitivity Analyses ◽

Outbreak Response ◽

Internally Displaced ◽

Health Authorities ◽

Campaign Coverage ◽

Measles Outbreaks

Abstract Background: From January to May 2019, large measles outbreaks affected Nigeria. Borno state was the most affected, recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 cases investigated and line-listed by March 2019. In Borno state, 22 of the 27 Local Government Areas (LGAs or Districts), including 37 internally displaced persons (IDPs) camps were affected. In response to the situation, an outbreak response immunization (ORI) campaign was conducted in the 13 most affected LGAs. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the outbreak and the ORI campaign. We also assess the measles-containing vaccine (MCV) coverage and vaccine effectiveness (VE) in order to quantify the population-level impactMethods: We reviewed the ORI activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We assessed VE of MCV by applying the screening-method. Sensitivity analyses were also conducted to assess the effect of final classification of cases on the VE of MCV. The MCV coverage was assessed by a post-campaign coverage survey (PCCS) after completion of the ORI through a quantitative survey in the 12 LGAs that were accessible. Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles by week 9 of 2019. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The overall VE for MCV was 98.4 % (95%CI: 97.8 – 98.8). No significant differences were observed in the VE estimates of lab-confirmed and epi-linked cases when compared to the original estimates. The aggregated weighted vaccination coverage was 85.7% (95% CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergencies affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

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Secondary Data Analysis of the 2012 Peru Demographic and Health Survey Examining Immunization Campaign Participation Among Children Aged 18 to 59 Months

Global Pediatric Health ◽

10.1177/2333794x18821948 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1882194

Author(s):

Michael Townsend Cooper ◽

Hélène Carabin ◽

David M. Thompson ◽

Paul Martin Darden

Keyword(s):

Secondary School ◽

Health Survey ◽

Urban Areas ◽

Maternal Education ◽

Vaccine Coverage ◽

Vaccination Campaign ◽

Demographic And Health Survey ◽

Prevalence Odds Ratio ◽

Relative Wealth ◽

Immunization Campaign

Objective. To evaluate the association between characteristics known to be associated with under-immunization and participation in immunization campaigns among Peruvian children. Methods. This is an analysis of data collected as part of the Peru 2012 Demographic and Health Survey. Analyses were conducted among children in 2 groups: children aged 18 to 29 months among whom core vaccine coverage is typically determined by the Peruvian authorities and children aged 30 to 59 months who may have received the core vaccines at older ages. The associations between relative wealth, location, maternal education, primary maternal language and the outcome, participation in an immunization campaign within the past 2 years were estimated using logistic regression models adjusted for survey design in each age group. Results. For children aged 18 to 29 months, campaign participation was higher if the mother had completed secondary school compared with those not having completed secondary school (27.4% vs 20.1% [prevalence odds ratio (POR) = 1.51 (1.08, 2.13)]). For children aged 30 to 59 months, campaign participation was higher if the mother had completed secondary school (40.4% vs 35.1% [POR = 1.23 (1.02, 1.49)], adjusted for residence) and if the child resided in Lima versus in other urban areas (46% vs 35.4% [POR = 1.52 (1.16, 2.01)], adjusted for maternal education). Relative wealth and mothers’ primary language were not associated with campaign participation. Conclusions. This study suggests that children of mothers with higher education and those residing in Lima had higher prevalence odds of reporting that their children had participated in a vaccination campaign. This contrasts with the populations vaccination campaigns typically target (poor, rural, or indigenous) to improve vaccination coverage.

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The impact of reactive mass vaccination campaigns on measles outbreaks in the Katanga region, Democratic Republic of Congo

10.1101/19003434 ◽

2019 ◽

Author(s):

Sebastian Funk ◽

Saki Takahashi ◽

Joel Hellewell ◽

Kartini Gadroen ◽

Isidro Carrion-Martin ◽

...

Keyword(s):

Vaccination Coverage ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Vaccination Campaign ◽

Effective Means ◽

Mass Vaccination ◽

Republic Of Congo ◽

Measles Outbreaks ◽

Vaccination Campaigns ◽

The Impact

AbstractThe Katanga region in the Democratic Republic of Congo (DRC) has been struck by repeated epidemics of measles, with large outbreaks occurring in 2010–13 and 2015. In many of the affected health zones, reactive mass vaccination campaigns were conducted in response to the outbreaks. Here, we attempted to determine how effective the vaccination campaigns in 2015 were in curtailing the ongoing outbreak. We further sought to establish whether the risk of large measles outbreaks in different health zones could have been determined in advance to help prioritise areas for vaccination campaign and speed up the response. In doing so, we first attempted to identify factors that could have been used in 2015 to predict in which health zones the greatest outbreaks would occur. Administrative vaccination coverage was not a good predictor of the size of outbreaks in different health zones. Vaccination coverage derived from surveys, on the other hand, appeared to give more reliable estimates of health zones of low vaccination coverage and, consequently, large outbreaks. On a coarser geographical scale, the provinces most affected in 2015 could be predicted from the outbreak sizes in 2010–13. This, combined with the fact that the vast majority of reported cases were in under-5 year olds, would suggest that there are systematic issues of undervaccination. If this was to continue, outbreaks would be expected to continue to occur in the affected health zones at regular intervals, mostly concentrated in under-5 year olds. We further used a model of measles transmission to estimate the impact of the vaccination campaigns, by first fitting a model to the data including the campaigns and then re-running this without vaccination. We estimated the reactive campaigns to have reduced the size of the overall outbreak by approximately 21,000 (IQR: 16,000–27,000; 95% CI: 8300–38,000) cases. There was considerable heterogeneity in the impact of campaigns, with campaigns started earlier after the start of an outbreak being more impactful. Taken together, these findings suggest that while a strong routine vaccination regime remains the most effective means of measles control, it might be possible to improve the effectiveness of reactive campaigns by considering predictive factors to trigger a more targeted vaccination response.

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Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Response in Borno State, Nigeria, 2019

10.21203/rs.3.rs-34385/v1 ◽

2020 ◽

Author(s):

Anne Eudes Jean Baptiste ◽

John Wagai ◽

Richard Ray Luce ◽

Balcha Girma Masresha ◽

Don Klinkenberg ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccination Campaign ◽

Screening Method ◽

Population Level ◽

Vaccine Effectiveness ◽

Outbreak Response ◽

Internally Displaced ◽

Measles Outbreak ◽

Complex Emergency ◽

Measles Outbreaks

Abstract Background: From January to May 2019, large measles outbreaks affected all states in Nigeria and the Federal Capital Territory. Borno state was the most affected by the measles outbreak recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 confirmed cases by March 2019. Twenty-two Local Government Areas (LGAs or Districts) and 37 internally displaced persons (IDPs) camps had been affected. In response to the situation, outbreak response immunization (ORI) was conducted. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the ORI and estimated the vaccine effectiveness (VE) for measles-containing vaccine (MCV) to assess the population-level impact. A post-campaign coverage survey (PCCS) was also carried out to assess the vaccination coverage.Methods: We reviewed the outbreak response-associated immunization activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We evaluated VE of MCV by applying the screening-method using data from the measles outbreak and the latest mass vaccination campaign. The PCCS was conducted after completion of the ORI through a quantitative survey assessment in 1,800 households in 12 LGAs involved in the response.Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles as at epidemiological week 9. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The median VE for MCV is 96.7% (95%CI: 94.7 – 98.1), and 87.3% (95%CI: 71.0 – 95.2) when vaccine was received at 9 – 11. The aggregated weighted vaccination coverage is 85.7% (95%CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

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Measles antibody levels in children of rural and urban areas of Nigeria following vaccination campaign

Epidemiology and Infection ◽

10.1017/s0950268800066887 ◽

1987 ◽

Vol 99 (1) ◽

pp. 85-89 ◽

Cited By ~ 1

Author(s):

N. O. Eghafona ◽

L. E. Odama ◽

S. O. Emejuaiwe ◽

E. N. Obineche ◽

D. S. Tafida

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Vaccination Campaign ◽

Age Groups ◽

Primary School Children ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Measles Vaccination ◽

Vaccination Campaigns ◽

Antibody Levels

SUMMARYThis study compares the presence and level of measles haemagglutination inhibiting antibody in the sera of primary school children in selected rural and urban areas of Kaduna State, Nigeria following a vaccination campaign. The results, analysed by Mann-Whitney statistical test at α=0·05, showed significantly higher levels of haemagglutination inhibiting antibody in all the age groups in urban areas when compared with rural areas. The implications of these findings on measles vaccination campaigns are discussed.

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