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

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.

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

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.

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

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.

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

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.

scholarly journals The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
C. N. Mburu ◽  
◽  
J. Ojal ◽  
R. Chebet ◽  
D. Akech ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Herd Immunity ◽  
African Region ◽  
Population Immunity ◽  
Measles Outbreak ◽  
Increased Risk ◽  
Measles Vaccination ◽  
Serological Data ◽  
Measles Outbreaks ◽  
Measles Vaccination Coverage

Abstract Background The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during the pandemic in Kenya as a case study for the African Region. Methods Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020. Results In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8–54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19–54), 46% (30–59), and 54% (43–64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25–56), 54% (43–63), and 67% (59–72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives. Conclusion While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya.

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

2016 ◽  
Vol 3 (2) ◽  
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.

scholarly journals Effective control measures limited measles outbreak after extensive nosocomial exposures in January-February 2008 in Gothenburg, Sweden

2008 ◽  
Vol 13 (30) ◽  
Author(s):  
P Follin ◽  
L Dotevall ◽  
M Jertborn ◽  
Y Khalid ◽  
J Å Liljeqvist ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Control Measures ◽  
Effective Control ◽  
Imported Case ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
Rubella Vaccination ◽  
And Control

In January-February 2008, one imported case of measles initiated a series of exposures with around 380 nosocomial secondary contacts. Susceptible individuals were traced early and control measures were initiated that managed to limit the consequences considerably. Only four secondary cases were identified by the end of March. This minor outbreak illustrates the importance and efficiency of early control measures as well as the fact that the risk of measles outbreaks still exists in a country that has high measles, mumps, rubella vaccination coverage among children.

scholarly journals ‘When you welcome well, you vaccinate well’: a qualitative study on improving vaccination coverage in urban settings in Conakry, Republic of Guinea

2020 ◽  
Author(s):  
Julita Gil Cuesta ◽  
Katherine Whitehouse ◽  
Salimou Kaba ◽  
Kassi Nanan-N’Zeth ◽  
Benoit Haba ◽  
...  
Keyword(s):  
Side Effects ◽  
Vaccination Coverage ◽  
Community Involvement ◽  
Health Workers ◽  
Urban Settings ◽  
Republic Of Guinea ◽  
Measles Outbreak ◽  
Sub Saharan ◽  
Measles Outbreaks ◽  
Vaccination Campaigns

Abstract Background Recurrent measles outbreaks followed by mass vaccination campaigns (MVCs) occur in urban settings in sub-Saharan countries. An understanding of the reasons for this is needed to improve future vaccination strategies. The 2017 measles outbreak in Guinea provided an opportunity to qualitatively explore suboptimal vaccination coverage within an MVC among participants through their perceptions, experiences and challenges. Methods We conducted focus group discussions with caregivers (n=68) and key informant interviews (n=13) with health professionals and religious and community leaders in Conakry. Data were audio-recorded, transcribed verbatim from Susu and French, coded and thematically analysed. Results Vaccinations were widely regarded positively and their preventive benefits noted. Vaccine side effects and the subsequent cost of treatment were commonly reported concerns, with further knowledge requested. Community health workers (CHWs) play a pivotal role in MVCs. Caregivers suggested recruiting CHWs from local neighbourhoods and improving their attitude, knowledge and skills to provide information about vaccinations. Lack of trust in vaccines, CHWs and the healthcare system, particularly after the 2014–2016 Ebola epidemic, were also reported. Conclusions Improving caregivers’ knowledge of vaccines, potential side effects and their management are essential to increase MVC coverage in urban settings. Strengthening CHWs’ capacities and appropriate recruitment are key to improving trust through a community involvement approach.

A US metropolitan county health department’s response to a measles outbreak in a childcare facility – challenges faced and lessons learned

2020 ◽  
pp. 175791392095520
Author(s):  
Diane Meyer ◽  
Marc Trotochaud ◽  
Lisa Ferguson ◽  
Jennifer Vines ◽  
Russell Barlow ◽  
...  
Keyword(s):  
Public Health ◽  
Health Department ◽  
Lessons Learned ◽  
Outbreak Response ◽  
Public Health Community ◽  
Local Public Health ◽  
Measles Outbreak ◽  
Health Community ◽  
Childcare Facility ◽  
Measles Outbreaks

Aims: In June 2018, the Multnomah County Health Department located in Portland, Oregon, US, responded to a measles exposure in a local childcare facility. This analysis describes lessons learned and challenges encountered during this measles response that may inform public health policy and help other local public health authorities prepare for measles outbreaks. These lessons will become increasingly important as measles cases continue to increase in both the US and abroad. Methods: A semi-structured videoconference interview was conducted with nine health department staff who were directly involved in the health department’s response to the measles outbreak. Interview notes were iteratively discussed between all authors to identify those outbreak response challenges and lessons learned that were generalizable to the broader public health community. Results: Some of the key challenges and lessons learned included the need for increased provider recognition and reporting of measles cases, difficulty in determining which staff and children to exclude from attending daycare during the 21-day postexposure monitoring period, determining who would be prioritized to receive immunoglobulin, and the need for childcare staff vaccine status requirements. Conclusion: Lessons from this response highlight important considerations for public health practitioners and policy makers. Given the relative severity of measles and the potential for spread in facilities that serve infants and young children, the public health community must continue to address key gaps through planning and policy.

scholarly journals Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

2020 ◽  
Author(s):  
Claire Biribawa ◽  
Joselyn Annet Atuhairwe ◽  
Lilian Bulage ◽  
Denis Othuba Okethwangu ◽  
Benon Kwesiga ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Vaccine Effectiveness ◽  
Pediatric Ward ◽  
Probable Case ◽  
Measles Outbreak ◽  
Isolation Ward ◽  
Control Study

Abstract Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (OR adj =34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients. Conclusions This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

scholarly journals Impact of vaccination and non-pharmaceutical interventions on SARS-CoV-2 dynamics in Switzerland

2021 ◽  
Author(s):  
Andrew J. Shattock ◽  
Epke A. Le Rutte ◽  
Robert P Duenner ◽  
Swapnoleena Sen ◽  
Sherrie L Kelly ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Vaccination Coverage ◽  
Vaccination Campaign ◽  
Population Level ◽  
Morbidity And Mortality ◽  
Transmission Model ◽  
Third Wave ◽  
The Impact ◽  
Pharmaceutical Interventions

As vaccination coverage against SARS-CoV-2 increases amidst the emergence and spread of more infectious and potentially more deadly viral variants, decisions on timing and extent of relaxing effective, but unsustainable, non-pharmaceutical interventions (NPIs) need to be made. An individual-based transmission model of SARS-CoV-2 dynamics, OpenCOVID, was developed to compare the impact of various vaccination and NPI strategies on the COVID-19 epidemic in Switzerland. We estimate that any relaxation of NPIs in March 2021 will lead to increasing cases, hospitalisations, and deaths resulting in a "third wave" in spring and into summer 2021. However, we find a cautious phased relaxation can substantially reduce population-level morbidity and mortality. We find that faster vaccination campaign can offset the size of such a wave, allowing more flexibility for NPI to be relaxed sooner. Our sensitivity analysis revealed that model results are particularly sensitive to the infectiousness of variant B.1.1.7.

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