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Full text, with tables and figures, is at http://www.who.int/wer/2013/wer8803.pdf
During 2000–2011, increasing global routine measles vaccination coverage combined with regular SIAs in MS lacking high coverage with 2 doses of MCV contributed to a 65% decrease in reported measles incidence and a 71% reduction in estimated measles mortality. Measles elimination has been achieved and maintained in the America, and Western Pacific Region is approaching measles elimination. However, since 2008, large measles outbreaks in African, Eastern Mediteranean, European and South East Asian regions have stalled progress towards regional measles control and elimination targets.
Field investigations of recent measles outbreaks found that most cases were among unvaccinated persons, suggesting the main underlying cause was persistent gaps in immunization coverage despite overall increased measles vaccine coverage. All 5 MS with the largest numbers of infants who did not receive MCV1 in 2011 had large measles outbreaks during 2011, highlighting the importance of strong routine immunization services. In addition, poor quality and/or delays in planned SIAs have contributed to the accumulation of measlessusceptible children and ongoing measles virus transmission.
In 2011, estimated global measles mortality increased from the 2010 estimate and 99% of the measles mortality burden was in African Region, Eastern Mediteranean Region, India, and other MS in the South East Asian Region. In India, the 36% decrease in estimated measles mortality during 2001–2011 was mainly due to the National Measles Catch-up Programme to provide MCV2, beginning in 2010 with MCV2 introduction in routine services in states with reported MCV1 coverage ≥80%, and with SIAs followed by MCV2 introduction in routine services in states with reported MCV1 coverage <80%.
In the Morbidity and Mortality Weekly report from CDC (available at http://www.cdc.gov/mmwr/pdf/wk/mm6202.pdf) , the following additions were made in editorial notes
To prevent measles epidemics and associated morbidity and mortality, WHO recommends that all children receive 2 doses of measles-containing vaccine.
The findings in this report are subject to at least three limitations. First, vaccination coverage estimates in this report include biases resulting from inaccurate estimates of the sizes of the target populations, inaccurate reporting of doses delivered, and inclusion of SIA doses given to children outside the target age group. Second, biases in surveillance data can occur because not all patients seek care and not all of those who seek care are reported. The use of measles surveillance data to estimate measles mortality improved on previously used methods that did not account for the effect of periodic outbreaks on mortality. Finally, the accuracy of the measles mortality model results is affected by biases in all model inputs, including country-specific measles vaccination coverage and measles case-based surveillance data.
In April 2012, the Measles and Rubella Initiative launched the 2012–2020 Global Measles and Rubella Strategic Plan to integrate rubella and measles elimination efforts, and provide strategies and guiding principles to resume progress toward regional measles elimination targets. The GVAP for the 2011–2020 Decade of Vaccines provides strategic objectives and recommended activities for increasing ownership, accountability, and vaccination coverage, as well as indicators for monitoring their impact through achievement of regional measles elimination targets. The GAVI Alliance commitment in 2012 to support eligible countries to introduce rubella vaccine using combined measles-rubella SIAs targeting children aged 9 months–14 years provides a unique opportunity to boost population immunity to both measles and rubella. The combination of new resources from immunization partners and commitments by countries to fully implement measles control and elimination strategies will help resume progress toward achieving regional measles targets.