IMPACT OF MEASLES NATIONAL VACCINATION COVERAGE ON BURDEN OF MEASLES ACROSS 29 MEMBER STATES OF THE EUROPEAN UNION AND EUROPEAN ECONOMIC AREA, 2006–2011

Monday, 23rd of June 2014

[source]Vaccine[|source]

Several studies have reported on the relationship between the measles incidence, or risk of measles outbreaks, and the vaccination coverage of a population. However, no reports have documented the relationship between vaccination coverage across European Union and European Economic Area Member States and the burden of measles using disability adjusted life years (DALYs).

In this report, the authors investigate the effect of vaccination programs on the burden of measles in Europe. The authors compared measles national vaccination coverage and burden of measles expressed in DALYs across Europe and studied their correlation in the period 2006–2011. The report documents that each percentage point increase in national measles vaccination coverage seems to lead to early significant reduction in the overall burden of measles. More details are accessible at: http://www.sciencedirect.com/science/article/pii/S0264410X14001571

 

ABSTRACT

 BACKGROUND: Challenges in reaching good vaccination coverage against measles emerged in several European Union/European Economic Area Member States (EU/EEA MS) leading to progressive accumulation of susceptible individuals and outbreaks. The Burden of Communicable Diseases in Europe (BCoDE) project developed a methodology for measuring the burden of communicable diseases expressed in Disability-Adjusted Life Years (DALYs) in the EU/EEA MS. The aim of this study was to compare national vaccination coverage and burden of measles across EU/EEA MS.

METHODS: Country-specific data on measles national vaccination coverage 2006-2011 from 29 EU/EEA MS (MCV1) were retrieved from Centralized Information System for Infectious Diseases (CISID). DALYs were calculated for each country separately using a disease progression model with a single input parameter (annual measles incidence, adjusted for under-estimation). A software application was used to compute estimated DALYs according to country-specific and year-specific population age-distributions (data retrieved from Eurostat). Log-linear mixed-effect regression modelling approach was used to investigate a linear relation between natural logarithm-transformed DALYs and coverage.

RESULTS: The reported annual vaccination coverage ranged from 72.6% to 100%. The estimated national annual burden ranged from 0 to 30.6 DALYs/100,000. Adjusting for year, there was a significant negative relationship between coverage and burden. For a given country there was a decrease in log-transformed DALYs/100,000 of 0.025 (95% confidence interval: -0.047 to -0.003) for every percentage increase in vaccination coverage. The largest effect of calendar time on estimated burden of measles was observed for the year 2011; the smallest was for the year 2007.

CONCLUSIONS: This study shows that the degree of success of national measles vaccination programs, when measured by the coverage obtained, is significantly associated with overall impact of measles across EU/EEA MS. In EU/EEA MS each percentage point increase in national vaccination coverage seems to lead to early significant reduction of overall burden of measles.