TIMING OF MEASLES IMMUNIZATION AND EFFECTIVE POPULATION VACCINE COVERAGE.

Monday, 11th of August 2014

[source]Pediatrics[|source]

Immunization programs with carefully chosen evidence-based recommended times for vaccination are key to ensure that elimination of measles can be achieved. Such programs and their recommendations must be well accepted by the target populations. In Switzerland, for example, measles vaccination coverage below the desirable 95% coverage was reported in the periods of 2005 to 2009. Coverage survey reports in the same country also described significant delays to measles immunization in one region of Switzerland.

In this report, the authors assess measles immunization levels and patterns in a Swiss cohort of children born between 2006 and 2008 to evaluate the value of incorporating timeliness and timing of first and second dose of measles vaccine administration in describing vaccine coverage. The report documents the much needed evidence in support of incorporating data on timeliness of vaccination in the evaluation of vaccine coverage. More details are accessible at: http://pediatrics.aappublications.org/content/130/3/e600.long 

 

ABSTRACT

OBJECTIVE: To describe measles vaccination patterns in a cohort of Swiss children aged up to 3 years insured with a single health insurer.

METHODS: A dynamic cohort study evaluating measles immunizations patterns in children born between 2006 and 2008 was conducted. Time-to-event analysis was used to describe timing of measles immunization. Effective vaccine coverage was calculated by using an area under the curve approach.

RESULTS: In the study cohort, 62.6% of 13-month-old children were up-to-date for the first measles immunization (recommended at 12 months of age). Approximately 59% of 25-month-old children were up-to-date for the second measles immunization (recommended at 15–24 months of age). Most doses were delivered during months in a childs life when well-child visits are recommended (eg, 12 months of age). For second measles vaccine dose, accelerations in vaccine delivery occurred at time points for well-child visits during the months 19 and 25 of age but with lower final uptake than for the first measles vaccine dose. Until their second birthday, children in our cohort spent on average 177 days replicas de relojes de lujo españa and 89 days susceptible to measles due to policy recommendations and additional delays, respectively. In a group of children aged 6 months to 2 years reflecting the age distribution in our cohort, effective vaccine coverage was only 48.6%.

CONCLUSIONS: Timing and timeliness of measles immunizations influence effective population vaccine coverage and should be routinely reported in addition to coverage whenever possible. Proposed timing and relation of recommended vaccinations to well-child visits could be relevant aspects in optimizing measles vaccine coverage to reach measles elimination.