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, 15th of September 2014

[source]Vaccine[|source]

In order to gain insight into the overall impact of communicable diseases on population health in Europe and to support health policy-making, in 2009 the European Centre for Disease Prevention and Control (ECDC) initiated the Burden of Communicable Diseases in Europe (BCoDE) project. The BCoDE project developed a methodology and a software application (BCoDE toolkit) for measuring the current and future burden of communicable diseases in the European Union and European Economic Area Member States (EU/EEA MS). The burden of communicable diseases was obtained through a pathogen-based and incidence-based approach, which allows for the calculation of Disability-Adjusted Life Years

In this report, the authors compared measles national vaccination coverage and burden of measles expressed in DALYs (using the BcoDE developed methodology) across EU/EEA MS and studied their correlation in the period 2006–2011. The report documents that the higher the vaccination coverage, the lower the burden of measles, suggesting that the degree of success of national measles vaccination programs, when measured by the coverage obtained, is significantly associated with the burden of measles across EU/EEA MS. More details findings and recommendations 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.