Maintaining high rates of measles immunization in Africa.

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Epidemiol Infect. 2011 Jul;139(7):1039-49. doi: 10.1017/S0950268810002232. Epub 2010 Oct 5.

Maintaining high rates of measles immunization in Africa.

Lessler J¹ Moss WJ¹ Lowther SA¹ Cummings DA¹.

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Abstract

Supplementary immunization activities (SIAs) are important in achieving high levels of population immunity to measles virus. Using data from a 2006 survey of measles vaccination in Lusaka Zambia we developed a model to predict measles immunity following routine vaccination and SIAs and absent natural infection. Projected population immunity was compared between the current programme and alternatives including supplementing routine vaccination with a second dose or SIAs at 1- 2- 3- 4- and 5-year intervals. Current routine vaccination plus frequent SIAs could maintain high levels of population immunity in children aged <5 years even if each frequent SIA has low coverage (e.g. ≥ 72% for bi-annual 60% coverage SIAs vs. ≥ 69% for quadrennial 95% coverage SIAs). A second dose at 12 months with current coverage could achieve 81% immunity. Circulating measles virus will only increase population immunity. Public health officials should consider frequent SIAs when resources for a two-dose strategy are unavailable.