Impact of measles supplementary immunization activities on reaching children missed by routine programs.

Tuesday, 7th of August 2018 Print

Vaccine. 2018 Jan 2;36(1):170-178. doi: 10.1016/j.vaccine.2017.10.080. Epub 2017 Nov 23.

Impact of measles supplementary immunization activities on reaching children missed by routine programs.

Portnoy A1 Jit M2 Helleringer S3 Verguet S4.

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Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness as well as measure progress towards measles control.


We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a childs routine measles vaccination status we examined whether children participated in the most recent measles SIA.


The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66% ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However when also including all children with routine measles vaccination data this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall the proportions of zero-dose children reached by SIAs declined with increasing household wealth.


Some countries appeared to reach a higher proportion of zero-dose children using SIAs than others with proportions reached varying according to the definition of measles vaccination (e.g. vaccination dates on the vaccination card vaccination marks on the vaccination card and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries SIAs played an important role in reaching children from poor households.

Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.


Equity; Low- and middle-income countries; Measles; Supplementary immunization activities; Vaccination

PMID: 29174680 PMCID: PMC5949217  [Available on 2019-01-02] DOI: 10.1016/j.vaccine.2017.10.080


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