scholarly journals Quantifying the success of measles vaccination campaigns in the Rohingya refugee camps

2019 ◽  
Author(s):  
Taylor Chin ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud
Keyword(s):  
Vaccination Coverage ◽  
Disease Outbreaks ◽  
Refugee Camps ◽  
Public Health Importance ◽  
Infectious Disease Outbreaks ◽  
Mass Migration ◽  
Measles Outbreak ◽  
Coverage Rates ◽  
Measles Outbreaks ◽  
Vaccination Campaigns

AbstractIn the wake of the Rohingya population’s mass migration from Myanmar, one of the world’s largest refugee settlements was constructed in Cox’s Bazar, Bangladesh to accommodate nearly 900,000 new refugees. Refugee populations are particularly vulnerable to infectious disease outbreaks due to many population and environmental factors. A large measles outbreak, with over 2,500 cases, occurred among the Rohingya population between September and December 2017. Here, we estimate key epidemiological parameters and use a dynamic mathematical model of measles transmission to evaluate the effectiveness of the reactive vaccination campaigns in the refugee camps. We also estimate the potential for subsequent outbreaks under different vaccination coverage scenarios. Our modeling results highlight the success of the vaccination campaigns in rapidly curbing transmission and emphasize the public health importance of maintaining high levels of vaccination in this population, where high birth rates and historically low vaccination coverage rates create suitable conditions for future measles outbreaks.

scholarly journals ‘When you welcome well, you vaccinate well’: a qualitative study on improving vaccination coverage in urban settings in Conakry, Republic of Guinea

2020 ◽  
Author(s):  
Julita Gil Cuesta ◽  
Katherine Whitehouse ◽  
Salimou Kaba ◽  
Kassi Nanan-N’Zeth ◽  
Benoit Haba ◽  
...  
Keyword(s):  
Side Effects ◽  
Vaccination Coverage ◽  
Community Involvement ◽  
Health Workers ◽  
Urban Settings ◽  
Republic Of Guinea ◽  
Measles Outbreak ◽  
Sub Saharan ◽  
Measles Outbreaks ◽  
Vaccination Campaigns

Abstract Background Recurrent measles outbreaks followed by mass vaccination campaigns (MVCs) occur in urban settings in sub-Saharan countries. An understanding of the reasons for this is needed to improve future vaccination strategies. The 2017 measles outbreak in Guinea provided an opportunity to qualitatively explore suboptimal vaccination coverage within an MVC among participants through their perceptions, experiences and challenges. Methods We conducted focus group discussions with caregivers (n=68) and key informant interviews (n=13) with health professionals and religious and community leaders in Conakry. Data were audio-recorded, transcribed verbatim from Susu and French, coded and thematically analysed. Results Vaccinations were widely regarded positively and their preventive benefits noted. Vaccine side effects and the subsequent cost of treatment were commonly reported concerns, with further knowledge requested. Community health workers (CHWs) play a pivotal role in MVCs. Caregivers suggested recruiting CHWs from local neighbourhoods and improving their attitude, knowledge and skills to provide information about vaccinations. Lack of trust in vaccines, CHWs and the healthcare system, particularly after the 2014–2016 Ebola epidemic, were also reported. Conclusions Improving caregivers’ knowledge of vaccines, potential side effects and their management are essential to increase MVC coverage in urban settings. Strengthening CHWs’ capacities and appropriate recruitment are key to improving trust through a community involvement approach.

scholarly journals The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
C. N. Mburu ◽  
◽  
J. Ojal ◽  
R. Chebet ◽  
D. Akech ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Herd Immunity ◽  
African Region ◽  
Population Immunity ◽  
Measles Outbreak ◽  
Increased Risk ◽  
Measles Vaccination ◽  
Serological Data ◽  
Measles Outbreaks ◽  
Measles Vaccination Coverage

Abstract Background The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during the pandemic in Kenya as a case study for the African Region. Methods Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020. Results In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8–54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19–54), 46% (30–59), and 54% (43–64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25–56), 54% (43–63), and 67% (59–72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives. Conclusion While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya.

scholarly journals Monitoring for outbreak associated excess mortality in an African city: Detection limits in Antananarivo, Madagascar

2020 ◽  
Author(s):  
Fidisoa Rasambainarivo ◽  
Anjarasoa Rasoanomenjanahary ◽  
Joelinotahiana Hasina Rabarison ◽  
Tanjona Ramiadantsoa ◽  
Rila Ratovoson ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Disease Outbreaks ◽  
African City ◽  
Middle Income ◽  
Notification System ◽  
Infectious Disease Outbreaks ◽  
Measles Outbreak ◽  
Death Notification ◽  
Notification Data ◽  
The Impact

AbstractQuantitative estimates of the impact of infectious disease outbreaks are required to develop measured policy responses. In many low- and middle-income countries, inadequate surveillance and incompleteness of death registration are important barriers. Here, we characterize how large an impact on mortality would have to be to be detectable using the uniquely detailed mortality notification data from the city of Antananarivo in Madagascar, with application to a recent measles outbreak. The weekly mortality rate of children during the 2018-2019 measles outbreak was 154% above the expected value at its peak, and the signal can be detected earlier in children than in the general population. This approach to detecting anomalies from expected baseline mortality allows us to delineate the prevalence of COVID-19 at which excess mortality would be detectable with the existing death notification system in the capital of Madagascar. Given current age-specific estimates of the COVID-19 fatality ratio and the age structure of the population in Antananarivo, we estimate that as few as 11 deaths per week in the 60-70 years age group (corresponding to an infection rate of approximately 1%) would detectably exceed the baseline. Data from 2020 will undergo necessary processing and quality control in the coming months. Our results provide a baseline for interpreting this information.

scholarly journals Effective control measures limited measles outbreak after extensive nosocomial exposures in January-February 2008 in Gothenburg, Sweden

2008 ◽  
Vol 13 (30) ◽  
Author(s):  
P Follin ◽  
L Dotevall ◽  
M Jertborn ◽  
Y Khalid ◽  
J Å Liljeqvist ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Control Measures ◽  
Effective Control ◽  
Imported Case ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
Rubella Vaccination ◽  
And Control

In January-February 2008, one imported case of measles initiated a series of exposures with around 380 nosocomial secondary contacts. Susceptible individuals were traced early and control measures were initiated that managed to limit the consequences considerably. Only four secondary cases were identified by the end of March. This minor outbreak illustrates the importance and efficiency of early control measures as well as the fact that the risk of measles outbreaks still exists in a country that has high measles, mumps, rubella vaccination coverage among children.

scholarly journals Influenza vaccination campaigns targeted at healthcare workers:results of four hospitals in Rome

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Tognetto ◽  
A Abbondanzieri ◽  
G Cerone ◽  
M Di Pumpo ◽  
A Nardi ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Seasonal Influenza ◽  
Teaching Hospitals ◽  
Easy Access ◽  
Cross Sectional ◽  
Seasonal Influenza Vaccination ◽  
Coverage Rates ◽  
Vaccination Campaigns

Abstract Background Seasonal influenza vaccination (SIV) of health care workers (HCWs) is well recognized as a public health measure that can protect both HCWs from infection and patients from the risk of influenza complications. Nevertheless, vaccination coverage rates among this specific population result generally lower than the recommended target. With our study, we aimed to describe the activities and the outcomes of four different SIV campaigns targeted at HCWs and organized during the season 2018/2019 in four hospitals in Rome. Methods A cross-sectional study involving four teaching hospitals was performed. The collected data were synthetized into a set of descriptors and indicators, validated through a previous study that had involved the same Centers. Results The Medical Directorates, in collaboration with the University Hygiene and Public Health Units of the four hospitals organized different strategies: Hospital 1, 3 and 4 realized educational courses for HCWs and actively promoted the campaigns through e-mail invitations to all HCWs. As for the access to vaccination, all the hospitals provided a dedicated unit for SIV; Hospital 1 and Hospital 4 organized also on-site vaccination sessions in the hospital wards, that required a large number of staff. The vaccination coverage rates resulted: 22.37% in Hospital 1, 18.10% in Hospital 4, 9.28% in Hospital 2 and 8,51% in Hospital 3. Conclusions Our results demonstrate that multi-activity campaigns, involving education, promotion and easy access to vaccination constitute an effective approach to reinforce the value of SIV. Our findings suggest that on-site vaccination may play a key role in determining a higher vaccination coverage. Key messages Multi-activity vaccination campaigns, involving education, promotion and easy access to vaccination constitute an effective approach to reinforce the value of seasonal influenza vaccination for HCWs. On-site vaccination may play a key role in determining a higher vaccination coverage.

scholarly journals VACCINATION COVERAGE RATES AND THE INCIDENCE OF VACCINE PREVENTABLE DISEASES AMONG CHILDREN IN SUMY REGION OF UKRAINE

2019 ◽  
Vol 72 (2) ◽  
pp. 255-260
Author(s):  
Vladyslav A. Smiianov ◽  
Halyna S. Zaitseva ◽  
Victorya A. Kurganskaya ◽  
Anatoly G. Dyachenko ◽  
Volodymyr P. Zbarazhskyi ◽  
...  
Keyword(s):  
World Health Organization ◽  
Vaccination Coverage ◽  
Statistical Data ◽  
Routine Immunization ◽  
World Health ◽  
Vaccine Preventable Diseases ◽  
Medical Institutions ◽  
Measles Outbreak ◽  
Health Organization ◽  
Coverage Rates

Introduction: Routine immunization contributes immensely to decline the incidence of vaccine preventable diseases among children. Statistical data shown the sharply decrease the vaccination coverage rates in Sumy region of Ukraine. The aim: Assess routine immunization uptake and its effect on the incidence of vaccine preventable diseases among children in Sumy region of Ukraine. Review: During some years, only 50-60 % of Sumy region children had received all recommended vaccines, which is far below World Health Organization target of 80 %. This has led to an increase of morbidity associated with some infectious diseases. Outbreaks of measles were registered in 2006 and 2012, when were ill 9346 and 7931 children respectively. Massive measles outbreak ongoing nowadays. Total number infected have already exceeded 35,000 cases. Conclusions: RI uptake in Ukraine is still below World Health Organization target. The main reason for the ongoing measles outbreak was low vaccination coverage for routine immunization antigens as a result of which collective immunity decreased to a critical level. Strict monitoring of the implementation of the immunization schedule by medical institutions at all levels are recommended to improve vaccination status of Ukrainian children.

scholarly journals Measles outbreak risk in Pakistan: exploring the potential of combining vaccination coverage and incidence data with novel data-streams to strengthen control

2018 ◽  
Vol 146 (12) ◽  
pp. 1575-1583 ◽  
Author(s):  
Amy Wesolowski ◽  
Amy Winter ◽  
Andrew J. Tatem ◽  
Taimur Qureshi ◽  
Kenth Engø-Monsen ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Data Streams ◽  
Human Mobility ◽  
Time Frame ◽  
Control Programs ◽  
Incidence Data ◽  
Mobility Data ◽  
Measles Outbreak ◽  
Measles Outbreaks

AbstractAlthough measles incidence has reached historic lows in many parts of the world, the disease still causes substantial morbidity globally. Even where control programs have succeeded in driving measles locally extinct, unless vaccination coverage is maintained at extremely high levels, susceptible numbers may increase sufficiently to spark large outbreaks. Human mobility will drive potentially infectious contacts and interact with the landscape of susceptibility to determine the pattern of measles outbreaks. These interactions have proved difficult to characterise empirically. We explore the degree to which new sources of data combined with existing public health data can be used to evaluate the landscape of immunity and the role of spatial movement for measles introductions by retrospectively evaluating our ability to predict measles outbreaks in vaccinated populations. Using inferred spatial patterns of accumulation of susceptible individuals and travel data, we predicted the timing of epidemics in each district of Pakistan during a large measles outbreak in 2012–2013 with over 30 000 reported cases. We combined these data with mobility data extracted from over 40 million mobile phone subscribers during the same time frame in the country to quantify the role of connectivity in the spread of measles. We investigate how different approaches could contribute to targeting vaccination efforts to reach districts before outbreaks started. While some prediction was possible, accuracy was low and we discuss key uncertainties linked to existing data streams that impede such inference and detail what data might be necessary to robustly infer timing of epidemics.

scholarly journals An agent-based model of school closing in under-vaccinated communities during measles outbreaks

SIMULATION ◽  
2017 ◽  
Vol 95 (5) ◽  
pp. 385-393 ◽  
Author(s):  
Wayne M Getz ◽  
Colin Carlson ◽  
Eric Dougherty ◽  
Travis C Porco ◽  
Richard Salter
Keyword(s):  
Vaccination Coverage ◽  
Herd Immunity ◽  
The United States ◽  
Vaccination Rate ◽  
Agent Based ◽  
School Closing ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
Low Coverage ◽  
Range Of Values

The winter 2014–15 measles outbreak in the United States represents a significant crisis in the emergence of a functionally extirpated pathogen. Conclusively linking this outbreak to decreases in the measles, mumps, and rubella (MMR) vaccination rate (driven by anti-vaccine sentiment) is critical to motivating MMR vaccination. We used the NOVA modeling platform to build a stochastic, spatially-structured, individual-based SEIR model of outbreaks, under the assumption that [Formula: see text] for measles. We show this implies that herd immunity requires vaccination coverage of greater than approximately 85%. We used a network structured version of our NOVA model that involved two communities, one at the relatively low coverage of 85% coverage and one at the higher coverage of 95%, both of which had 400-student schools embedded, as well as students occasionally visiting superspreading sites (e.g., high-density theme parks, and cinemas). These two vaccination coverage levels are within the range of values occurring across Californian counties. Transmission rates at schools and superspreading sites were arbitrarily set to respectively 5 and 15 times the background community rates. Simulations of our model demonstrate that a ‘send unvaccinated students home’ policy in low coverage counties is extremely effective at shutting down outbreaks of measles.

scholarly journals The impact of reactive mass vaccination campaigns on measles outbreaks in the Katanga region, Democratic Republic of Congo

2019 ◽  
Author(s):  
Sebastian Funk ◽  
Saki Takahashi ◽  
Joel Hellewell ◽  
Kartini Gadroen ◽  
Isidro Carrion-Martin ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Vaccination Campaign ◽  
Effective Means ◽  
Mass Vaccination ◽  
Republic Of Congo ◽  
Measles Outbreaks ◽  
Vaccination Campaigns ◽  
The Impact

AbstractThe Katanga region in the Democratic Republic of Congo (DRC) has been struck by repeated epidemics of measles, with large outbreaks occurring in 2010–13 and 2015. In many of the affected health zones, reactive mass vaccination campaigns were conducted in response to the outbreaks. Here, we attempted to determine how effective the vaccination campaigns in 2015 were in curtailing the ongoing outbreak. We further sought to establish whether the risk of large measles outbreaks in different health zones could have been determined in advance to help prioritise areas for vaccination campaign and speed up the response. In doing so, we first attempted to identify factors that could have been used in 2015 to predict in which health zones the greatest outbreaks would occur. Administrative vaccination coverage was not a good predictor of the size of outbreaks in different health zones. Vaccination coverage derived from surveys, on the other hand, appeared to give more reliable estimates of health zones of low vaccination coverage and, consequently, large outbreaks. On a coarser geographical scale, the provinces most affected in 2015 could be predicted from the outbreak sizes in 2010–13. This, combined with the fact that the vast majority of reported cases were in under-5 year olds, would suggest that there are systematic issues of undervaccination. If this was to continue, outbreaks would be expected to continue to occur in the affected health zones at regular intervals, mostly concentrated in under-5 year olds. We further used a model of measles transmission to estimate the impact of the vaccination campaigns, by first fitting a model to the data including the campaigns and then re-running this without vaccination. We estimated the reactive campaigns to have reduced the size of the overall outbreak by approximately 21,000 (IQR: 16,000–27,000; 95% CI: 8300–38,000) cases. There was considerable heterogeneity in the impact of campaigns, with campaigns started earlier after the start of an outbreak being more impactful. Taken together, these findings suggest that while a strong routine vaccination regime remains the most effective means of measles control, it might be possible to improve the effectiveness of reactive campaigns by considering predictive factors to trigger a more targeted vaccination response.

scholarly journals Heterogeneity in social and epidemiological factors determines the risk of measles outbreaks

2020 ◽  
Vol 117 (48) ◽  
pp. 30118-30125
Author(s):  
Paolo Bosetti ◽  
Piero Poletti ◽  
Massimo Stella ◽  
Bruno Lepri ◽  
Stefano Merler ◽  
...  
Keyword(s):  
Large Scale ◽  
Disease Outbreaks ◽  
Mobile Phone Data ◽  
Epidemic Dynamics ◽  
Effective Strategies ◽  
Regional Conflicts ◽  
Societal Challenges ◽  
Risk Of Disease ◽  
Measles Outbreaks ◽  
Vaccination Campaigns

Political and environmental factors—e.g., regional conflicts and global warming—increase large-scale migrations, posing extraordinary societal challenges to policymakers of destination countries. A common concern is that such a massive arrival of people—often from a country with a disrupted healthcare system—can increase the risk of vaccine-preventable disease outbreaks like measles. We analyze human flows of 3.5 million (M) Syrian refugees in Turkey inferred from massive mobile-phone data to verify this concern. We use multilayer modeling of interdependent social and epidemic dynamics to demonstrate that the risk of disease reemergence in Turkey, the main host country, can be dramatically reduced by 75 to 90% when the mixing of Turkish and Syrian populations is high. Our results suggest that maximizing the dispersal of refugees in the recipient population contributes to impede the spread of sustained measles epidemics, rather than favoring it. Targeted vaccination campaigns and policies enhancing social integration of refugees are the most effective strategies to reduce epidemic risks for all citizens.

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