This article is more than 5 years old. Information may no longer be current.
Worldwide measles vaccination prevents 17.1 million deaths over 15 years
Click Here to Manage Email Alerts
Due to increased vaccination efforts, the number of measles-related deaths decreased by 79% from 2000 to 2014, resulting in an estimated 17.1 million saved lives, according to a WHO press release.
The World Health Assembly adopted three milestone goals in 2010 to expand measles vaccine coverage to at least 90% of children, reduce and maintain measles incidence to less than 5 cases per 1 million people and to reduce the number of mortalities reported in 2000 by 95%. The organization also launched the Global Vaccine Action Plan in 2012 to eliminate measles in four WHO regions, which was achieved in 2014 through mass vaccination campaigns supported by the Measles & Rubella Initiative and Gavi, the Vaccine Alliance. The vaccination campaigns and other routine vaccination programs reached nearly 221 million children worldwide.
Jean-Marie Okwo-Bele
Despite these efforts, the WHO Strategic Advisory Group of Experts on Immunization recently announced the agency will not reach its 2015 milestone goals due to a 4-year standstill in vaccine rates.
“We cannot afford to drop our guard,” Jean-Marie Okwo-Bele, MD, MPH, director of WHO’s immunization for vaccines and biologicals department, said in a press release. “If children miss routine vaccination and are not reached by national immunization campaigns, we will not close the immunization gap.”
Measles incidence declines, fewer mortalities reported
WHO and the United Nations Children’s Fund (UNICEF) assessed data on routine immunization records and survey results reported by 194 countries between 2000 and 2014 to estimate coverage of the measles-containing vaccine (MCV).
The first dose of MCV coverage increased from 72% in 2000 to 85% in 2010, but remained at 85% through 2014, according to a recent MMWR. The number of countries that achieved at least 90% coverage of the first dose increased from 44% in 2000 to 68% in 2012, then decreased to 63% in 2014. The second dose of MCV coverage increased from 15% in 2000 to 56% in 2014, with six countries introducing the second dose to their vaccine schedule in 2014. The rise in coverage contributed to a 73% decrease in reported measles incidence, according to the report.
A model adjusted for MCV coverage and age- and country-specific case-fatality ratios estimated that measles deaths decreased 79%, from 546,800 cases to 114,900 cases, and that all regions had substantial reductions in measles-related mortalities. Based on available data, the model projected that measles vaccination prevented approximately 17.1 million deaths between 2000 and 2014 compared with no new vaccination coverage.
“Despite the welcome reduction in measles deaths, this highly infectious disease continues to take a terrible toll on the lives of children around the world,” Seth Berkley, MD, CEO of Gavi Alliance, said in the release. “A coordinated approach that puts stronger routine immunization at its core will be central to getting measles under control and securing further reductions in mortality from this vaccine-preventable disease.”
A call to resume progress
While all countries include the first dose of MCV in their vaccine schedule, only 63% countries vaccinated 90% or more of the pediatric population, according to WHO. Furthermore, only 50% of children worldwide received the recommended second dose.
Robert T. Perry, MD, from the department of immunization, vaccines and biologicals at WHO, and colleagues estimated that 20.6 million infants did not receive routine immunization services in 2014. Most of these children were from the Democratic Republic of the Congo (n = 600,000), Ethiopia (n = 900,000), Indonesia (n = 1 million), Pakistan (n = 1.6 million), Nigeria (n = 3.3 million) and India (n = 4.2 million).
In 2014, measles outbreaks occurred in the United States (n = 667), Brazil (n = 727), Russia (n = 4,711), Somalia (n = 10,278), Angola (n = 11,699), Ethiopia (n = 12,739), Vietnam (n = 15,033), India (n = 24,977), China (n = 52,628) and the Philippines (n = 58,848). Sixty-nine countries reported 24 measles virus genotypes, which mainly included genotypes H1 (n = 4,610), B3 (n = 1,328) and D8 (n = 1,083).
Outbreak investigators found that inadequate coverage of the first MCV dose in high-burden, low-coverage countries was linked to longstanding policies that prevented vaccinations in children aged older than 12 months, discouraged opening new vials when few children were present, and limited vaccine administrations to once every month.
“Addressing these gaps, maximizing how [supplementary immunization activity (SIA)] planning and implementation can improve routine services, and conducting high-quality SIA should increase coverage and equity for all vaccines and further reduce the number of measles cases and deaths,” Perry and colleagues wrote. “As coverage improves, establishing a visit during the second year of life integrating [the second dose of] MCV and other child health interventions should help to further reduce measles burden.” – by Stephanie Viguers
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts