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Sustained investments needed for measles elimination in Philippines
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Estimated coverage rates for the first dose of the measles-containing vaccine increased from 80% in 1998 to 90% in 2013 and from 10% in 2010 to 53% in 2013 for the second dose of the vaccine in the Phillipines, according to new findings published in the Morbidity and Mortality Weekly Report.
However, while implementation of nationwide supplementary immunization activities during 1998 and 2004 led to significantly low numbers in measles cases in 2006, reported cases and incidence of measles increased between 2007 and 2012 and significant measles outbreaks occurred during 2013 and 2014 despite nationwide activities during 2007 and 2011.
“For the goal of measles elimination in the Western Pacific Region to be achieved, sustained investments are required in the Philippines to strengthen health systems, implement the recommended elimination strategies, and develop additional strategies to identify and reduce measles susceptibility in specific geographic areas and older age groups,” Yoshihiro Takashima, MD, from the Expanded Programme on Immunization at WHO Western Pacific Regional Office, in the Philippines, and colleagues wrote.
The measles outbreaks that occurred in 2013 and 2014 affected infants, young and older children and young adults. These outbreaks were lengthen because of delays in and the geographical limitation of outbreak response activities during 2013 and 2014.
According to the CDC, the resurgence highlighted key program challenges, including persistent suboptimal MCV1 coverage; low MCV2 coverage since introduction during 2009 and 2010; suboptimal supplementary immunization activities coverage with significant variations in coverage by region; recent supplementary immunization activities targeting age groups too narrow to interrupt measles virus transmission among older children; and inadequate outbreak response activities before widespread measles virus transmission started.
“The failure to achieve high population immunity among the targeted age groups before 2013 contributed to the observed increase in the proportion of measles cases among older children and young adults that indicated a shift in the age of the measles-susceptible population from young children to a wider age group during the nationwide measles resurgence in 2013–2014,” Takashima and colleagues wrote. “This shift will require special strategies for vaccination activities.”
Disclosure: The researchers report no relevant financial disclosures.
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