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Demographics, epidemiology and the impact of vaccination campaigns in a measles-free world – Can elimination be maintained?

Prada, Joaquin, Metcalf, C.J.E., Takahashi, S., Lessler, J., Tatem, A.J. and Ferrari, M. (2017) Demographics, epidemiology and the impact of vaccination campaigns in a measles-free world – Can elimination be maintained? Vaccine, 35 (11). pp. 1488-1493.

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Abstract

Introduction All six WHO regions currently have goals for measles elimination by 2020. Measles vaccination is delivered via routine immunization programmes, which in most sub-Saharan African countries reach children around 9 months of age, and supplementary immunization activities (SIAs), which target a wider age range at multi-annual intervals. In the absence of endemic measles circulation, the proportion of individuals susceptible to measles will gradually increase through accumulation of new unvaccinated individuals in each birth cohort, increasing the risk of an epidemic. The impact of SIAs and the financial investment they require, depend on coverage and target age range. Materials and methods We evaluated the impact of target population age range for periodic SIAs, evaluating outcomes for two different levels of coverage, using a demographic and epidemiological model adapted to reflect populations in 4 sub-Saharan African countries. Results We found that a single SIA can maintain elimination over short time-scales, even with low routine coverage. However, maintaining elimination for more than a few years is difficult, even with large (high coverage/wide age range) recurrent SIAs, due to the build-up of susceptible individuals. Across the demographic and vaccination contexts investigated, expanding SIAs to target individuals over 10 years did not significantly reduce outbreak risk. Conclusions Elimination was not maintained in the contexts we evaluated without a second opportunity for vaccination. In the absence of an expanded routine program, SIAs provide a powerful option for providing this second dose. We show that a single high coverage SIA can deliver most key benefits in terms of maintaining elimination, with follow-up campaigns potentially requiring smaller investments. This makes post-campaign evaluation of coverage increasingly relevant to correctly assess future outbreak risk. © 2017 The Author(s)

Item Type: Article
Divisions : Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Prada, Joaquinj.prada@surrey.ac.uk
Metcalf, C.J.E.
Takahashi, S.
Lessler, J.
Tatem, A.J.
Ferrari, M.
Date : 2017
DOI : 10.1016/j.vaccine.2017.02.008
Uncontrolled Keywords : Epidemiology, Mathematical models, Measles, SIR, Vaccines
Additional Information : Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Vaccine [Field not mapped to EPrints] C2 - 28216186 [Field not mapped to EPrints] AD - Department of Ecology and Evolutionary Biology, Princeton University, United States [Field not mapped to EPrints] AD - Office of Population Research, WWS, Princeton University, United States [Field not mapped to EPrints] AD - Fogarty International Center, National Institutes of Health, United States [Field not mapped to EPrints] AD - Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States [Field not mapped to EPrints] AD - WorldPop, Department of Geography and Environment, University of Southampton, United Kingdom [Field not mapped to EPrints] AD - Flowminder Foundation, Stockholm, Sweden [Field not mapped to EPrints] AD - Center for Infectious Disease Dynamics, Pennsylvania State University, United States [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints] M3 - Article [Field not mapped to EPrints]
Depositing User : Rebecca Cooper
Date Deposited : 03 Jan 2019 09:19
Last Modified : 07 Jan 2019 14:06
URI: http://epubs.surrey.ac.uk/id/eprint/850092

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