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Journal of Pharmaceutical Policy and... 2024Measles became a public health important disease in sub-Saharan Africa. World Health Organization recommended measles-containing vaccine dose 2 (MCV2) through routine... (Review)
Review
BACKGROUND
Measles became a public health important disease in sub-Saharan Africa. World Health Organization recommended measles-containing vaccine dose 2 (MCV2) through routine service delivery. This study aims to determine coverage of second-dose measles vaccination uptake and its predictors among children aged 24-35 months in sub-Saharan Africa.
METHODS AND MATERIALS
We conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, and HINARI literature.
RESULTS
The overall uptake of the second dose of measles vaccine uptake was 41% (95% CI: 28.90-53.47). Caregiver's awareness of the importance of the second dose of measles (2.51, 95% CI 1.77, 3.25), educational status of mothers (1.30, 95% CI 1.16, 1.45), distance from vaccination site (1.22, 95% CI 1.12, 1.32), and attending four and above ANC visit (2.72, 95% CI 2.29, 3.15) were determinants for second dose measles vaccine uptake.
CONCLUSION
Coverage of the second dose of measles uptake in Sub-Saharan Africa was low (41%) which is lower than the recommendation from WHO. Therefore policymakers and stakeholders should increase mother's awareness. Also, special strategies should be developed for those who are far from the vaccination site.
ABBREVIATION AND ACRONYMS
ANC: Ante Natal Care; JBI: Joanna Briggs Institute; MCV1: Measles containing vaccine dose 1; MCV2: Measles containing vaccine dose 2; WHO: World Health Organization.
PubMed: 38205190
DOI: 10.1080/20523211.2023.2285507 -
Przeglad Epidemiologiczny May 2024Rubella is a viral infectious disease, and humans are the only reservoir of the virus. In 2020, all WHO member countries conducted epidemiological surveillance for...
INTRODUCTION
Rubella is a viral infectious disease, and humans are the only reservoir of the virus. In 2020, all WHO member countries conducted epidemiological surveillance for rubella, and almost all (99%) had access to rubella testing at laboratories operating under the WHO Global Measles and Rubella Laboratory Network.
OBJECTIVES
The aim of this study was to evaluate epidemiological indicators of rubella in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic.
MATERIAL AND METHODS
The assessment of the epidemiological situation was based on a review of data from the bulletin , "Infectious Diseases and Poisons in Poland in 2021" (5), and the assessment of the immunization status of the population was based on data from the bulletin , "Immunization in Poland in 2021" (6). Classification of cases was made based on the definition used in the 2021 surveillance (7). Data from the epidemiological surveillance system "EpiBase" were also used.
RESULTS
In 2021, 50 cases of rubella were registered, 48 fewer than in 2020 (98 cases). There was also a decrease in incidence to 0.13 per 100,000, compared to 0.26 per 100,000 in 2020. The highest incidence, regardless of gender and residential environment, was recorded in the 0-4 age group (1.23 per 100 thousand). No cases of congenital rubella syndrome were reported in 2021.
CONCLUSIONS
In 2021, there was a decrease in the number of rubella cases in Poland, which could be a result of the COVID-19 pandemic and the introduced restrictions. In addition, rubella was registered 99% on the basis of clinical diagnoses, without the required laboratory confirmation, which means that other rash diseases could be registered as rubella.
Topics: Humans; Rubella; Poland; Female; Male; Adolescent; Child; Adult; Child, Preschool; Infant; COVID-19; Incidence; Young Adult; Middle Aged; Infant, Newborn; Age Distribution; SARS-CoV-2; Registries; Sex Distribution; Urban Population; Rubella Vaccine
PubMed: 38783657
DOI: 10.32394/pe.77.39 -
Journal of the Pediatric Infectious... Apr 2024Measles is a vaccine-preventable illness. Nevertheless, in recent years, measles is still endemic and epidemic in both the developed world and the developing world. The... (Review)
Review
Measles is a vaccine-preventable illness. Nevertheless, in recent years, measles is still endemic and epidemic in both the developed world and the developing world. The public perception of measles in the past was that it was not a big deal. However, measles is associated with a number of complications which can be places in three categories which are: acute(diarrhea, otitis media, pneumonia, encephalitis, seizures, and death) and delayed-subacute sclerosing panencephalitis (SSPE) and post-measles immune amnesia. Contrary to the beliefs of the anti-vaccine lobby, measles is bad. In acute measles, the death rate is 1-3 per 1000 and the risk of encephalitis is 1 per 1000. Relatively recent investigations indicate that SSPE is considerably more common than previously believed. The worldwide contribution of post-measles immune amnesia to morbidity and mortality is likely to be huge. In exposure situations, two doses of measles vaccine will prevent 99% of cases. Presently in the United States, the first dose is given at 12 through 15 months of age. The second dose is most often administered at 4 through 6 years of age. In my opinion, the second dose of measles vaccine should be given 4-6 weeks after the first dose rather than at 4-6 years of age. Children who don't have antibody to measles should not travel to risk areas.
Topics: Humans; Measles; Measles Vaccine; Developing Countries; Developed Countries; Child; Subacute Sclerosing Panencephalitis; Infant; Child, Preschool; Immunization Schedule; Vaccination
PubMed: 38422396
DOI: 10.1093/jpids/piae018 -
Journal of Clinical Virology : the... Aug 2024Measles, mumps, and rubella(MMR) vaccination is critical to measles outbreak responses. However, vaccine reactions and detection of measles vaccine RNA in recently...
BACKGROUND
Measles, mumps, and rubella(MMR) vaccination is critical to measles outbreak responses. However, vaccine reactions and detection of measles vaccine RNA in recently immunized persons may complicate case classification especially in those presenting with another respiratory viral illness. We aim to characterize cases of measles vaccine shedding in recently vaccinated children presenting with respiratory viral symptoms.
METHODS
Children who were tested with a multiplex respiratory panel <30 days after receiving MMR were identified. Remnant nasopharyngeal(NP) samples were tested for measles vaccine by PCR. Medical records were reviewed for demographics, presenting symptoms, and test results.
RESULTS
From January 2022 to March 2023, 127 NP from children who received MMR were tested. Ninety-six NP were collected after the first dose, of which 33(34.4 %) were positive for vaccine RNA. The median interval between MMR and detection was 11.0 days. Thirty-one NP were collected after the second MMR and 1(3.2 %) was positive; time between the vaccination and detection was 18.9 days. Median cycle threshold(Ct) value of the measles PCR for vaccine shedding was significantly higher than median Ct in children with wild-type infection.
CONCLUSION
Shedding of measles vaccine RNA is not uncommon and vaccine RNA can be detected up to 29 days post MMR; the amount of vaccine RNA shedding is low indicated by high Ct values. Clinicians and public health officials should consider performing measles vaccine testing on those testing positive for measles within one month of MMR vaccination, especially if the Ct value is high and definitive epidemiological links are absent.
Topics: Humans; Measles-Mumps-Rubella Vaccine; Female; Male; Virus Shedding; RNA, Viral; Child, Preschool; Infant; Vaccination; Child; Measles; Nasopharynx; Mumps; Rubella; Adolescent
PubMed: 38823291
DOI: 10.1016/j.jcv.2024.105696 -
Vaccine Oct 2023Chikungunya virus (CHIKV) is an alphavirus transmitted by mosquitos that causes a debilitating disease characterized by fever and long-lasting polyarthralgia. To date,...
Chikungunya virus (CHIKV) is an alphavirus transmitted by mosquitos that causes a debilitating disease characterized by fever and long-lasting polyarthralgia. To date, no vaccine has been licensed, but multiple vaccine candidates are under evaluation in clinical trials. One of these vaccines is based on a measles virus vector encoding for the CHIKV structural genes C, E3, E2, 6K, and E1 (MV-CHIK), which proved safe in phase I and II clinical trials and elicited CHIKV-specific antibody responses in adult measles seropositive vaccine recipients. Here, we predicted T-cell epitopes in the CHIKV structural genes and investigated whether MV-CHIK vaccination induced CHIKV-specific CD4 and/or CD8 T-cell responses. Immune-dominant regions containing multiple epitopes in silico predicted to bind to HLA class II molecules were found for four of the five structural proteins, while no such regions were predicted for HLA class I. Experimentally, CHIKV-specific CD4 T-cells were detected in six out of twelve participants after a single MV-CHIK vaccination and more robust responses were found 4 weeks after two vaccinations (ten out of twelve participants). T-cells were mainly directed against the three large structural proteins C, E2 and E1. Next, we sorted and expanded CHIKV-specific T cell clones (TCC) and identified human CHIKV T-cell epitopes by deconvolution. Interestingly, eight out of nine CD4 TCC recognized an epitope in accordance with the in silico prediction. CHIKV-specific CD8 T-cells induced by MV-CHIK vaccination were inconsistently detected. Our data show that the MV-CHIK vector vaccine induced a functional transgene-specific CD4 T cell response which, together with the evidence of neutralizing antibodies as correlate of protection for CHIKV, makes MV-CHIK a promising vaccine candidate in the prevention of chikungunya.
Topics: Adult; Humans; Antibodies, Neutralizing; Antibodies, Viral; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Chikungunya Fever; Chikungunya virus; Epitopes, T-Lymphocyte; Measles Vaccine; Measles virus; Viral Vaccines
PubMed: 37726181
DOI: 10.1016/j.vaccine.2023.09.022 -
Transplantation Oct 2023Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent...
BACKGROUND
Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent morbidity from these preventable diseases. However, data for this approach are scarce. Thus, we aimed to describe the seroprevalence of MMRV and the efficacy of the vaccines in our transplant center.
METHODS
Pre-SOT candidates >18 y of age were retrospectively retrieved from SOT database in Memorial Hermann Hospital Texas Medical Center. MMRV serologies are routinely screened at the time of pretransplant evaluation. We divided patients into 2 groups: MMRV-positive group versus MMRV-negative group, patients with positive all MMRV serologies and with negative immunity to at least 1 dose of MMRV, respectively.
RESULTS
A total of 1213 patients were identified. Three hundred ninety-four patients (32.4%) did not have immunity to at least 1 dose of MMRV. Multivariate analysis was conducted. Older age (odds ratio [OR]: 1.04) and liver transplant candidates (OR: 1.71) were associated with seropositivity. Previous history of SOT (OR: 0.54) and pancreas/kidney transplant candidates (OR: 0.24) were associated with seronegativity. Among 394 MMRV seronegative patients, 60 patients received 1 dose of MMR vaccine and 14 patients received 1 dose of varicella-zoster virus vaccine without severe adverse events. A total of 35% (13/37) of patients who had follow-up serologies did not have a serological response.
CONCLUSIONS
A significant number of pre-SOT candidates were not immune to at least 1 dose of MMRV. This highlights the importance of MMRV screening and vaccinations pre-SOT. Postvaccination serological confirmation should be performed to evaluate the necessity for a second dose.
Topics: Humans; Adult; Infant; Herpesvirus 3, Human; Mumps; Seroepidemiologic Studies; Retrospective Studies; Vaccines, Combined; Measles; Rubella; Chickenpox Vaccine; Chickenpox; Vaccination; Organ Transplantation; Antibodies, Viral
PubMed: 37309028
DOI: 10.1097/TP.0000000000004681 -
Vaccines Jun 2024Global measles cases are on the rise following disruptions to routine immunisation programs during the COVID-19 pandemic, with devastating consequences. According to the...
Global measles cases are on the rise following disruptions to routine immunisation programs during the COVID-19 pandemic, with devastating consequences. According to the World Health Organization, the behavioural and social drivers of vaccination include what people think and feel about vaccines, social processes, motivation to vaccinate and practical barriers to vaccination. However, the drivers of measles vaccine uptake are not necessarily the same as those for other childhood vaccines, and we lack data on how these drivers specifically have changed during and since the COVID-19 pandemic. Without accurately measuring the behavioural and social drivers for measles vaccination, and ideally measuring them serially over time, countries cannot design, target and implement interventions that effectively increase and sustain measles vaccine coverage. This paper outlines what is and is not known about the behavioural and social drivers of measles vaccination and provides recommendations for improving their post-pandemic assessment.
PubMed: 38932421
DOI: 10.3390/vaccines12060692 -
BMC Public Health Nov 2023Malaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of...
BACKGROUND
Malaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of MCV1 and MCV2, Malaysia continues to report high measles incidence. This study suggests a novel indicator for investigating population immunity against measles in the Malaysian population.
METHODS
We define effective vaccine coverage (EVC) of measles as the proportion of a population vaccinated with measles-containing vaccine (MCV) and effectively protected against measles infection. A quantitative evaluation of EVC throughout the life course of Malaysian birth cohorts was conducted accounting for both vaccine efficacy (VE) and between-dose correlation (BdC). Measles vaccination coverage was sourced from WHO-UNICEF estimates of Malaysia's routine immunisation coverage and supplementary immunisation activities (SIAs). United Nations World population estimates and projections (UNWPP) provided birth cohort sizes stratified by age and year. A step wise joint Bernoulli distribution was used to proportionate the Malaysian population born between 1982, the first year of Malaysia's measles vaccination programme, and 2021, into individuals who received zero dose, one dose and multiple doses of MCV. VE estimates by age and doses received are then adopted to derive EVC. A sensitivity analysis was conducted using 1000 random combinations of BdC and VE parameters.
RESULTS
This study suggests that no birth cohort in the Malaysian population has achieved > 95% population immunity (EVC) conferred through measles vaccination since the measles immunisation programme began in Malaysia.
CONCLUSION
The persistence of measles in Malaysia is due to pockets of insufficient vaccination coverage against measles in the population. Monitoring BdC through immunisation surveillance systems may allow for the identification of susceptible subpopulations (primarily zero-dose MCV individuals) and increase the coverage of individuals who are vaccinated with multiple doses of MCV. This study provides a tool for assessment of national-level population immunity of measles conferred through vaccination and does not consider subnational heterogeneity or vaccine waning. This tool can be readily applied to other regions and vaccine-preventable diseases.
Topics: Humans; Immunization Programs; Immunization Schedule; Measles; Measles Vaccine; Measles virus; Measles-Mumps-Rubella Vaccine; Vaccination; Vaccine Efficacy
PubMed: 38017415
DOI: 10.1186/s12889-023-17082-9 -
Przeglad Epidemiologiczny May 2024Mumps is a contagious viral disease occurring mainly in children, the source of infection being the sick/infected person. Since 2003, vaccination against mumps has been...
INTRODUCTION
Mumps is a contagious viral disease occurring mainly in children, the source of infection being the sick/infected person. Since 2003, vaccination against mumps has been mandatory in Poland, performed according to a two-dose schedule. As part of the Public Health Immunization Program (PSO), the MMR combination vaccine (against measles, mumps and rubella) is used for the entire population of children.
OBJECTIVES
The aim of this study was to evaluate epidemiological indicators of mumps in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic.
MATERIAL AND METHODS
The analysis of the epidemiological situation of mumps in Poland in 2021 was based on the interpretation of data from the bulletin , "Infectious diseases and poisonings in Poland in 2021" and , "Immunization in Poland in 2021".
RESULTS
484 cases of mumps were registered in Poland in 2021. The total incidence was 1.3 per 100,000 residents, which was lower than in 2020. The highest incidence of 1.8 per 100,000 residents was registered in Pomorskie Province, and the lowest incidence of 0.7 in Lower Silesia Province. The highest incidence (6.4/100 thousand) was recorded in children aged 0-4 and 5-9. The incidence rate for men (1.4/100,000) was higher than for women (1.1). In 2021, there were 9 patients hospitalized due to mumps, this was more than in 2020.
CONCLUSIONS
The decrease in the number of cases of mumps in 2021 remained related to the ongoing pandemic - the restrictions introduced during the pandemic period led to a decrease in the number of cases not only of COVID-19, but also of other diseases spread by the droplet route, including mumps. The number of registered cases based on the reports of diagnosing physicians may be underestimating the actual number of cases due to the continued difficult access of patients to primary care physicians.
Topics: Humans; Mumps; Poland; Child, Preschool; Infant; Child; Female; Male; Adolescent; Incidence; Adult; Young Adult; COVID-19; Age Distribution; Middle Aged; Infant, Newborn; Measles-Mumps-Rubella Vaccine; Registries; Urban Population; Sex Distribution; Rural Population; SARS-CoV-2
PubMed: 38783656
DOI: 10.32394/pe.77.38 -
Vaccine: X Aug 2023Vaccination coverage for the second dose of the measles-containing vaccine (MCV2) among children has remained stagnant in Sierra Leone at nearly 67% since its...
Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020.
BACKGROUND
Vaccination coverage for the second dose of the measles-containing vaccine (MCV2) among children has remained stagnant in Sierra Leone at nearly 67% since its introduction in 2015. Identifying community-specific barriers faced by caregivers in accessing MCV2 services for their children and by health workers in delivering MCV2 is key to informing strategies to improve vaccination coverage.
METHODS
We used Photovoice, a participatory method using photographs and narratives to understand community barriers to MCV2 uptake from March- September 2020. Six female and five male caregivers of MCV2-eligible children (15-24 months of age), and six health care workers (HCWs) in Freetown, Sierra Leone participated. After having an orientation to photovoice, they photographed barriers related to general immunization and MCV2 uptake in their community. This was followed by facilitated discussions where participants elaborated on the barriers captured in the photos. Transcripts from the six immunization-related discussions were analyzed to deduce themes through open-ended coding. A photo exhibition was held for participants to discuss the barriers and suggested solutions with decision-makers, such as the ministry of health.
RESULTS
We identified and categorized nine themes into three groups: 1) individual or caregiver level barriers (e.g., caregivers' lack of knowledge on MCV2, concerns about vaccine side effects, and gender-related barriers); 2) health system barriers, such as HCWs' focus on children below one year and usage of old child health cards; and 3) contextual barriers, such as poverty, poor infrastructure, and the COVID-19 pandemic. Participants suggested the decision-makers to enhance community engagement with caregivers and HCW capacity including, increasing accountability of their work using performance-based approaches, among different strategies to improve MCV2 uptake.
CONCLUSION
Photovoice can provide nuanced understanding of community issues affecting MCV2. As a methodology, it should be integrated in broader intervention planning activities to facilitate the translation of community-suggested strategies into action.
PubMed: 37577263
DOI: 10.1016/j.jvacx.2023.100338