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CMAJ : Canadian Medical Association... May 2024
Topics: Humans; Measles; Measles Vaccine; Canada
PubMed: 38802137
DOI: 10.1503/cmaj.240415-f -
Vaccine Nov 2021All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on... (Review)
Review
INTRODUCTION
All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children 9-59 months), and intensified measles case-based surveillance system.
METHODS
We reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017-18. Additionally, we analyzed measles case-based surveillance reports from 2008-2018 to determine annual, regional and age-specific incidence rates.
FINDINGS
Survey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9-11 months (524.0 per million) and 12-59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million).
CONCLUSION
The aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals.
Topics: Child; Disease Eradication; Humans; Immunization Programs; Incidence; Infant; Measles; Measles Vaccine; Nigeria; Population Surveillance; Vaccination; Vaccination Coverage
PubMed: 33875267
DOI: 10.1016/j.vaccine.2021.03.095 -
Bulletin of the World Health... Apr 2024To quantify the association between reduction in child mortality and routine immunization across 204 countries and territories from 1990 to 2019.
OBJECTIVE
To quantify the association between reduction in child mortality and routine immunization across 204 countries and territories from 1990 to 2019.
METHODS
We used child mortality and vaccine coverage data from the Global Burden of Disease Study. We used a modified child survival framework and applied a mixed-effects regression model to estimate the reduction in deaths in children younger than 5 years associated with eight vaccines.
FINDINGS
Between 1990 and 2019, the diphtheria-tetanus-pertussis (DTP), measles, rotavirus and type b vaccines were significantly associated with an estimated 86.9 (95% confidence interval, CI: 57.2 to 132.4) million fewer deaths in children younger than 5 years worldwide. This decrease represented a 24.2% (95% CI: 19.8 to 28.9) reduction in deaths relative to a scenario without vaccines. The DTP and measles vaccines averted 46.7 (95% CI: 30.0 to 72.7) million and 37.9 (95% CI: 25.4 to 56.8) million deaths, respectively. Of the total reduction in child mortality associated with vaccines, 84.2% (95% CI: 83.0 to 85.1) occurred in 73 countries supported by Gavi, the Vaccine Alliance, with an estimated 45.4 (95% CI: 29.8 to 69.2) million fewer deaths from 2000 to 2019. The largest reductions in deaths associated with these four vaccines were in India, China, Ethiopia, Pakistan and Bangladesh (in order of the size of reduction).
CONCLUSION
Vaccines continue to reduce childhood mortality significantly, especially in Gavi-supported countries, emphasizing the need for increased investment in routine immunization programmes.
Topics: Child; Humans; Infant; Immunization Programs; Vaccination; Measles Vaccine; Child Mortality; Whooping Cough; Measles; Diphtheria-Tetanus-Pertussis Vaccine
PubMed: 38562199
DOI: 10.2471/BLT.23.290129 -
Pediatrics Jul 2021The impact of the coronavirus disease 2019 pandemic on vaccination coverage, critical to preventing vaccine-preventable diseases, has not been assessed during the...
OBJECTIVES
The impact of the coronavirus disease 2019 pandemic on vaccination coverage, critical to preventing vaccine-preventable diseases, has not been assessed during the reopening period.
METHODS
Vaccine uptake and vaccination coverage for recommended vaccines and for measles-containing vaccines at milestone ages were assessed in a large cohort of children aged 0 to 18 years in Southern California during January to August 2020 and were compared with those in the same period in 2019. Differences in vaccine uptake and vaccination coverage (recommended vaccines and measles-containing vaccines) in prepandemic (January to March), stay-at-home (April to May), and reopening (June to August) periods in 2020 and 2019 were compared.
RESULTS
Total and measles-containing vaccine uptake declined markedly in all children during the pandemic period in 2020 compared with 2019, but recovered in children aged 0 to 23 months. Among children aged 2 to 18 years, measles-containing vaccine uptake recovered, but total vaccine uptake remained lower. Vaccination coverage (recommended and measles-containing vaccines) declined and remained reduced among most milestone age cohorts ≤24 months during the pandemic period, whereas recommended vaccination coverage in older children decreased during the reopening period in 2020 compared with 2019.
CONCLUSIONS
Pediatric vaccine uptake decreased dramatically during the pandemic, resulting in decreased vaccination coverage that persisted or worsened among several age cohorts during the reopening period. Additional strategies, including immunization tracking, reminders, and recall for needed vaccinations, particularly during virtual visits, will be required to increase vaccine uptake and vaccination coverage and reduce the risk of outbreaks of vaccine-preventable diseases.
Topics: Adolescent; COVID-19; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Measles Vaccine; Retrospective Studies; Vaccination Coverage; Vaccines
PubMed: 33858983
DOI: 10.1542/peds.2020-047092 -
Pediatrics Jul 2019From January 2018 to June 2018, World Health Organization (WHO) European Region countries reported >41 000 measles cases, including 37 deaths, a record high since the... (Review)
Review
From January 2018 to June 2018, World Health Organization (WHO) European Region countries reported >41 000 measles cases, including 37 deaths, a record high since the 1990s. Low vaccination coverage in previous years is the biggest contributing factor to the increase in cases. The Ukraine reported the majority of cases, but France, Georgia, Greece, Italy, the Russian Federation, and Serbia also reported high case counts. Europe is the most common travel destination worldwide and is widely perceived as being without substantial infectious disease risks. For this reason, travelers may not consider the relevance of a pretravel health consultation, including vaccination, in their predeparture plans. Measles is highly contagious, and the record number of measles cases in the WHO European Region not only puts unvaccinated and inadequately vaccinated travelers at risk but also increases the risk for nontraveling US residents who come into close contact with returned travelers who are ill. The US Centers for Disease Control and Prevention encourage US travelers to be aware of measles virus transmission in Europe and receive all recommended vaccinations, including for measles, before traveling abroad. Health care providers must maintain a high degree of suspicion for measles among travelers returning from Europe or people with close contact with international travelers who present with a febrile rash illness. The current WHO European Region outbreak should serve to remind health care providers to stay current with the epidemiology of highly transmissible diseases, such as measles, through media, WHO, and Centers for Disease Control and Prevention reports and encourage measles vaccination for international travelers.
Topics: Disease Outbreaks; Europe; Humans; Measles; Measles Vaccine; Travel-Related Illness; United States; Vaccination Coverage
PubMed: 31209161
DOI: 10.1542/peds.2019-0414 -
The New England Journal of Medicine Mar 2020
Topics: Evidence-Based Medicine; Freedom; Humans; Measles; Measles Vaccine; Truth Disclosure; Vaccination Refusal
PubMed: 32160659
DOI: 10.1056/NEJMp2000807 -
Journal of Pediatric Health Care :... 2019
Topics: Education, Medical; Humans; Measles; Measles Vaccine; Patient Education as Topic; United States
PubMed: 31227121
DOI: 10.1016/j.pedhc.2019.05.002 -
Cytokine & Growth Factor Reviews Dec 2020The study of measles virus (MeV) as a cancer immunotherapeutic was prompted by clinical observations of leukemia and lymphoma regressions in patients following measles... (Review)
Review
The study of measles virus (MeV) as a cancer immunotherapeutic was prompted by clinical observations of leukemia and lymphoma regressions in patients following measles virus infection in the 1970s and 1980s. Since then, numerous preclinical studies have confirmed the oncolytic activity of MeV vaccine strains as well as their potential to promote long-lasting tumor-specific immune responses. Early clinical data indicate that some of these effects may translate to the treatment of cancer patients. In this review, we provide a structured summary of current evidence for the anti-tumor immune activity of oncolytic MeV. We start with an overview of MeV oncolysis and MeV-induced immunogenic cell death. Next, we relate findings on MeV-mediated activation of antigen-presenting cells, T cell priming and effector mechanisms to the cancer immunity cycle. We discuss additional factors in the tumor microenvironment which are modulated by MeV treatment as well as the role of anti-viral immunity. Based on these findings, we highlight avenues for rational enhancement of oncolytic MeV immunotherapy by vector engineering. We further point to advantages and drawbacks of experimental models and propose areas warranting promising research. Lastly, we review the available immunomonitoring data from several Phase I clinical trials. While this review presents data for MeV, the concepts and principles introduced herein apply to other oncolytic viruses, providing a framework to assess novel cancer immunotherapies.
Topics: Humans; Immunotherapy; Measles Vaccine; Measles virus; Oncolytic Virotherapy; Oncolytic Viruses
PubMed: 32660751
DOI: 10.1016/j.cytogfr.2020.07.009 -
The Journal of Emergency Medicine Apr 2020It is vital for frontline emergency physicians to immediately recognize the signs and symptoms of measles to initiate appropriate therapy and prevent spread to the... (Review)
Review
BACKGROUND
It is vital for frontline emergency physicians to immediately recognize the signs and symptoms of measles to initiate appropriate therapy and prevent spread to the health care team and other patients.
OBJECTIVE
This review serves as a clinically practical updated reference for when the differential diagnosis includes measles.
DISCUSSION
Measles is a highly contagious illness that classically presents with a rash, fever, cough, coryza, and conjunctivitis. Cases in the United States since 2000 have been attributed mainly to travelers who are infected abroad and then spread the illness to small, susceptible populations within the United States. Complications from measles are relatively common and can be associated with significant morbidity and mortality. Clinical suspicion should be confirmed with laboratory testing, which is most commonly a serum immunoglobulin M. The management of measles is mainly supportive. Patients that require more aggressive management include those who are pregnant, immunocompromised, or unvaccinated. Treatment may consist of the measles vaccine, intravenous immunoglobulin, vitamin A, and even ribavirin. Additionally, special precautions are required by hospital workers to help prevent the spread of the virus, which include N-95 masks and patient isolation in an airborne infection isolation room.
CONCLUSION
Emergency physicians must be readily able to identify, contain patients with suspected measles, and determine who will need further medical management for this potentially life-threatening illness. As this public health crisis evolves, novel ways of screening for and reporting cases of measles is needed.
Topics: Disease Outbreaks; Female; Fever; Humans; Immunoglobulin M; Measles; Measles Vaccine; Physicians; Pregnancy
PubMed: 32241708
DOI: 10.1016/j.jemermed.2020.02.007 -
BMC Public Health Nov 2022Childhood immunization is a cost-effective way to protect individuals against communicable diseases. However, although there is a large literature on childhood...
BACKGROUND
Childhood immunization is a cost-effective way to protect individuals against communicable diseases. However, although there is a large literature on childhood immunization in Indonesia, there is a paucity of research on the age-appropriateness on measles and DTwP-3 vaccination, and the inequities in immunization coverage across Indonesia.
METHODS
In this paper, using seven waves of data from the nationally representative Indonesia Demographic and Health Surveys (DHS) covering the period 1991- 2017, we empirically analyse the socio-economic and demographic factors influencing the uptake of four routine vaccines (BCG, Polio-3, DTwP-3, and Measles). Specifically, using multivariate regression analysis, we identify the socio-economic and demographic factors influencing childhood immunization coverage. We further analyse the socio-economic and demographic correlates of the age-appropriateness of the measles and DTwP-3 vaccination coverage.
RESULTS
Our findings show that parental education and use of healthcare services are strong predictors of full immunization and age-appropriate vaccinations. This study also finds evidence of spatial heterogeneity in both full immunization rates and age-appropriate vaccinations for measles and DTwP-3 vaccines.
CONCLUSIONS
Our analysis finds that despite an improvement in the timing of vaccinations over the last two decades, a significant proportion of children continue to receive their measles and DTwP vaccinations age inappropriately. In particular, we find that maternal education and maternal engagement with healthcare services are critical in improving age appropriateness of vaccinations. From a policy perspective, these results call for concerted efforts by policy makers to address regional gaps in access to health services and immunization coverage, as well as to improve the age-appropriateness of vaccination.
Topics: Child; Humans; Infant; Immunization Programs; Indonesia; Vaccination; Measles Vaccine; Measles; Diphtheria-Tetanus-Pertussis Vaccine; Immunization; Immunization Schedule
PubMed: 36333713
DOI: 10.1186/s12889-022-14408-x