| District MCV1 coverage (administrative coverage reports, survey coverage estimates) |
Quality of RI for first dose of MCV |
≥95% (+0)
90–94% (+2)
85–89% (+4)
80–84% (+6)
<80% (+8) |
Calculate the average administrative coverage from the past three years to assign risk point. If coverage survey estimates available at district level (conducted within past three years and includes birth cohorts of recent three years) can replace administrative coverage.
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| Proportion of neighboring districts with <80% MCV1 (administrative coverage reports, survey coverage estimates) |
Provides context about geographical gaps in immunity |
<50% (+0)
50–74% (+2)
≥75% (+4) |
Assess representativeness of immunity gap in surrounding area of a district. If coverage survey estimates available at district level (conducted within past three years and includes birth cohorts of recent three years) can replace administrative coverage. Also consider districts from bordering countries if data are available.
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| District MCV2 coverage (administrative coverage reports, survey coverage estimates) |
Quality of RI for second dose of MCV |
≥ 95% (+0)
90–94% (+2)
85–89% (+4)
80–84% (+6)
<80% (+8) |
Calculate the average administrative coverage from the past three years to assign risk point. If MCV2 was introduced in the past three years, then only use the years with reported coverage. If MCV2 has not been introduced, then give maximum score. If coverage survey estimates available at district level (conducted within past three years and includes birth cohorts of recent three years) can replace administrative coverage.
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| Measles SIA conducted within the past three years (administrative SIA coverage reports, survey coverage estimates) |
Raises population immunity beyond RI |
Yes, ≥95% coverage (+0)
Yes, 90–94% coverage (+2)
Yes, 85–89% coverage (+4)
Yes, <85% coverage/no coverage data (+6)
No SIA(+8) |
Assess SIA administrative coverage to assign risk point. Districts with routine MCV1 and MCV2 administrative coverage (>95%) receives 0 points. If no nationwide SIA was conducted in the past three years but an outbreak response immunization (ORI) campaign was performed for an entire district, report coverage to assign risk point. If post-SIA coverage survey estimates available at district level can replace administrative coverage. If measles SIAs not part of national strategy, assign 0 risk points (i.e., countries in postelimination period or high-income countries)
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| Target age group of measles SIA conducted within the past three years (administrative SIA coverage reports) |
Suggests a larger susceptible population if narrow age group targeted |
Wide age group (+0)
Narrow age group (+2)
No SIA (+2) |
Narrow age group is defined as <5 birth cohorts (9–59 m or less). Wide age group is defined as > 5 birth cohorts (greater than 9–59 m). Districts with >95% for both routine MCV1&2 receive 0 risk points. If measles SIAs not part of national strategy, assign 0 risk points (i.e., countries in postelimination period or high-income countries).
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| Years since the last measles SIA (administrative SIA coverage reports) |
Indicates a buildup of susceptible population |
≤1 year (+0)
2 years (+2)
≥3 years(+4) |
Districts with >95% for both MCV1&2 receive 0 risk points. If measles SIAs not part of national strategy, assign 0 risk points (i.e., countries in postelimination period or high-income countries).
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| Proportion of suspected measles cases who are unvaccinated or have unknown vaccination status (case-based surveillance data) |
Suggests clusters of susceptible population |
<20% (+0)
≥20% (+6) |
Calculate proportion of suspected measles cases who are unvaccinated with MCV or have unknown vaccination status from the past three years to assign risk point. Limit calculation to only those who are age-eligible for MCV1 and older. If no suspected measles cases were reported over the past three years, then give maximum score.
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