Table 1.

Assumptions for coverage forecasts and delivery components of measles vaccines

Delivery components and target population	Coverage projection of target population		Effect of MR-MAPs
	Higher coverage	Lower coverage
A: MCV1 for children aged 9 months old, RI B: MCV2 for children aged 16.5 months old, RI	Annual growth depending on the overall coverage level: 3% per year for <70% 1% per year for 70%–85% 0.5% per year for >85% Capped at 95% or a higher level shown in the past programme	Stagnant coverage estimates at the 2019 level	Replace a country-specific proportion of N&S doses: 0% for major MMR use in their immunisation programmes 30% for partial MMR use 80% for no MMR use
C: SIA coverage for children aged 9–59 months old, campaign	Frequency depending on MCV2 coverage: Every 2 years for <60% Every 3 years for 60%–80% Every 4–5 years for >80% Discontinuation for >90% over three consecutive years Fixed coverage: 95%	Frequency is the same as under the ‘higher’ coverage projection assumptions. Fixed coverage of 85%
D: MCV1 for children aged 1–2 years old with MOV or living in HTR areas, RI E: MCV2 for children aged 1–2 years old with MOV or living in HTR areas, RI	Fixed coverage: 20% of children experiencing MOV or living in HTR areas		Reach additional populations that were assumed not being reached with N&S vaccines.
F: One-time catch-up SIA for population aged 2–15 years old with MOV or living in HTR areas, campaign	Fixed coverage: 10% of children experiencing MOV or living in HTR areas

Measles vaccine delivery is modelled through six components (A–F) with different age and vaccination status of target populations, coverage projection assumptions, delivery approaches (RI or campaign) and dose presentations (N&S or MR-MAP). Details of the parameters and data sources used in shaping these assumptions are included in the demand forecast analysis by Ko et al.²⁹ Introducing MR-MAPs was assumed to partially replace doses in the existing needle-based immunisation programmes with MR-MAPs (components A–C) and provide additional MR-MAP doses to children with MOV or living in HTR areas (components D–F). The level of replacement with MR-MAPs (market penetration) depends on the size of the different use cases for MR-MAPs and the characteristics of the measles and rubella programmes (inclusive of the use of MMR N&S vaccines) in each country.

HTR, hard-to-reach; MCV1, the first routine dose of measles-containing vaccine; MMR, measles-mumps-rubella; MOV, missed opportunities for vaccination; MR-MAP, measles-rubella microarray patch; N&S, needle and syringe; RI, routine immunisation; SIA, supplementary immunisation activity.