Table 2.
Mass vaccination response details *
| Region/ Country |
Time to response** | Target Area | Target Age | Doses/ Coverage |
Author's Reported Impact | Documented Impact (authors' assessment) |
|---|---|---|---|---|---|---|
| AMERICAS | ||||||
| Bolivia | MV1: 1998 4 m after 1st case | Nonselective Nationwide |
6 m -5 y | 85% | Persistent cases | Epidemic ended after multiple immunization activities |
| MV2: 1999 | house-to-house Nationwide | 6 m - 4 y + 6 m - 14 y in 2 dpts | 98% | Persistent cases but decreased over time | ||
| MV3: 2000 | House-to-house in high risk municipalities |
N/A | N/A | N/A | ||
| MV4: 2002 | House to house | 6 m - 4 y | 95% | Transmission stopped | ||
| Haiti | MV1: < 4 w after 1st case | Nonselective Provincial city |
6 m - 14 y | 95% | No cases in city within 2 w of end of campaign; spread to rest of island | Epidemic ended after multiple immunization activities |
| MV2: N/A | Departments | 6 m - 14 y | 65 - 95% | No cases after early August in department | ||
| MV3: 5-9/00 | Port-au-Prince | 6 m - 14 y | 82% | |||
| MV4: 11/00-1/01 | Port-au-Prince neighborhood | 6 m - 14 y | 80 - 90% | Reduced number of cases island-wide |
||
| MV5: 9-12/01 | Nationwide | N/A | > 85% | Measles transmission interrupted | ||
| Colombia | Various | door to door vaccination in high risk municipalities | 6 m-5 y | N/A | N/A but editorial suggests proactive response averted large outbreak | Compared to outbreak in neighboring Venezuela, prompt, door to door targeted vaccination and surveillance may have prevented a large outbreak in a country where EPI is limited by long term conflict |
| ASIA | ||||||
| Afghanistan | 12/2001-5/2002 | Nonselective, Central region districts and returning refugees in catchment area. Revaccination in districts with low coverage | 6 m-12 y | 77% (62-90%) by May 2002 63-92% by December 2002 |
Impact on incidence not assessed. Campaign achieved high coverage despite many obstacles. Authors recommend vaccinating extended age groups in complex emergencies. |
Unable to assess impact from data provided, but from WHO records measles incidence decreased dramatically for next 2 years. |
| India | Soon after flood began | Flood area, areas of congregation then cut-off villages | 6 m to 14 y Catch-up |
75% Catch-up:60% |
Qualitative analysis on the vaccination in multiple stages. Initial one prevented large scale measles o/b and death, later stages contained smaller o/b and high mortality was prevented with a joint surveillance system | Insufficient data |
| India | Dec 29, 04 to Jan 9, 05 | Non-selective, 58 villages in Namil-Tadu district, Eastern India | 6 m to 60 m No catch-up |
117.2% | Qualitative analysis transmission continued despite vaccine coverage and was unrelated to tsunami. Target age was too restrictive, recommendation to vaccinate children up to 14 years during complex emergencies like tsunami. | Insufficient data |
| Sri Lanka | N/A | Nonselective Refugee camps, welfare centers, preschools, & slums |
Children " < 10 y" | N/A | N/A | Not clear |
| AFRICA | ||||||
| Niger | Outreach services in some health centers | N/A | N/A | N/A | Impact not specified but authors discuss the need to include older than 5 y children in vaccination campaigns due to high CFR in this group. | Insufficient information to determine impact |
| Tanzania | Epidemic started in March, ORI were in April, June and August in 3 camps | Nonselective, refugee camps. | ORI: 6 m-5 y. But new arrivals 6 m-15 y are routinely vaccinated |
N/A | 6 m-5 y campaign prevented cases and deaths, but to halt transmission, campaigns targeting a wider age group would have been more effective | May have influenced epidemic. given large proportion of cases in older age groups, vaccinating up to age 15 early in the epidemic would have likely shortened the duration of the outbreaks. |
| Ethiopia | Within 1 month | Nonselective | 9 m -5 y | Despite ORI in February measles cases continued to be reported in the district including among vaccinated. Recommend extending vaccinated age group to 12-15 y in acute emergencies. Epidemic was not halted until August when a vaccination campaign with grater coverage and efficacy implemented | The authors calculate low coverage and poor efficacy of vaccine in February campaign. These alone could have allowed outbreak to continue, but including a wider age range for vaccination may have been useful in containing the outbreak. No age breakdown of cases available. | |
| Mozambique | Varied reactive SIAs | Nonselective, targeted urban (province capitals) |
9 m-4 y | Measles campaigns had limited impact. Recommend increasing target age group and including rural areas linked to cities via transport routes. | Campaigns may have had some impact, as noted by reduced caseload in subsequent years. Targeting a wider age group in catch up and outbreak campaigns could have had greater impact. | |
| Niger | Wk 24 after o/b | LQAS selection, 46 lots of 65 children | 6 m - 5 y | Other SIAs after the survey: 99% | SIA are a first response to reinforcement of routine immunization activities (children under 5) | CFR = 3.3% (global o/b) No data otherwise |
| Nigeria | Wk 18 after o/b | Non-selective | 6 m - 5 y | Other SIAs after the survey: 80% | same | |
| Chad | Wk 22 after o/b | Non-selective | 6 m - 5 y | Other SIAs after the survey: 96% | same | |
| South Africa | Jan 04 | Non-selective | 6 m to 14 y Catch-up: 9 m-4 y |
Catch-up: 86% | Importance of maintaining high immunity by means of routine immunization to prevent transmission following importation of the virus | N/A |
| Tanzania | 11 wks after o/b | Non-selective | 6 m to 14 y | 882789 doses given Administrative: 100% Measured: 66% |
Measles incidence declined in the targeted age group | Incidence would have been high in the target group without intervention |
| Sudan | 06/05/04 | North Darfur only | 9 m - 15 y | 93% of the accessible pop 77% of the global |
The restricted access to population and the low coverage explains that measles cases still occurred after the vaccination campaign. | North Darfur: CFR = 17% West Darfur: CFR = 14% Similar results to other studies in comparable situations |
| EUROPE | ||||||
| Albania | 2 wks after o/b | Only two districts (Kukes and Has) | 6 m - 5 y | 90% | Surveillance system allowed for early epidemic detection | N/A |
* Abbreviations contained in the body of the table: N/A = not available, d = day, w = week, m = month, y = year, o/b = outbreak, popn = population. For references of reports, see Table 1.
** In some cases, multiple rounds of vaccination were conducted. In this table, each round is designated by a number (ex, MV1).
†Selective indicates that only children without evidence of vaccination were targeted; nonselective indicates that all children regardless of vaccination status were targeted