Mapping routine measles vaccination inlow- and middle-income countries
Kisa, Adnan; Vaccine Coverage Collaborators, Local Burden of Disease; Sbarra, Alyssa N.; Rolfe, Sam; Nguyen, Jason Q.; Earl, Lucas; Galles, Natalie C.; Marks, Ashley; Kisa, Sezer; Abbas, Kaja M.; Hay, Simon I.; Lim, Stephen S.; Mokdad, Ali H.
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2020-12-16Metadata
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Kisa A, Vaccine Coverage Collaborators, Sbarra AN, Rolfe, Nguyen, Earl L, Galles, Marks, Kisa S, Abbas KM, Hay SI, Lim SS, Mokdad AH. Mapping routine measles vaccination inlow- and middle-income countries. Nature. 2020 https://doi.org/10.1038/s41586-020-03043-4Abstract
The safe, highly efective measles vaccine has been recommended globally since 1974,
yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in
children under 5 years old, and more than 99% of both occurred in low- and
middle-income countries (LMICs)1–4 . Globally comparable, annual, local estimates of
routine frst-dose measles-containing vaccine (MCV1) coverage are critical for
understanding geographically precise immunity patterns, progress towards the
targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions
to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8
. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2
Pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantifed
geographical inequality and assessed vaccination status by geographical remoteness.
After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than
half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP
goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in
urban locations, although a larger proportion of unvaccinated children overall lived in
urban locations; strategies to provide essential vaccination services should address
both geographical contexts. These results provide a tool for decision-makers to
strengthen routine MCV1 immunization programmes and provide equitable disease
protection for all children.