A novel measles outbreak control strategy in the Netherlands in 2013–2014 using a national electronic immunization register: A study of early MMR uptake and its determinants

Lochlainn, Laura Nic; Woudenberg, Tom; Lier, Alies van; Zonnenberg, Irmgard; Philippi, M. C.; Melker, Hester E. de; Hahné, Susan

doi:10.1016/j.vaccine.2017.09.018

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Immunization registry data, for example, has recently been used to identify areas and/or groups with low measles vaccine uptake. 13-15 When coverage data are unavailable, the Pan American Health Organization (PAHO) recommends use of Rapid Coverage Monitoring (RCM), an assessment tool that helps local managers identify areas where vaccination may be suboptimal. 16 Other factors that might influence the risk for an outbreak include the size and population density of the affected community, and other contextual issues such as acceptability of vaccination in certain groups.…”

Section: Outbreak Response Activitiesmentioning

confidence: 99%

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

Gastañaduy

Banerjee

DeBolt

et al. 2018

Human Vaccines & Immunotherapeutics

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In late September 2016, the Americas became the first region in the world to have eliminated endemic transmission of measles virus. Several other countries have also verified measles elimination, and countries in all six World Health Organization regions have adopted measles elimination goals. The public health strategies used to respond to measles outbreaks in elimination settings are thus becoming relevant to more countries. This review highlights the strategies used to limit measles spread in elimination settings: (1) assembly of an outbreak control committee; (2) isolation of measles cases while infectious; (3) exclusion and quarantining of individuals without evidence of immunity; (4) vaccination of susceptible individuals; (5) use of immunoglobulin to prevent measles in exposed susceptible high-risk persons; (6) and maintaining laboratory proficiency for confirmation of measles. Deciding on the extent of containment efforts should be based on the expected benefit of reactive interventions, balanced against the logistical challenges in implementing them.

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Section: Outbreak Response Activitiesmentioning

confidence: 99%

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

Gastañaduy

Banerjee

DeBolt

et al. 2018

Human Vaccines & Immunotherapeutics

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“…Apart from hindering efforts to eliminate measles, these outbreaks pose immediate risks to vulnerable populations, including young children who can't yet receive vaccinations and people with certain medical conditions. This phenomenon of clustering in vaccine hesitancy within social groups is particularly clear in the Netherlands, where members of the Orthodox Protestant Church and the Anthroposophic community tend to have lower MMR vaccine uptake [11,12]. This clustering of susceptible children has given-way to a number of measles outbreaks since introduction of MMR vaccine in 1989 with the largest occurring in 1999 and 2013, each of these with an estimated total infection count of c. 30,000 with large portions of the country affected [13], in both outbreaks the majority of infections reported were in children, with 77% of cases in 2013/14 amongst 4 to 17 year olds [14].…”

Section: Introductionmentioning

confidence: 99%

Anticipating the risk and spatial spread of measles in populations with high MMR uptake: using school-household networks to understand the 2013 - 2014 outbreak in the Netherlands

Munday,

Atkins,

Klinkenberg

et al. 2024

Preprint

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Measles outbreaks are still routine, even in countries where vaccination coverage exceeds the guideline of 95%. Therefore, achieving ambitions for measles eradication will require understanding how unvaccinated children interact with others who are unvaccinated. Here we propose a novel framework for modelling measles transmission to better understand outbreaks in high uptake situations.The high importance of school- and home-based transmission to overall outbreak dynamics is well established. Making use of this, we created a network of all primary and secondary schools in the Netherlands based on the total number of household pairs between each school. A household pair are siblings from the same household who attend a different school. We parameterised the network with individual level administrative household data provided by the Dutch Ministry for Education and estimates of school level uptake of the Mumps, Measles and Rubella (MMR) vaccine. We analyse the network to establish the relative strength of contact between schools. We simulated measles outbreaks on the network and evaluated the model against empirical measles data per postcode-area from a large outbreak in 2013 (2766 cases), comparing the model to alternative models that do not account for specific network structure or school-level vaccine uptake.Our network analysis shows that schools associated with low vaccine uptake are highly connected, particularly Orthodox-Protestant schools (Coleman Homophily Index = 0.63). Simulations on the Network were able to reproduce the observed size and spatial distribution of the historic outbreak much more clearly than the alternative models, with a case weighted Receiver Operating Condition sensitivity of 0.94 for the data-driven network model and 0.38 and 0.23 for the alternative models. Further, we establish that variation in local network properties result in clear differences in final size of outbreaks seeded in orthodox-protestant-affiliated and other schools with low MMR coverage.Our framework indicates that clustering of unvaccinated children in primary schools connected by unvaccinated children in related secondary schools lead to large, connected clusters of unvaccinated children. Using our approach, we could explain historical outbreaks on a spatial level. Our framework could be further developed to aid future outbreak response.

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Impfverhalten psychologisch erklären, messen und verändern

Betsch

Schmid

Korn

et al. 2019

Bundesgesundheitsbl

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A novel measles outbreak control strategy in the Netherlands in 2013–2014 using a national electronic immunization register: A study of early MMR uptake and its determinants

Cited by 6 publications

References 11 publications

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

Public health responses during measles outbreaks in elimination settings: Strategies and challenges

Anticipating the risk and spatial spread of measles in populations with high MMR uptake: using school-household networks to understand the 2013 - 2014 outbreak in the Netherlands

Impfverhalten psychologisch erklären, messen und verändern

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