Community-Oriented Epidemic Preparedness and Response to the Jerusalem 2018–2019 Measles Epidemic

Abstract

Measles epidemics are still a public health challenge worldwide, necessitating a rapid response. The Jerusalem District Health Office applied a community-oriented intervention during the 2018–2019 epidemic (2150 notified cases). Program development targeted the socioeconomic and cultural characteristics of high-incidence Jewish ultraorthodox communities. Health care and community collaboration led to coverage rates of measles vaccination increasing from 80% to 95% within three months and a significant decline in incidence. Epidemic preparedness calls for maintaining the infrastructure of countermeasures combined with sustaining immunization coverage.

The measles outbreak in Israel in 2018-19: lessons for COVID-19 pandemic

“…Increased measles incidence rates and considerable disease burden have been observed in under-vaccinated (predominantly Jewish ultraorthodox) communities. [4][5][6] The measles outbreak containment measures necessitated the application of a culture-sensitive approach with community-based campaigns aimed to rapidly increase the measles vaccination coverage. 5 The communities affected by 2018-2019 measles outbreak have shown recurrent Vaccine-Preventable Disease outbreaks previously (e.g.…”

“…[4][5][6] The measles outbreak containment measures necessitated the application of a culture-sensitive approach with community-based campaigns aimed to rapidly increase the measles vaccination coverage. 5 The communities affected by 2018-2019 measles outbreak have shown recurrent Vaccine-Preventable Disease outbreaks previously (e.g. measles, mumps), with international transmission occurring between similar communities worldwide (mainly orthodox communities in Europe, UK, and the US).…”

“…Possible attributing factors are high population density, low socio-economic level, and large households, increasing the probability of communicable disease transmission. 5,7,25 As to households' size, the total fertility rate in Israel was the highest among Organization for Economic Co-operation and Development (OECD) countries in 2016 (3.1), and exceptionally high among ultraorthodox Jews (7.1). 26 Neighborhoods and cities with sizable ultraorthodox Jewish population showed a disproportionately increased fraction of the COVID-19 cases.…”

“…29 In that context, the ultraorthodox Jewish population in Israel has previously shown lower childhood vaccination coverage rates, vaccination delay, and increased risk for outbreaks as compared to other population groups. [4][5][6][7]10,25,30 The role of the community-based child health services and particularly that of the public health nurses are indeed vital in promoting sustainable measles immunization coverage. 31 Therefore, the preventive child health services should be given substantial support and proper budgeting in order to assure coping with the increase in the population of children and the requirements of special population groups.…”

A Perfect Storm: The Social and Institutional Contexts of Samoa’s 2019-2020 Measles Epidemic and the Lessons learned for the COVID-19 Pandemic

“…Overcrowded waiting areas for vaccinations were observed at TTMH in the period leading up to the countrywide shut down for mass vaccinations in December. The fear of potential exposure in a crowded environment while waiting for a vaccine may have dissuaded some parents from bringing children for vaccination (Stein-Zamir et al 2019).…”