Measles outbreak response vaccination in the Federated States of Micronesia

Gopalani, Sameer Vali; Helgenberger, Louisa; Apaisam, Carter; Donre, Spencer; Takiri, Keyleen; Charley, Jocelyne; Yomai, Anamaria; Judicpa, Peter; Nakazono, Naoki; Johnson, Eliaser; Setik, Eleanor; Taulung, Livinson; Elias, Augustus; Barrow-Kohler, Lisa

doi:10.1093/ije/dyw111

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…In Chuuk, coverage with ≥1 dose of MMR was similar on the main island (86%) and outer islands (89%). This might be attributed to a 2014 mass MMR vaccination campaign, targeting all persons aged 6 months–49 years across the state, in response to a measles outbreak ( 8 ). Among children in this cohort who received at least one MMR dose (1,077), 42.2% received a dose during the 2014 campaign.…”

Section: Discussionmentioning

confidence: 99%

Vaccination Coverage Among Children Aged 2 Years — U.S. Affiliated Pacific Islands, April–October, 2016

Tippins¹,

Murthy²,

Meghani³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau). Differences in vaccination coverage between main and outer islands were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ≥3 doses of inactivated poliovirus vaccine (IPV); ≥1 dose of measles, mumps, and rubella vaccine (MMR); ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; ≥3 doses of hepatitis B (HepB) vaccine; and ≥4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ≥3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions, is essential to maintain protection from VPD outbreaks in the region and the mainland United States.

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Section: Discussionmentioning

confidence: 99%

Vaccination Coverage Among Children Aged 2 Years — U.S. Affiliated Pacific Islands, April–October, 2016

Tippins¹,

Murthy²,

Meghani³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

Self Cite

View full text Add to dashboard Cite

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“…Although 16 suspected cases were investigated in Yap, these cases were ruled out following negative laboratory results. Cases were identified by febrile rash illness surveillance at the hospital, contact tracing, and a retrospective investigation of earlier fever and rash cases [7,10]. …”

Section: Methodsmentioning

confidence: 99%

“…When boats could not reach the shore during low tides, immunization staff had to carry the campaign supplies over the reef. Further, fixed and outreach vaccination posts were set up, as well as mobile vaccination units and door-to-door efforts, which were utilized to immunize hard-to-reach populations, such as isolated communities inhabiting mountainous terrain [10]. …”

Section: Methodsmentioning

confidence: 99%

Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak

Pike

Tippins

Nyaku

et al. 2017

Vaccine

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After 20 years with no reported measles cases, on May 15, 2014 the Centers for Disease Control and Prevention (CDC) was notified of two cases testing positive for measles-specific immunoglobulin M (IgM) antibodies in the Federated States of Micronesia (FSM). Under the Compact of Free Association, FSM receives immunization funding and technical support from the United States (US) domestic vaccination program managed by the Centers for Disease Control and Prevention (CDC). In a collaborative effort, public health officials and volunteers from FSM and the US government worked to respond and contain the measles outbreak through an emergency mass vaccination campaign, contact tracing, and other outbreak investigation activities. Contributions were also made by United Nations Children’s Emergency Fund (UNICEF) and World Health Organization (WHO). Total costs incurred as a result of the outbreak were nearly $4,000,000; approximately $10,000 per case. Direct medical costs (≈$141,000) were incurred in the treatment of those individuals infected, as well as lost productivity of the infected and informal caregivers (≈$250,000) and costs to contain the outbreak (≈$3.5 million). We assessed the economic burden of the 2014 measles outbreak to FSM, as well as the economic responsibilities of the US. Although the US paid the majority of total costs of the outbreak (≈67%), examining each country’s costs relative to their respective economy illustrates a far greater burden to FSM. We demonstrate that while FSM was heavily assisted by the US in responding to the 2014 Measles Outbreak, the outbreak significantly impacted their economy. FSM’s economic burden from the outbreak is approximately equivalent to their entire 2016 Fiscal Year budget dedicated to education.

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“…2 Pacific island countries and territories, including FSM, face a triple burden of communicable diseases, noncommunicable diseases (NCDs), and health impact of climate change. 3 In addition to recent outbreaks of vector-borne, [4][5][6] foodborne, 7 vaccine-preventable, 8 and neglected tropical diseases, 9 there is an ongoing epidemic of NCDs in FSM where they account for more than twothirds of all registered deaths. 10 NCDs are the leading cause of death globally, 11 regionally, 12 and nationally in FSM.…”

Section: Introductionmentioning

confidence: 99%

Premature Mortality From Noncommunicable Diseases in the Federated States of Micronesia, 2003-2012

Gopalani

Samo

Soaz

et al. 2017

Asia Pac J Public Health

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This study was conducted to assess status, and understand burden, of premature and leading causes of deaths from noncommunicable diseases (NCDs) in the Federated States of Micronesia (FSM). From 2003 to 2012, ICD-10 coded mortality data from the national Health Information System were analyzed. Proportional mortality was calculated and a ranking list of the leading causes of premature death was produced. Of the 2349 premature deaths reported, 1970 (83.9%) were due to NCDs, and 1680 (71.5%) were from 4 main NCD groups-cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. Diabetes (19.5%), ischemic heart diseases (13.2%), and cerebrovascular diseases (7.1%) were the leading causes of premature deaths. The findings indicate that the burden of premature NCD deaths in FSM is higher than global levels, and existing efforts need to be strengthened to alter their course.

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Measles outbreak response vaccination in the Federated States of Micronesia

Cited by 4 publications

References 2 publications

Vaccination Coverage Among Children Aged 2 Years — U.S. Affiliated Pacific Islands, April–October, 2016

Vaccination Coverage Among Children Aged 2 Years — U.S. Affiliated Pacific Islands, April–October, 2016

Cost of a measles outbreak in a remote island economy: 2014 Federated States of Micronesia measles outbreak

Premature Mortality From Noncommunicable Diseases in the Federated States of Micronesia, 2003-2012

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