Sub-national variation in measles vaccine coverage and outbreak risk: a case study from a 2010 outbreak in Malawi

Kundrick, Avery; Huang, Zhengjing; Carran, Spencer; Kagoli, Matthew; Grais, Rebecca F.; Hurtado, Northan; Ferrari, Matthew J.

doi:10.1186/s12889-018-5628-x

Cited by 25 publications

(14 citation statements)

References 27 publications

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“…Of these countries, 71 reported MCV1 coverage greater than 100% in at least one unit and 55 reported such coverage in at least a quarter of units. Although researchers have estimated subnational MCV1 coverage in select countries or years for which there have been reliable surveys, to date, no comprehensive analysis of all available vaccine coverage data to produce subnational estimates of MCV1 coverage annually in all LMICs has been undertaken [21][22][23][24] .…”

Section: Subnational Routine Mcv1 Coveragementioning

confidence: 99%

Mapping routine measles vaccination in low- and middle-income countries

Sbarra¹,

Rolfe²,

Nguyen³

et al. 2020

Nature

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The safe, highly effective 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 first-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, quantified 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.

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Section: Subnational Routine Mcv1 Coveragementioning

confidence: 99%

Mapping routine measles vaccination in low- and middle-income countries

Sbarra¹,

Rolfe²,

Nguyen³

et al. 2020

Nature

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“…Despite improvements in vaccine coverage, universal vaccination coverage is not yet achieved and there are areas in many countries where coverage remains low ( World Health Organization, 2021b ; Hamlet et al, 2019 ; Kundrick et al, 2018 ; Takahashi et al, 2017 ; Vanderslott et al, 2013 ). The model estimates presented in this study do not account for such geographic or socioeconomic clustering of vaccine coverage, which could increase disease transmission.…”

Section: Discussionmentioning

confidence: 99%

Lives saved with vaccination for 10 pathogens across 112 countries in a pre-COVID-19 world

Toor

Echeverría-Londoño

et al. 2021

eLife

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Background:Vaccination is one of the most effective public health interventions. We investigate the impact of vaccination activities for Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae, and yellow fever over the years 2000–2030 across 112 countries.Methods:Twenty-one mathematical models estimated disease burden using standardised demographic and immunisation data. Impact was attributed to the year of vaccination through vaccine-activity-stratified impact ratios.Results:We estimate 97 (95%CrI[80, 120]) million deaths would be averted due to vaccination activities over 2000–2030, with 50 (95%CrI[41, 62]) million deaths averted by activities between 2000 and 2019. For children under-5 born between 2000 and 2030, we estimate 52 (95%CrI[41, 69]) million more deaths would occur over their lifetimes without vaccination against these diseases.Conclusions:This study represents the largest assessment of vaccine impact before COVID-19-related disruptions and provides motivation for sustaining and improving global vaccination coverage in the future.Funding:VIMC is jointly funded by Gavi, the Vaccine Alliance, and the Bill and Melinda Gates Foundation (BMGF) (BMGF grant number: OPP1157270 / INV-009125). Funding from Gavi is channelled via VIMC to the Consortium’s modelling groups (VIMC-funded institutions represented in this paper: Imperial College London, London School of Hygiene and Tropical Medicine, Oxford University Clinical Research Unit, Public Health England, Johns Hopkins University, The Pennsylvania State University, Center for Disease Analysis Foundation, Kaiser Permanente Washington, University of Cambridge, University of Notre Dame, Harvard University, Conservatoire National des Arts et Métiers, Emory University, National University of Singapore). Funding from BMGF was used for salaries of the Consortium secretariat (authors represented here: TBH, MJ, XL, SE-L, JT, KW, NMF, KAMG); and channelled via VIMC for travel and subsistence costs of all Consortium members (all authors). We also acknowledge funding from the UK Medical Research Council and Department for International Development, which supported aspects of VIMC's work (MRC grant number: MR/R015600/1).JHH acknowledges funding from National Science Foundation Graduate Research Fellowship; Richard and Peggy Notebaert Premier Fellowship from the University of Notre Dame. BAL acknowledges funding from NIH/NIGMS (grant number R01 GM124280) and NIH/NIAID (grant number R01 AI112970). The Lives Saved Tool (LiST) receives funding support from the Bill and Melinda Gates Foundation.This paper was compiled by all coauthors, including two coauthors from Gavi. Other funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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“…For example, the lack of coordinated public health policies has been cited in criticism of Canada's and Australia's responses to SARS [16,17] and the United States' response to bioterrorism [18,19]. Yet at the same time, centralized responses to public health emergencies are known to underperform policies tailored to local conditions [20,21], and debates over the proper level of government to manage infectious diseases have recently come to the forefront in light of the COVID-19 pandemic [22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Governance structure affects transboundary disease management under alternative objectives

et al. 2021

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Background The development of public health policy is inextricably linked with governance structure. In our increasingly globalized world, human migration and infectious diseases often span multiple administrative jurisdictions that might have different systems of government and divergent management objectives. However, few studies have considered how the allocation of regulatory authority among jurisdictions can affect disease management outcomes. Methods Here we evaluate the relative merits of decentralized and centralized management by developing and numerically analyzing a two-jurisdiction SIRS model that explicitly incorporates migration. In our model, managers choose between vaccination, isolation, medication, border closure, and a travel ban on infected individuals while aiming to minimize either the number of cases or the number of deaths. Results We consider a variety of scenarios and show how optimal strategies differ for decentralized and centralized management levels. We demonstrate that policies formed in the best interest of individual jurisdictions may not achieve global objectives, and identify situations where locally applied interventions can lead to an overall increase in the numbers of cases and deaths. Conclusions Our approach underscores the importance of tailoring disease management plans to existing regulatory structures as part of an evidence-based decision framework. Most importantly, we demonstrate that there needs to be a greater consideration of the degree to which governance structure impacts disease outcomes.

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Sub-national variation in measles vaccine coverage and outbreak risk: a case study from a 2010 outbreak in Malawi

Cited by 25 publications

References 27 publications

Mapping routine measles vaccination in low- and middle-income countries

Mapping routine measles vaccination in low- and middle-income countries

Lives saved with vaccination for 10 pathogens across 112 countries in a pre-COVID-19 world

Governance structure affects transboundary disease management under alternative objectives

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