Feasibility of measles and rubella vaccination programmes for disease elimination: a modelling study

Details

• Alternative Title:
  Lancet Glob Health
• Personal Author:
  Winter, Amy K ; Lambert, Brian ; Klein, Daniel ; Klepac, Petra ; Papadopoulos, Timos ; Truelove, Shaun ; Burgess, Colleen ; Santos, Heather ; Knapp, Jennifer K ; Reef, Susan E ; Kayembe, Lidia K ; Shendale, Stephanie ; Kretsinger, Katrina ; Lessler, Justin ; Vynnycky, Emilia ; McCarthy, Kevin ; Ferrari, Matthew ; Jit, Mark
• Description:
  Background
  
  Marked reductions in the incidence of measles and rubella have been observed since the widespread use of the measles and rubella vaccines. Although no global goal for measles eradication has been established, all six WHO regions have set measles elimination targets. However, a gap remains between current control levels and elimination targets, as shown by large measles outbreaks between 2017 and 2019. We aimed to model the potential for measles and rubella elimination globally to inform a WHO report to the 73rd World Health Assembly on the feasibility of measles and rubella eradication.
  
  Methods
  
  In this study, we modelled the probability of measles and rubella elimination between 2020 and 2100 under different vaccination scenarios in 93 countries of interest. We evaluated measles and rubella burden and elimination across two national transmission models each (Dynamic Measles Immunisation Calculation Engine [DynaMICE], Pennsylvania State University [PSU], Johns Hopkins University, and Public Health England models), and one subnational measles transmission model (Institute for Disease Modeling model). The vaccination scenarios included a so-called business as usual approach, which continues present vaccination coverage, and an intensified investment approach, which increases coverage into the future. The annual numbers of infections projected by each model, country, and vaccination scenario were used to explore if, when, and for how long the infections would be below a threshold for elimination.
  
  Findings
  
  The intensified investment scenario led to large reductions in measles and rubella incidence and burden. Rubella elimination is likely to be achievable in all countries and measles elimination is likely in some countries, but not all. The PSU and DynaMICE national measles models estimated that by 2050, the probability of elimination would exceed 75% in 14 (16%) and 36 (39%) of 93 modelled countries, respectively. The subnational model of measles transmission highlighted inequity in routine coverage as a likely driver of the continuance of endemic measles transmission in a subset of countries.
  
  Interpretation
  
  To reach regional elimination goals, it will be necessary to innovate vaccination strategies and technologies that increase spatial equity of routine vaccination, in addition to investing in existing surveillance and outbreak response programmes.
  
  
• Keywords:
  Disease Eradication Feasibility Studies Humans Measles Rubella United States Vaccination
• Source:
  Lancet Glob Health. 10(10):e1412-e1422
• Pubmed ID:
  36113527
• Pubmed Central ID:
  PMC9557212
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  10
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d51c154e332de24cb196f014e1d2d69ff5908371562f670287f5a5152dbff4d8
• Download URL:
  https://stacks.cdc.gov/view/cdc/121808/cdc_121808_DS1.pdf
• File Type:
  [PDF - 1.71 MB ]