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Table 2 Mass vaccination response details *

From: Measles vaccination in humanitarian emergencies: a review of recent practice

Region/
Country
Time to response** Target Area Target Age Doses/
Coverage
Author's Reported Impact Documented Impact (authors' assessment)
AMERICAS       
Bolivia MV1: 1998 4 m after 1st case Nonselective
Nationwide
6 m -5 y 85% Persistent cases Epidemic ended after multiple immunization activities
MV2: 1999 house-to-house Nationwide 6 m - 4 y + 6 m - 14 y in 2 dpts 98% Persistent cases but decreased over time  
MV3: 2000 House-to-house
in high risk municipalities
N/A N/A N/A  
MV4: 2002 House to house 6 m - 4 y 95% Transmission stopped  
Haiti MV1: < 4 w after 1st case Nonselective
Provincial city
6 m - 14 y 95% No cases in city within 2 w of end of campaign; spread to rest of island Epidemic ended after multiple immunization activities
MV2: N/A Departments 6 m - 14 y 65 - 95% No cases after early August in department  
MV3: 5-9/00 Port-au-Prince 6 m - 14 y 82%   
MV4: 11/00-1/01 Port-au-Prince neighborhood 6 m - 14 y 80 - 90% Reduced number of
cases island-wide
 
MV5: 9-12/01 Nationwide N/A > 85% Measles transmission interrupted  
Colombia Various door to door vaccination in high risk municipalities 6 m-5 y N/A N/A but editorial suggests proactive response averted large outbreak Compared to outbreak in neighboring Venezuela, prompt, door to door targeted vaccination and surveillance may have prevented a large outbreak in a country where EPI is limited by long term conflict
ASIA       
Afghanistan 12/2001-5/2002 Nonselective, Central region districts and returning refugees in catchment area. Revaccination in districts with low coverage 6 m-12 y 77% (62-90%) by May 2002
63-92% by December 2002
Impact on incidence not assessed.
Campaign achieved high coverage despite many obstacles. Authors recommend vaccinating extended age groups in complex emergencies.
Unable to assess impact from data provided, but from WHO records measles incidence decreased dramatically for next 2 years.
India Soon after flood began Flood area, areas of congregation then cut-off villages 6 m to 14 y
Catch-up
75%
Catch-up:60%
Qualitative analysis on the vaccination in multiple stages. Initial one prevented large scale measles o/b and death, later stages contained smaller o/b and high mortality was prevented with a joint surveillance system Insufficient data
India Dec 29, 04 to Jan 9, 05 Non-selective, 58 villages in Namil-Tadu district, Eastern India 6 m to 60 m
No catch-up
117.2% Qualitative analysis transmission continued despite vaccine coverage and was unrelated to tsunami. Target age was too restrictive, recommendation to vaccinate children up to 14 years during complex emergencies like tsunami. Insufficient data
Sri Lanka N/A Nonselective
Refugee camps,
welfare centers,
preschools, & slums
Children " < 10 y" N/A N/A Not clear
AFRICA       
Niger Outreach services in some health centers N/A N/A N/A Impact not specified but authors discuss the need to include older than 5 y children in vaccination campaigns due to high CFR in this group. Insufficient information to determine impact
Tanzania Epidemic started in March, ORI were in April, June and August in 3 camps Nonselective, refugee camps. ORI:
6 m-5 y.
But new arrivals 6 m-15 y are routinely vaccinated
N/A 6 m-5 y campaign prevented cases and deaths, but to halt transmission, campaigns targeting a wider age group would have been more effective May have influenced epidemic. given large proportion of cases in older age groups, vaccinating up to age 15 early in the epidemic would have likely shortened the duration of the outbreaks.
Ethiopia Within 1 month Nonselective 9 m -5 y   Despite ORI in February measles cases continued to be reported in the district including among vaccinated. Recommend extending vaccinated age group to 12-15 y in acute emergencies. Epidemic was not halted until August when a vaccination campaign with grater coverage and efficacy implemented The authors calculate low coverage and poor efficacy of vaccine in February campaign. These alone could have allowed outbreak to continue, but including a wider age range for vaccination may have been useful in containing the outbreak. No age breakdown of cases available.
Mozambique Varied reactive SIAs Nonselective, targeted urban
(province capitals)
9 m-4 y   Measles campaigns had limited impact. Recommend increasing target age group and including rural areas linked to cities via transport routes. Campaigns may have had some impact, as noted by reduced caseload in subsequent years. Targeting a wider age group in catch up and outbreak campaigns could have had greater impact.
Niger Wk 24 after o/b LQAS selection, 46 lots of 65 children 6 m - 5 y Other SIAs after the survey: 99% SIA are a first response to reinforcement of routine immunization activities (children under 5) CFR = 3.3% (global o/b)
No data otherwise
Nigeria Wk 18 after o/b Non-selective 6 m - 5 y Other SIAs after the survey: 80% same  
Chad Wk 22 after o/b Non-selective 6 m - 5 y Other SIAs after the survey: 96% same  
South Africa Jan 04 Non-selective 6 m to 14 y
Catch-up: 9 m-4 y
Catch-up: 86% Importance of maintaining high immunity by means of routine immunization to prevent transmission following importation of the virus N/A
Tanzania 11 wks after o/b Non-selective 6 m to 14 y 882789 doses given
Administrative: 100%
Measured: 66%
Measles incidence declined in the targeted age group Incidence would have been high in the target group without intervention
Sudan 06/05/04 North Darfur only 9 m - 15 y 93% of the accessible pop
77% of the global
The restricted access to population and the low coverage explains that measles cases still occurred after the vaccination campaign. North Darfur: CFR = 17%
West Darfur: CFR = 14%
Similar results to other studies in comparable situations
EUROPE       
Albania 2 wks after o/b Only two districts (Kukes and Has) 6 m - 5 y 90% Surveillance system allowed for early epidemic detection N/A
  1. * Abbreviations contained in the body of the table: N/A = not available, d = day, w = week, m = month, y = year, o/b = outbreak, popn = population. For references of reports, see Table 1.
  2. ** In some cases, multiple rounds of vaccination were conducted. In this table, each round is designated by a number (ex, MV1).
  3. †Selective indicates that only children without evidence of vaccination were targeted; nonselective indicates that all children regardless of vaccination status were targeted