Measles vaccine coverage estimates in an outbreak three years after the nation-wide campaign in China: implications for measles elimination, 2013

BMC Infectious Diseases

Lidong Gao⁶  Huiming Luo⁴  Junhua Li⁶  Li Li⁴  Huaqing Wang⁴  Shanliang Xiao⁵  Bosong Guo¹  Lance Rodewald²  Qiru Su⁴  Lixin Hao⁴  Yanhua Yang⁶  Mengjuan Duan⁴  Hong Zhang⁶  Xiang Zheng³  Fangjun Li⁶  Chao Ma⁴ 

[1]Longhui County Center for Disease Control and Prevention, Shaoyang, Hu Nan province, China

[2]World Health Organization Office in China, Beijing, China

[3]Taizhou Prefecture Center for Disease Control and Prevention, Taizhou, Zhe Jiang province, China

[4]National Immunization Programme, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, China

[5]Shaoyang Prefecture Center for Disease Control and Prevention, Shaoyang, Hu Nan province, China

[6]Hunan Province Center for Disease Control and Prevention, Changsha, Hu Nan province, China

关键词: China;    Elimination;    Estimation;    Coverage;    Vaccination;    Measles;   

Others  :  1089840
DOI  :  10.1186/s12879-015-0752-z

 received in 2014-10-27, accepted in 2015-01-12,  发布年份 2015

【 摘 要 】

Background

China is approaching measles elimination, but indigenous measles still circulates. County L in China has reported measles-containing vaccine (MCV) coverage rates >95% since 2000. Despite high reported coverage, a large measles outbreak occurred among young children in L County. We measured MCV coverage using 5 different methods during an investigation on this outbreak and compared our estimates with reported rates.

Methods

Reported coverage rates are determined by aggregating clinic-based data across the county: doses administered in each clinic divided by the number of children registered in each clinic. Our methods estimated coverage for the 2010–2012 birth cohort, and were (1) administrative method: doses administered in clinics divided by the birth cohort recorded in the Statistical Year Book, (2) house-to-house convenience-sample survey of children living near cases, (3) vaccination clinic records review, (4) determination of a convenience sample of measles outbreak cases’ vaccination statuses and using the field vaccine efficacy outbreak equation to estimate population coverage, and (5) a seroprevalence survey using a convenience sample of residual blood samples from hospitals.

Results

The measles outbreak totaled 215 cases, representing an incidence of 195.8 per million population. Our estimated MCV coverage rates were: (1) administrative method: 84.1%-87.0% for MCV1 and 80.3%-90.0% for MCV2, (2) in-house survey: 83.3% of 9–17 month children received MCV1, and 74.5% of 24–47 month children received MCV2, (3) clinic record review: 85.5% of 9–17 month children received MCV1, and 73.2% of 24–59 month children received MCV2, (4) field VE method: 83.6% of 9–47 month children received one or more MCV doses, and (5) serology: seropositive rates were <80% in the 12–17 and 18–23 month age cohorts.

Conclusions

Compared with reported coverage >95%, our 5 coverage assessments all showed substantially lower coverage. China should evaluate guidelines for reporting vaccination coverage and identify feasible improvements to the assessment methods.

【 授权许可】

   
2015 Ma et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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