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


Alyssa N. Sbarra, Institute for Health Metrics and Evaluation
Sam Rolfe, Institute for Health Metrics and Evaluation
Jason Q. Nguyen, Institute for Health Metrics and Evaluation
Lucas Earl, Institute for Health Metrics and Evaluation
Natalie C. Galles, Institute for Health Metrics and Evaluation
Ashley Marks, Institute for Health Metrics and Evaluation
Kaja M. Abbas, London School of Hygiene & Tropical Medicine
Mohsen Abbasi-Kangevari, Shahid Beheshti University of Medical Sciences
Hedayat Abbastabar, Advanced Diagnostic and Interventional Radiology Research Center
Foad Abd-Allah, Cairo University
Ahmed Abdelalim, Cairo University
Mohammad Abdollahi, The Institute of Pharmaceutical Sciences (TIPS)
Kedir Hussein Abegaz, Yakin Doğu Üniversitesi
Hailemariam Abiy Alemu Abiy, Debre Markos University
Hassan Abolhassani, Karolinska Universitetssjukhuset
Lucas Guimarães Abreu, Universidade Federal de Minas Gerais
Michael R.M. Abrigo, Philippine Institute for Development Studies
Abdelrahman I. Abushouk, Cleveland Clinic Foundation
Manfred Mario Kokou Accrombessi, London School of Hygiene & Tropical Medicine
Maryam Adabi, Hamadan University of Medical Sciences
Oladimeji M. Adebayo, University College Hospital, Ibadan
Victor Adekanmbi, King's College London
Olatunji O. Adetokunboh, Stellenbosch University
Davoud Adham, Ardabil University of Medical Sciences
Mohsen Afarideh, Mayo Clinic
Mohammad Aghaali, Qom University of Medical Sciences and Health Services
Tauseef Ahmad, Southeast University
Raman Ahmadi, Drug Applied Research Center, Tabriz University of Medical Sciences
Keivan Ahmadi, Lincoln Medical School
Muktar Beshir Ahmed, Jimma University
Fahad Mashhour Alanezi, Imam Abdulrahman Bin Faisal university
Turki M. Alanzi, Imam Abdulrahman Bin Faisal university

Document Type

Journal Article

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© 2020, The Author(s). 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.