4.7 Article

Measles in the 21st Century: Progress Toward Achieving and Sustaining Elimination

期刊

JOURNAL OF INFECTIOUS DISEASES
卷 224, 期 -, 页码 S420-S428

出版社

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiaa793

关键词

measles; measles; mumps; rubella vaccine; MMR; elimination; eradication

资金

  1. Bill and Melinda Gates Foundation

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The global measles vaccination program has been successful in reducing measles-related diseases and deaths worldwide. Routine immunization with measles-containing vaccines has significantly decreased measles incidence and mortality globally. However, the recent global measles resurgence highlights the importance of maintaining high vaccination coverage and strengthening efforts to achieve measles elimination.
The global measles vaccination program has been extraordinarily successful in reducing measles-related disease and deaths worldwide. Eradication of measles is feasible because of several key attributes, including humans as the only reservoir for the virus, broad access to diagnostic tools that can rapidly detect measles-infectious persons, and availability of highly safe and effective measles-containing vaccines (MCVs). All 6 World Health Organization (WHO) regions have established measles elimination goals. Globally, during 2000-2018, measles incidence decreased by 66% (from 145 to 49 cases per million population) and deaths decreased by 73% (from 535 600 to 142 300), drastically reducing global disease burden. Routine immunization with MCV has been the cornerstone for the control and prevention of measles. Two doses of MCV are 97% effective in preventing measles, qualifying MCV as one of the most effective vaccines ever developed. Mild adverse events occur in <20% of recipients and serious adverse events arc extremely rare. 'I he economic benefits of measles vaccination are highlighted by an overall return on investment of 58 times the cost of the vaccine, supply chains, and vaccination. Because measles is one of the most contagious human diseases, maintenance of high (>= 95%) 2-dose MCV coverage is crucial for controlling the spread of measles and successfully reaching measles elimination; however, the plateauing of global MCV coverage for nearly a decade and the global measles resurgence during 2018-2019 demonstrate that much work remains. Global commitments to increase community access to and demand for immunizations, strengthen national and regional partnerships for building public health infrastructure, and implement innovations that can overcome access barriers and enhance vaccine confidence, are essential to achieve a world free of measles.

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