Evaluating the effect of measles and rubella mass vaccination campaigns on seroprevalence in India: a before-and-after cross-sectional household serosurvey in four districts, 2018-2020.

India did phased measles-rubella supplementary immunisation activities (MR-SIAs; ie, mass-immunisation campaigns) targeting children aged 9 months to less than 15 years. We estimated measles-rubella seroprevalence before and after the MR-SIAs to quantify the effect on population immunity and identify remaining immunity gaps. Between March 9, 2018 and March 19, 2020 we did community-based, cross-sectional serosurveys in four districts in India before and after MR-SIAs. 30 villages or wards were selected within each district, and one census enumeration block from each was selected as the survey cluster. Households were enumerated and 13 children in the younger age group (9 months to <5 years) and 13 children in the older ager group (5 to <15 years) were randomly selected by use of computer-generated random numbers. Serum samples were tested for IgG antibodies to measles and rubella viruses by enzyme immunoassay. Specimens were collected from 2570 children before the MR-SIA and from 2619 children afterwards. The weighted MR-SIA coverage ranged from 73·7% to 90·5% in younger children and from 73·6% to 93·6% in older children. Before the MR-SIA, district-level measles seroprevalence was between 80·7% and 88·5% among younger children in all districts, and between 63·4% and 84·5% among older children. After the MR-SIA, measles seroprevalence among younger children increased to more than 90% (range 91·5 to 96·0) in all districts except Kanpur Nagar, in which it remained unchanged 80·4%. Among older children, measles seroprevalence increased to more than 90·0% (range 93·7% to 96·5%) in all districts except Hoshiarpur (88·7%). A significant increase in rubella seroprevalence was observed in all districts in both age groups, with the largest effect in Dibrugarh, where rubella seroprevalence increased from 10·6% to 96·5% among younger children. Measles-rubella seroprevalence increased substantially after the MR-SIAs but the serosurvey also identified remaining gaps in population immunity. The Bill & Melinda Gates Foundation and Indian Council of Medical Research.

Murhekar MV ，Gupta N ，Hasan AZ ，Kumar MS ，Kumar VS ，Prosperi C ，Sapkal GN ，Thangaraj JWV ，Kaduskar O ，Bhatt V ，Deshpande GR ，Thankappan UP ，Bansal AK ，Chauhan SL ，Grover GS ，Jain AK ，Kulkarni RN ，Sharma SK ，Chaaithanya IK ，Kharwal S ，Mishra SK ，Salvi NR ，Sharma S ，Sarmah NP ，Sabarinathan R ，Duraiswamy A ，Rani DS ，Kanagasabai K ，Lachyan A ，Gawali P ，Kapoor M ，Shrivastava AK ，Chonker SK ，Tilekar B ，Tandale BV ，Ahmad M ，Sangal L ，Winter A ，Mehendale SM ，Moss WJ ，Hayford K ... -  《Lancet Global Health》

Post-campaign coverage evaluation of a measles and rubella supplementary immunization activity in five districts in India, 2019-2020.

In alignment with the Measles and Rubella (MR) Strategic Elimination plan, India conducted a mass measles and rubella vaccination campaign across the country between 2017 and 2020 to provide a dose of MR containing vaccine to all children aged 9 months to 15 years. We estimated campaign vaccination coverage in five districts in India and assessed campaign awareness and factors associated with vaccination during the campaign to better understand reasons for not receiving the dose. Community-based cross-sectional serosurveys were conducted in five districts of India among children aged 9 months to 15 years after the vaccination campaign. Campaign coverage was estimated based on home-based immunization record or caregiver recall. Campaign coverage was stratified by child- and household-level risk factors and descriptive analyses were performed to assess reasons for not receiving the campaign dose. Three thousand three hundred and fifty-seven children aged 9 months to 15 years at the time of the campaign were enrolled. Campaign coverage among children aged 9 months to 5 years documented or by recall ranged from 74.2% in Kanpur Nagar District to 90.4% in Dibrugarh District, Assam. Similar coverage was observed for older children. Caregiver awareness of the campaign varied from 88.3% in Hoshiarpur District, Punjab to 97.6% in Dibrugarh District, Assam, although 8% of children whose caregivers were aware of the campaign were not vaccinated during the campaign. Failure to receive the campaign dose was associated with urban settings, low maternal education, and lack of school attendance although the associations varied by district. Awareness of the MR vaccination campaign was high; however, campaign coverage varied by district and did not reach the elimination target of 95% coverage in any of the districts studied. Areas with lower coverage among younger children must be prioritized by strengthening the routine immunization programme and implementing strategies to identify and reach under-vaccinated children.

Thangaraj JWV ，Prosperi C ，Kumar MS ，Hasan AZ ，Kumar VS ，Winter AK ，Bansal AK ，Chauhan SL ，Grover GS ，Jain AK ，Kulkarni RN ，Sharma SK ，Soman B ，Chaaithanya IK ，Kharwal S ，Mishra SK ，Salvi NR ，Sarmah NP ，Sharma S ，Varghese A ，Sabarinathan R ，Duraiswamy A ，Rani DS ，Kanagasabai K ，Lachyan A ，Gawali P ，Kapoor M ，Chonker SK ，Sangal L ，Mehendale SM ，Sapkal GN ，Gupta N ，Hayford K ，Moss WJ ，Murherkar MV ... -  《PLoS One》

Added value of the measles-rubella supplementary immunization activity in reaching unvaccinated and under-vaccinated children, a cross-sectional study in five Indian districts, 2018-20.

Prosperi C ，Thangaraj JWV ，Hasan AZ ，Kumar MS ，Truelove S ，Kumar VS ，Winter AK ，Bansal AK ，Chauhan SL ，Grover GS ，Jain AK ，Kulkarni RN ，Sharma SK ，Soman B ，Chaaithanya IK ，Kharwal S ，Mishra SK ，Salvi NR ，Sharma NP ，Sharma S ，Varghese A ，Sabarinathan R ，Duraiswamy A ，Rani DS ，Kanagasabai K ，Lachyan A ，Gawali P ，Kapoor M ，Chonker SK ，Cutts FT ，Sangal L ，Mehendale SM ，Sapkal GN ，Gupta N ，Hayford K ，Moss WJ ，Murhekar MV ... -  《-》

Evaluation of nationwide supplementary immunization in Lao People's Democratic Republic: Population-based seroprevalence survey of anti-measles and anti-rubella IgG in children and adults, mathematical modelling and a stability testing of the vaccine.

Hachiya M ，Miyano S ，Mori Y ，Vynnycky E ，Keungsaneth P ，Vongphrachanh P ，Xeuatvongsa A ，Sisouk T ，Som-Oulay V ，Khamphaphongphane B ，Sengkeopaseuth B ，Pathammavong C ，Phounphenghak K ，Kitamura T ，Takeda M ，Komase K ... -  《PLoS One》

Measles and rubella serosurvey identifies rubella immunity gap in young adults of childbearing age in Zambia: The added value of nesting a serological survey within a post-campaign coverage evaluation survey.

Serological surveys can potentially complement vaccine coverage surveys, such as post-vaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. We estimate age-specific population immunity to measles and rubella viruses in Southern Province, Zambia, and assess the value of adding serological data to vaccination coverage estimates by nesting a serological survey within a PCES. Dried blood spots (DBS) from fingerprick blood were collected from all individuals ages nine months or older in households participating in the PCES and tested for measles and rubella virus-specific immunoglobulin G (IgG) by enzyme immunoassay (Siemens Enzygnost, Marburg, Germany). Overall seroprevalence was 95.5% (95% CI: 92.8, 97.2) for measles virus-specific IgG and 97.7% (95% CI: 96.0, 98.7) for rubella virus-specific IgG. Rubella seroprevalence was 98.4% (95% CI: 95.9, 99.4) among children eligible for the MR vaccination campaign, significantly higher than the reported measles-rubella (MR) vaccination campaign coverage of 89.8% (p = 0.003), and higher than the 91.3% rubella seroprevalence for adolescents and adults 16-30 years of age (p = 0.049). Seroprevalence to measles and rubella viruses in children younger than 16 years of age was significantly higher than expected from vaccination coverage estimates, likely reflecting exposure to wild-type viruses and underreporting of vaccination. The serosurvey revealed rubella immunity gaps among women 16-30 years of age, precisely the age group in which protection from rubella is most important to prevent congenital rubella syndrome. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs.

Hayford K ，Mutembo S ，Carcelen A ，Matakala HK ，Munachoonga P ，Winter A ，Wanyiri JW ，Searle K ，Mwansa FD ，Mwiche A ，Phiri C ，Book C ，Thuma PE ，Moss WJ ... -  《-》