Measles vaccination coverage in high-incidence areas of the Western Cape, following the mass vaccination campaign

• Published in: South African medical journal Vol. 103; no. 3; pp. 181 - 186
• Main Authors: Bernhardt, G L, Cameron, N A, Willems, B, Boulle, A, Coetzee, D
• Format: Journal Article
• Language: English
• Published: South Africa Health & Medical Publishing Group 01.03.2013
• Subjects: Adult; Caregivers - statistics & numerical data; Child, Preschool; Confidence Intervals; Data Collection; Disease Outbreaks - prevention & control; Female; Health aspects; Humans; Immunity - drug effects; Incidence; Infant; Male; Mass Vaccination - methods; Mass Vaccination - organization & administration; Mass Vaccination - statistics & numerical data; Measles; Measles - epidemiology; Measles - immunology; Measles - prevention & control; Measles Vaccine - therapeutic use; Outcome and Process Assessment (Health Care) - methods; Outcome and Process Assessment (Health Care) - statistics & numerical data; Prevention; South Africa - epidemiology; Vaccination; South Africa; South Africa, Western Cape
• ISSN: 0256-9574
• DOI: 10.7196/SAMJ.6196

Despite significant advances in measles control, large epidemics occurred in many African countries in 2009 - 2011, including South Africa. South Africa's control strategy includes mass vaccination campaigns about every 4 years, the last of which was conducted nationally in April 2010 and coincided with the epidemic. A community survey was conducted in the Western Cape to assess measles vaccination coverage attained by routine and campaign services, in children aged 6 months to 59 months at the time of the mass campaign, from high-incidence areas. Households were consecutively sampled in high-incidence areas identified using measles epidemic surveillance data. A caregiver history of campaign vaccination and routine vaccination status from the child's Road to Health card were collected. Pre- and post-campaign immunity was estimated by analytical methods. Of 8 332 households visited, there was no response at 3 435 (41.2%); 95.1% (1 711/1 800) of eligible households participated; and 91.2% (1 448/1 587; 95% confidence interval 86 - 94%) of children received a campaign vaccination. Before the campaign, 33.0% (103/312) of 9 - 17-month-olds had not received a measles vaccination, and this was reduced to 4.5% (14/312) after the campaign. Of the 1 587 children, 61.5% were estimated to have measles immunity before the campaign, and this increased to 94.0% after the campaign. Routine services had failed to achieve adequate herd immunity in areas with suspected highly mobile populations. Mass campaigns in such areas in the Western Cape significantly increased coverage. Extra vigilance is required to monitor and sustain adequate coverage in these areas.