Measles-rubella vaccine support

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Gavi’s support for measles-rubella vaccine is a game changer in the control of two deadly and debilitating diseases

Measles-rubella Tanzania

In 2014 Tanzania launched a nationwide campaign to protect 21 million children against measles and rubella. Credit: Gavi/2014/Karel Prinsloo.

Gavi provides support for large-scale catch-up campaigns with the measles‑rubella (MR) vaccine. This is done on the basis that countries then self-finance routine introductions of the vaccine.

Our support is a major step in accelerating global progress in the control of two life-threatening diseases.

By the end of 2015, 164 million children between 9 months and 14 years of age had been immunised with measles-rubella vaccine with Gavi support.

Gavi’s support for rubella is a game changer in the control of a disease that causes serious, life-long disabilities in infants.  

Dr Susan Reef, Medical Epidemiologist, Centers for Disease Control and Prevention

The largest Gavi supported MR campaign to date was in Bangladesh in January 2014. More than 53 million boys and girls were vaccinated in a single nationwide campaign.

Rubella infection in early pregnancy can result in foetal death or birth defects

Measles remains one of the top vaccine-preventable killers of children

Rubella is no longer the threat it once was in many countries, thanks to widespread vaccination. But for millions of mothers and their children in developing countries, it poses an ongoing danger.

According to WHO, more than 100,000 babies are born with congenital rubella syndrome each year. The majority are in Africa and South-East Asia. Although rubella vaccine has been available since the 1970s, it is still underused in these regions.

Measles is highly contagious and remains one of the top vaccine-preventable killers of children. Thanks to the widespread introduction of measles vaccine, global measles deaths have fallen dramatically. But progress has stalled and outbreaks continue in Africa and Europe.

DISEASE BURDEN

Rubella usually affects children and young adults. It is considered a mild illness, except in pregnant women. When a woman is infected with the rubella virus early in pregnancy, she has a 90% risk of passing the virus on to her foetus. This can cause miscarriage, stillbirth or severe birth defects known as congenital rubella syndrome (CRS).

Africa and South-East Asia have the highest number of estimated CRS cases. At the same time, they have the lowest uptake of rubella-containing vaccine. In 2015 more than 30 Gavi-supported countries, mostly in Africa, did not use rubella vaccine as part of their routine programmes.

Before 2001, more than 750,000 children died every year from measles, whose symptoms include high fever and a severe skin rash.

Global measles deaths fell by 79% from an estimated 562,000 in 2000 to approximately 115,000 in 2014. This was largely helped by the Measles & Rubella Initiative, a global partnership committed to ensuring no child dies from measles or is born with congenital rubella syndrome. Still, measles remains a pressing public health issue, which kills more than 300 people every day.

Gavi’s support for rubella vaccine benefits women’s and children’s health

The combined measles-rubella vaccine provides a 2-in-1 shot against two devastating diseases

THE VACCINE

Rubella vaccine gives long-term protection. It is often given in combination with measles vaccine in the form of measles‑rubella or measles‑mumps‑rubella vaccine.

WHO’s 2011 recommendation for universal immunisation against rubella supported a paradigm shift.

Earlier thinking had only focused on immunising adolescent girls and women of child-bearing age against rubella. The purpose was to decrease the risk of congenital rubella syndrome (CRS). But in many settings women were difficult to access. This led to limited vaccine coverage, and the rubella virus continued to circulate.

When routine childhood immunisation coverage is low, rubella continues to spread. Children remain susceptible into adulthood. The new approach uses wide-age-range campaigns followed by rapid routine introductions. The aim is to eliminate rubella and CRS over the long term.

SUSTAINING IMPACT

The measles-rubella vaccine is Gavi’s first support to address the two diseases at the same time. The programme builds on efforts by the Measles & Rubella Initiative.

Gavi is investing more than US$ 600 million in large-scale catch-up campaigns. The campaigns target children aged 9 months to 14 years. By embedding MR vaccine into the routine system they help to ensure long-term impact on both rubella and measles control efforts.

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