Measles vaccine support

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Second dose of measles vaccine introduced in 20 countries

118 million children reached through Gavi-supported measles catch-up campaigns

164 million children immunised with measles-rubella vaccine

Gavi supported a measles-rubella vaccine campaign in Cambodia in 2013.

Gavi supported a measles-rubella vaccine campaign in Cambodia in 2013. A few months later, the country introduced the vaccine into the routine immunisation system. Credit: Gavi/2013/Luc Forsyth.

Gavi impacts measles control through different types of support:

MEASLES SECOND DOSE

By the end of 2015, Gavi had supported a second dose of measles vaccine in 20 countries. To date, our support has helped countries immunise 32 million children.

MEASLES SUPPLEMENTARY IMMUNISATION ACTIVITIES (CATCH-UP CAMPAIGNS)

Gavi also funds measles campaigns in countries at risk of outbreaks. Since 2013, 118 million children have been protected from measles thanks to Gavi-funded campaigns.

MEASLES-RUBELLA

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. Continued investment in the combined measles-rubella vaccine will significantly reduce outbreaks and deaths from the two diseases.

Although measles is vaccine-preventable, it claims more than 100,000 lives every year

Measles is a highly contagious virus. Symptoms include high fever and a severe skin rash. Before 2001, more than 750,000 children died every year from measles.

According to the WHO, global measles deaths fell by 79% between 2000 and 2014. But even with this impressive decline, approximately 115,000 deaths occurred in 2014. Most of those who die from measles are children under the age of five.

More than 95% of measles deaths occur in low-income countries with weak health systems.

In places with large numbers of displaced people, malnourishment and poor health services, up to 10% of measles cases result in death. Measles weakens the immune system of those who are affected. This means it can also lead to other health problems such as pneumonia, blindness, diarrhoea and encephalitis.

Recent experience shows that failure to vaccinate enough children (93%–95%) can result in measles outbreaks. According to WHO, progress is stalled in the WHO Eastern Mediterranean region. This is because weak health systems, conflict and displacement have hampered vaccination efforts.

Meanwhile, the European region has seen measles re-emerge.1 According to the Centres for Disease Control, the United States experienced an increase in measles cases in 2014–2015.2 

There is also a resurgence of measles in Africa. This reinforces the importance of stronger routine immunisation services and timely measles campaigns.

PREVENTABLE WITH IMMUNISATION

Measles is preventable with immunisation. The vaccine is safe, effective and relatively inexpensive, and has existed for more than half a century. All children should receive two doses of the measles vaccine.

According to WHO, measles vaccination prevented an estimated 17.1 million deaths in the 2000–2014 period. This makes it one of the best buys in public health.


1 WHO press release: WHO warns that progress towards eliminating measles has stalled, 13 November 2014. Available at: http://www.who.int/mediacentre/news/releases/2014/eliminating-measles/en/. Accessed on: 8 September 2015.
2www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a1.htm

Gavi helps to protect against measles through four types of support

The Vaccine Alliance is working to counter the measles resurgence in four main ways:

1. Measles second dose

Countries can get support to introduce a second dose of measles vaccine into the routine system.

Providing a second opportunity for measles vaccination is a powerful tool to reach children who missed the first dose. It also produces measles immunity in the small number of persons who failed to develop it after the first dose.

2. Measles supplementary immunisation activities (catch-up campaigns)

In 2012, Gavi approved support for measles catch-up campaigns for six “high-risk” countries. Afghanistan, Chad, Ethiopia, the Democratic Republic of the Congo, Nigeria and Pakistan have received this type of support. From the September 2016 application round, this funding was extended to all Gavi-supported countries that need it.

3. Measles-rubella vaccine

Gavi provides support for the measles-rubella (MR) vaccine. This includes wide-age-range (9 month–14 year) catch-up campaigns with the vaccine.  Countries then finance and introduce the MR vaccine into their routine immunisation systems.

4. Measles outbreak response

Gavi provides US$ 55 million to the Measles & Rubella Initiative (M&RI, formerly the Measles Initiative) for the 2013–2017 period. The funding is used for outbreak response in Gavi-supported countries.  

M&RI is a global partnership committed to ensuring no child dies from measles or is born with congenital rubella syndrome. It is led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and WHO. The M&RI aims to reach the measles and rubella elimination goals of the Global Vaccine Action Plan.

New measles and rubella strategy

Over the past five years, measles vaccine coverage has stagnated in Gavi-supported countries at around 78%. At the same time, the number of outbreaks has increased – both in developing and industrialised countries.

In 2015, the Gavi Board approved a new strategy designed to reverse this trend and put countries back on track to control measles and rubella. Immunisation experts guiding the rethink include representatives from WHO, UNICEF, the United States Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation.

The new strategy came into effect ahead of the September 2016 application round. It puts routine immunisation at the centre of a comprehensive approach to tackling measles and rubella.

The new approach extends our support to include measles second dose and measles-rubella first and second dose. It also:

  • shifts support for campaigns from six large countries to all Gavi-supported countries that need it;
  • funds periodic follow-up measles or measles-rubella vaccine campaigns in all Gavi-supported countries; and
  • encourages better planned, more data-driven campaigns.

Gavi’s past investment in measles campaigns

In the 2004–2008 period, Gavi provided US$ 176 million to the Measles Initiative for measles campaigns. This support contributed to averting 860,000 future deaths.

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