Measles and measles-rubella vaccine support

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Number of measles deaths drop below 100,000 for the first time

Over 52 million children reached with a second dose of measles-rubella vaccine

More than 211 million children immunised through measles-rubella vaccination campaigns

Measles-rubella Tanzania

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

RECORD LOW NUMBER OF MEASLES DEATHS

In 2016, the number of measles deaths dropped to below 100,000 for the first time, an achievement that can largely be attributed to immunisation. However, coverage with the first dose of measles-containing vaccine in Gavi-supported countries has plateaued at 78% - a long way from the 95% herd-immunity target.

Coverage with a full course of rubella-containing vaccines in Gavi-supported countries amounted to 24% in 2017 - a 7 percentage point increase from the year before.

OVER 200 MILLION CHILDREN IMMUNISED

By the end of 2017, our support for a second dose of measles-rubella vaccine through the routine immunisation system had helped immunise more than 52 million children. This support provides a second opportunity to reach children who missed the first dose. It also produces immunity in the small number of people who failed to develop it after the first dose.

In order to have a long-term impact on both measles and rubella control, we have invested more than US$ 600 million in large-scale measles-rubella campaigns since 2012. This catalytic support requires countries to introduce MR vaccines into their routine system after a campaign.

So far, over 211 million children have been immunised through Gavi-supported measles-rubella campaigns. Initial, nationwide catch-up campaigns target all children aged 9 months to 14 years, while follow-up campaigns target children aged 9-59 months every 2-4 years. 

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

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

DISEASE BURDEN

Measles is a highly contagious virus and remains one of the top vaccine-preventable killers of children. Symptoms include high fever and a severe skin rash.

Thanks to the widespread introduction of measles vaccine, global measles deaths have fallen dramatically. Before 2001, more than 750,000 children died every year from measles. According to the WHO, global measles deaths fell by 84% between 2000 and 2016.

But even with this impressive decline, progress has stalled. Outbreaks continue across Africa and Europe, with children under the age of five most affected. More than 95% of measles deaths occur in low-income countries with weak health systems.

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. 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).

Every year, more than 100,000 babies are born with CRS  - the majority in Africa and South-East Asia. Although the rubella vaccine has been available since the 1970s, it is still underused in these regions.

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

NEW MEASLES AND RUBELLA STRATEGY

2017 marked the first year of Gavi-supported measles vaccine introductions and campaigns under our new measles and rubella strategy. The bulk of our support for measles vaccine is allocated towards the combined measles-rubella (MR) vaccine, which also provides protection against congenital rubella syndrome.

The revised approach involves increases in both vaccine support and introduction grants, as well as enhanced technical assistance from Alliance partners. It aims to help countries deliver high-quality plans, implementation and evaluation of routine programmes and campaigns. For instance, countries are required to conduct independent surveys to track campaign coverage.

During 2017 we increased our collaboration with the Measles & Rubella Initiative, with particular focus on the six countries with the largest number of children who are not reached with a first dose of measles vaccine. 

FOUR TYPES OF SUPPORT

Measles-rubella routine immunisation

Gavi supports a first and second dose of the MR vaccine. Countries contribute to the cost of these Gavi-supported vaccines by co-financing some of the required doses. 

Supporting a second dose of the vaccine provides a second opportunity to reach children who missed the first dose. It also produces immunity in the small number of persons who failed to develop it after the first dose.

Measles follow-up campaigns

Nationwide follow-up campaigns immunise children aged 9–59 months every 2–4 years with measles vaccine.

Measles-rubella mass, catch-up and follow-up campaigns

Gavi provides support for measles-rubella vaccine mass and catch-up campaigns before the vaccine is introduced into the routine system. The campaigns target children aged 9 months to 14 years. By catalysing the vaccine’s introduction into the routine immunisation system, they help to ensure long-term impact on both measles and rubella control efforts.

Measles outbreak response (through the Measles & Rubella Initiative)

Gavi provided 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 achieve the measles and rubella elimination goals outlined in the Global Vaccine Action Plan.

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