Classification of measles cases from 2014 to 2018: Implications for progress towards measles elimination in China |
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| Affiliation: | 1. Accelerated Disease Control and Surveillance Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States;2. Immunisation and Vaccine Development Program, Regional Office for Africa, World Health Organization, Brazzaville, People’s Republic of Congo;3. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States;4. Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland;5. Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;6. Hubert Department of Global Health, Rollins School of Public Health, Emory University, United States;7. Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, United States;8. Bill and Melinda Gates Foundation, Seattle, Washington, United States;9. School of Medicine and Public Health, University of Newcastle, Australia;1. Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan;2. Departments of Pediatrics, National Taiwan University Children''s Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;1. Accelerated Disease Control and Surveillance Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;3. School of Medicine and Public Health, University of Newcastle, Australia;4. Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA;5. Viral Vaccine Preventable Diseases Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;6. Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA;7. Immunisation and Vaccine Development Program, Regional Office for Africa, World Health Organization, Brazzaville, Republic of the Congo;8. Expanded Programme on Immunization, Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland;9. Bill and Melinda Gates Foundation, Seattle, WA, USA;1. Servicio de Pediatría, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain;2. National Reference Laboratory for Measles and Rubella Elimination, National Centre for Microbiology, Institute of Health Carlos III, 28220 Majadahonda, Spain;3. Laboratorio Regional de Salud Pública, Comunidad de Madrid, 28052 Madrid, Spain;4. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain |
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| Abstract: | Measles incidence has decreased dramatically in China due to the implement of measles-containing vaccine (MCV). However, a measles epidemic caused resurgence recently, even among vaccinated individuals. To evaluate the effectiveness of current immunization programs and discuss initiatives for the next step in measles elimination in mainland China, the characteristics of 121,969 laboratory-confirmed measles cases reported in the measles surveillance system (MSS) during 2014–2018 were analyzed according to the vaccination status of the cases in this study.Children under 2 years of age without MCV vaccination (44,424, 36.42% of all cases) and adults over 20 years of age with an unknown vaccination history (37,564, 30.80% of all cases) accounted for the majority of measles cases from 2014 to 2018. 42,425 (34.78%) of the 77,384 cases with available vaccination information were categorized as programmatically preventable. 38,840 (91.55%) of the 42,425 cases were aged ≥8 months without the MCV vaccination history. 34,959 (28.66%) cases were categorized as programmatically non-preventable, of whom 22,611 (64.68%) were too young to receive their first MCV dose, 6857 (19.61%) received their first dose and were too young to receive their second dose, 5491 (15.71%) received at least two doses of MCV.15,933 (13.06%) of the 121,969 cases had a history of MCV vaccination. Measles virus infection in cases with an MCV vaccination history mainly occurred within the first month after MCV vaccination, especially in those who received a one-dose measles vaccination. MCV vaccination could reduce the frequencies of clinical symptoms and complications of measles cases.Our study confirmed that the current measles immunization programs used in mainland China is effective in reducing the measles incidence in China. Unvaccinated infants/children aged 8–23 months and high risk susceptible adults over 20 years of age with unknown vaccination histories should be the focus groups of measles immunization activities in China in the future. |
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| Keywords: | Measles Measles-containing vaccine Vaccination status |
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