Mapping routine measles vaccination in low- and middle-income countries

Sbarra, A.N. and Rolfe, S. and Nguyen, J.Q. and Earl, L. and Galles, N.C. and Marks, A. and Abbas, K.M. and Abbasi-Kangevari, M. and Abbastabar, H. and Abd-Allah, F. and Abdelalim, A. and Abdollahi, M. and Abegaz, K.H. and Abiy, H.A.A. and Abolhassani, H. and Abreu, L.G. and Abrigo, M.R.M. and Abushouk, A.I. and Accrombessi, M.M.K. and Adabi, M. and Adebayo, O.M. and Adekanmbi, V. and Adetokunboh, O.O. and Adham, D. and Afarideh, M. and Aghaali, M. and Ahmad, T. and Ahmadi, R. and Ahmadi, K. and Ahmed, M.B. and Alanezi, F.M. and Alanzi, T.M. and Alcalde-Rabanal, J.E. and Alemnew, B.T. and Ali, B.A. and Ali, M. and Alijanzadeh, M. and Alinia, C. and Alipoor, R. and Alipour, V. and Alizade, H. and Aljunid, S.M. and Almasi, A. and Almasi-Hashiani, A. and Al-Mekhlafi, H.M. and Altirkawi, K.A. and Amare, B. and Amini, S. and Amini-Rarani, M. and Amiri, F. and Amit, A.M.L. and Amugsi, D.A. and Ancuceanu, R. and Andrei, C.L. and Anjomshoa, M. and Ansari, F. and Ansari-Moghaddam, A. and Ansha, M.G. and Antonio, C.A.T. and Antriyandarti, E. and Anvari, D. and Arabloo, J. and Arab-Zozani, M. and Aremu, O. and Armoon, B. and Aryal, K.K. and Arzani, A. and Asadi-Aliabadi, M. and Asgari, S. and Atafar, Z. and Ausloos, M. and Awoke, N. and Quintanilla, B.P.A. and Ayanore, M.A. and Aynalem, Y.A. and Azadmehr, A. and Azari, S. and Babaee, E. and Badawi, A. and Badiye, A.D. and Bahrami, M.A. and Baig, A.A. and Bakhtiari, A. and Balakrishnan, S. and Banach, M. and Banik, P.C. and Barac, A. and Baradaran-Seyed, Z. and Baraki, A.G. and Basu, S. and Bayati, M. and Bayou, Y.T. and Bedi, N. and Behzadifar, M. and Bell, M.L. and Berbada, D.A. and Berhe, K. and Bhattarai, S. and Bhutta, Z.A. and Bijani, A. and Birhanu, M. and Bisanzio, D. and Biswas, A. and Bohlouli, S. and Bolla, S.R. and Borzouei, S. and Brady, O.J. and Bragazzi, N.L. and Briko, A.N. and Briko, N.I. and Nagaraja, S.B. and Butt, Z.A. and Cámera, L.A. and Campos-Nonato, I.R. and Car, J. and Cárdenas, R. and Carvalho, F. and Castaldelli-Maia, J.M. and Castro, F. and Chattu, V.K. and Chehrazi, M. and Chin, K.L. and Chu, D.-T. and Cook, A.J. and Cormier, N.M. and Cunningham, B. and Dahlawi, S.M.A. and Damiani, G. and Dandona, R. and Dandona, L. and Danovaro, M.C. and Dansereau, E. and Daoud, F. and Darwesh, A.M. and Darwish, A.H. and Das, J.K. and Weaver, N.D. and De Neve, J.-W. and Demeke, F.M. and Demis, A.B. and Denova-Gutiérrez, E. and Desalew, A. and Deshpande, A. and Desta, D.M. and Dharmaratne, S.D. and Dhungana, G.P. and Dianatinasab, M. and Diaz, D. and Dipeolu, I.O. and Djalalinia, S. and Do, H.T. and Dorostkar, F. and Doshmangir, L. and Doyle, K.E. and Dunachie, S.J. and Duraes, A.R. and Kalan, M.E. and Leylabadlo, H.E. and Edinur, H.A. and Effiong, A. and Eftekhari, A. and El Sayed, I. and El Sayed Zaki, M. and Elema, T.B. and Elhabashy, H.R. and El-Jaafary, S.I. and Elsharkawy, A. and Emamian, M.H. and Enany, S. and Eshrati, B. and Eskandari, K. and Eskandarieh, S. and Esmaeilnejad, S. and 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and Keiyoro, P.N. and Khader, Y.S. and Khafaie, M.A. and Khammarnia, M. and Khan, M.S. and Khan, E.A. and Khan, J. and Khan, M.N. and Khatab, K. and Khater, M.M. and Khatib, M.N. and Khayamzadeh, M. and Khazaei, M. and Khazaei, S. and Khosravi, A. and Khubchandani, J. and Kianipour, N. and Kim, Y.J. and Kimokoti, R.W. and Kinyoki, D.K. and Kisa, A. and Kisa, S. and Kolola, T. and Komaki, H. and Kosen, S. and Koul, P.A. and Koyanagi, A. and Kraemer, M.U.G. and Krishan, K. and Kuate Defo, B. and Kumar, M. and Kumar, P. and Kumar, G.A. and Kusuma, D. and La Vecchia, C. and Lacey, B. and Lad, S.D. and Lal, D.K. and Lam, F. and Lami, F.H. and Lansingh, V.C. and Larson, H.J. and Lasrado, S. and Lee, S.W.H. and Lee, P.H. and LeGrand, K.E. and Lenjebo, T.L. and Li, S. and Liang, X. and Liu, P.Y. and Lopukhov, P.D. and Machado, D.B. and Mahasha, P.W. and Mahdavi, M.M. and Maheri, M. and Mahotra, N.B. and Maled, V. and Maleki, S. and Malik, M.A. and Malta, D.C. and Mansour-Ghanaei, F. and 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F. and Zerfu, T.A. and Zhang, Y. and Zhang, Z.-J. and Zhao, X.-J.G. and Zhou, M. and Ziapour, A. and Hay, S.I. and Lim, S.S. and Mosser, J.F. and of Disease Vaccine Coverage Collaborators, Local Burden Mapping routine measles vaccination in low- and middle-income countries. Nature.

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Abstract

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99 of both occurred in low- and middle-income countries (LMICs)1�4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5�8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 � 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80 coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children. © 2020, The Author(s).

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