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The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya
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Mburu, C. N., Ojal, J., Chebet, R., Akech, D., Karia, B., Tuju, J., Sigilai, A., Abbas, K., Jit, M., Funk, S., Smits, G., van Gageldonk, P. G. M., van der Klis , F. R. M., Tabu, C., Nokes, D. James, LSHTM CMMID COVID19 Working Group, , Scott, J. A. G., Flasche, S. and Adetifa, I. M. O. (2021) The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya. BMC Medicine, 19 . 35. doi:10.1186/s12916-021-01906-9 ISSN 1741-7015.
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Official URL: https://doi.org/10.1186/s12916-021-01906-9
Abstract
Background:
The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during the pandemic in Kenya as a case study for the African Region.
Methods:
Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020.
Results:
In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8–54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19–54), 46% (30–59), and 54% (43–64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25–56), 54% (43–63), and 67% (59–72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives.
Conclusion:
While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RJ Pediatrics |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | |||||||||
| Library of Congress Subject Headings (LCSH): | COVID-19 Pandemic, 2020- -- Kenya, Immunization of children -- Kenya, Measles -- Vaccination -- Kenya | |||||||||
| Journal or Publication Title: | BMC Medicine | |||||||||
| Publisher: | BioMed Central Ltd. | |||||||||
| ISSN: | 1741-7015 | |||||||||
| Official Date: | 3 February 2021 | |||||||||
| Dates: |
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| Volume: | 19 | |||||||||
| Article Number: | 35 | |||||||||
| DOI: | 10.1186/s12916-021-01906-9 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Date of first compliant deposit: | 25 January 2021 | |||||||||
| Date of first compliant Open Access: | 25 January 2021 | |||||||||
| RIOXX Funder/Project Grant: |
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