Progress in measles and rubella elimination in Iran

Area of Science:

• Public Health
• Epidemiology
• Immunization Programs

Background:

• Measles and rubella pose significant global health threats, necessitating robust control strategies.
• The Islamic Republic of Iran prioritized measles and rubella prevention, developing a national elimination strategy in 2002.
• A key component of Iran's strategy involved a mass immunization campaign using the measles-rubella (MR) vaccine.

Purpose of the Study:

• To review the outcomes of Iran's nationwide measles-rubella immunization campaign.
• To assess the progress made in the elimination of measles and rubella in Iran.
• To evaluate the impact of a comprehensive strategy on disease incidence.

Main Methods:

• Review of measles vaccination coverage data from 1980-2005.
• Analysis of supplemental immunization activities and national surveillance data.
• Evaluation of a nationwide serosurvey conducted post-campaign.

Main Results:

• A nationwide campaign in 2003 vaccinated 98% of individuals aged 5-25 years.
• Post-campaign serosurvey showed over 97.4% immunity to measles and rubella in the 5-40 age group.
• Measles incidence dramatically decreased, with most cases in immigrant communities; rubella surveillance identified 37 cases.

Conclusions:

• Iran's comprehensive measles and rubella elimination strategy significantly reduced disease incidence to less than 1 case per million.
• Sporadic measles and rubella transmission persists, particularly in immigrant and nomadic populations.
• Sustained high vaccination coverage and targeted interventions are crucial for continued elimination efforts.