Progress Toward Measles Elimination - Eastern Mediterranean Region, 2013-2019

Area of Science:

• Public Health
• Epidemiology
• Vaccinology

Background:

• The World Health Organization (WHO) Eastern Mediterranean Region (EMR) committed to measles elimination in 1997, with this goal prioritized in the Eastern Mediterranean Vaccine Action Plan 2016-2020 (EMVAP).
• A four-pronged strategy was developed: achieving 95% coverage for the first (MCV1) and second (MCV2) doses of measles-containing vaccine, implementing high-quality surveillance, and ensuring optimal clinical case management.

Purpose of the Study:

• To describe progress toward measles elimination in the EMR between 2013 and 2019.
• To update previous reports on measles control efforts in the region.

Main Methods:

• Analysis of estimated vaccination coverage rates for MCV1 and MCV2 from 2013 to 2018.
• Review of data on measles-containing vaccine administration during Supplementary Immunization Activities (SIAs) from 2013 to 2019.
• Examination of reported confirmed measles incidence and non-measles case discard rates from 2013 to 2019.

Main Results:

• Estimated MCV1 coverage rose from 79% in 2013 to 82% in 2018; MCV2 coverage increased from 59% to 74% during the same period.
• Approximately 326.4 million children received MCV through SIAs between 2013 and 2019.
• Reported measles incidence increased from 33.5 per million in 2013 to 91.2 in 2018, with a decrease to 23.3 in 2019, despite significant outbreaks in Pakistan, Somalia, and Yemen. The rate of discarded non-measles cases was 5.4 per 100,000 in 2019.

Conclusions:

• Significant progress in vaccination coverage and SIA implementation has been made, but measles incidence remains a concern, particularly with outbreaks in specific countries.
• Achieving measles elimination requires enhanced visibility of efforts, sustained and predictable investments in vaccination campaigns, improved surveillance, and targeted interventions for at-risk populations.