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Using Regular High-Quality Serosurveys to Identify and Close National Immunity Gaps-Measles and Rubella Elimination
Tomimasa Sunagawa1, Yusuke Kobayashi1, Yoshihiro Takashima2
1National Institute of Infectious Diseases, Tokyo 162-8640, Japan.
Abstract:
In Japan, periodic measles outbreaks occurred mainly among young children under the routine immunization program with one dose of the measles-containing vaccine (MCV). A second dose of MCV was introduced in 2006. During a nationwide measles resurgence in 2007-2008, the most affected age group was teenagers. The national serological surveillance for vaccine-preventable diseases made it clear that there was a measles immunity gap among teenagers who had not received a second dose of MCV. To fill this immunity gap, nationwide non-selective supplementary immunization activities (SIAs) were carried out as a five-year program from April 2008 to March 2013 by providing an opportunity to be vaccinated with the measles and rubella vaccine during the first year of junior high school (12-13 years old) and the last year of high school (17-18 years old). The SIA was conducted with the strong involvement of local governments in charge of vaccination delivery and collaboration between the health and education sectors. Japan was verified as achieving measles elimination in 2015 and this has been sustained to date. The challenge of rubella elimination following a similar strategy of a serological diagnosis of an immunity gap and targeted vaccination is also discussed.
Insights
Japan implemented supplementary immunization activities (SIAs) to address a measles immunity gap in teenagers. This strategy successfully eliminated measles, demonstrating effective public health intervention.
Area of Science:
- Public Health
- Epidemiology
- Immunization Programs
Background:
- Measles outbreaks in Japan primarily affected young children under the initial one-dose vaccination program.
- A measles resurgence in 2007-2008 highlighted a significant immunity gap in teenagers who had not received a second dose of the measles-containing vaccine (MCV).
Purpose of the Study:
- To address the identified measles immunity gap in the teenage population.
- To implement and evaluate supplementary immunization activities (SIAs) for measles and rubella vaccination.
Main Methods:
- Nationwide, non-selective supplementary immunization activities (SIAs) were conducted from April 2008 to March 2013.
- Vaccination opportunities were provided to junior high school (12-13 years) and high school (17-18 years) students.
- Collaboration between local governments, health, and education sectors was crucial for delivery.
Main Results:
- Japan achieved verified measles elimination in 2015, with sustained elimination to date.
- The SIAs successfully closed the measles immunity gap among teenagers.
Conclusions:
- Nationwide supplementary immunization activities effectively addressed measles immunity gaps.
- The strategy contributed to the successful elimination and sustained control of measles in Japan.
- Similar strategies are being considered for rubella elimination.
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