The introduction of 'No jab, No school' policy and the refinement of measles immunisation strategies in high-income countries
| Autor: | Stefano Merler, Filippo Trentini, Piero Poletti, Alessia Melegaro |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Adolescent Population Measles Vaccine lcsh:Medicine High coverage Measles Disease Outbreaks 03 medical and health sciences 0302 clinical medicine Mathematical model Environmental health medicine Humans 030212 general & internal medicine education Child Measles elimination education.field_of_study business.industry lcsh:R Infant General Medicine Measles immunisation High-income countries Models Theoretical medicine.disease Compulsory vaccination 3. Good health Vaccination Socioeconomic Factors Who guidelines Child Preschool School entry vaccination Female business High income countries COMPULSORY VACCINATION HIGH-INCOME COUNTRIES MATHEMATICAL MODEL MEASLES ELIMINATION SCHOOL ENTRY VACCINATION 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Medicine BMC Medicine, Vol 17, Iss 1, Pp 1-8 (2019) |
| Popis: | Background In recent years, we witnessed a resurgence of measles even in countries where, according to WHO guidelines, elimination should have already been achieved. In high-income countries, the raise of anti-vaccination movements and parental vaccine hesitancy are posing major challenges for the achievement and maintenance of high coverage during routine programmes. Italy and France approved new regulations, respectively in 2017 and 2018, aimed at raising immunisation rates among children by introducing mandatory vaccination at school entry. Methods We simulated the evolution of measles immunity profiles in seven distinct countries for the period 2018–2050 and evaluated the effect of possible adjustments of immunisation strategies adopted in the past on the overall fraction and age distribution of susceptible individuals in different high-income demographic settings. The proposed model accounts for country-specific demographic components, current immunity gaps and immunisation activities in 2018. Vaccination strategies considered include the enhancement of coverage for routine programmes already in place and the introduction of a compulsory vaccination at primary school entry in countries where universal school enrolment is likely achieved. Results Our model shows that, under current vaccination policies, the susceptible fraction of the population would remain below measles elimination threshold only in Singapore and South Korea. In the UK, Ireland, the USA and Australia either the increase of coverage of routine programmes above 95% or the introduction of a compulsory vaccination at school entry with coverage above 40% are needed to maintain susceptible individuals below 7.5% up to 2050. Although the implementation of mandatory vaccination at school entry would be surely beneficial in Italy, strategies targeting adults would also be required to avoid future outbreaks in this country. Conclusions Current vaccination policies are not sufficient to achieve and maintain measles elimination in most countries. Strategies targeting unvaccinated children before they enter primary school can remarkably enhance the fulfilment of WHO targets. Electronic supplementary material The online version of this article (10.1186/s12916-019-1318-5) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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