Seasonal gaps in measles vaccination coverage in Madagascar
Vaccine·
- DOI
- 10.1016/j.vaccine.2019.02.069
- PMID
- 30940486
- PMCID
- PMC6466641
- OpenAlex
- W2934109675
- Study type
- Journal article
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings suggest that maintaining routine immunization during SIAs and VWs may be important for sustaining population immunity and preventing future measles outbreaks in Madagascar.
Structured evidence summary
Research question
The study examines how routine measles vaccination coverage in Madagascar fluctuates seasonally and how supplementary immunization activities (SIAs) and vaccination weeks (VWs) interact with routine services over time.
Study design
An observational analysis combining national administrative vaccination delivery data (2013–2016), digitized vaccination cards from 49 health centers across 6 districts, and a health worker survey, analyzed with linear regressions, ANOVA, and t-tests.
Population and setting
Children eligible for measles vaccination in Madagascar, with health facility data drawn from 49 health centers in 6 health districts between 2013 and 2016.
Main findings
Doses delivered rose during SIA and VW windows, but routine vaccination coverage declined in the months following these activities. Most missed vaccination opportunities occurred during the rainy season, and children born in June were least likely to be vaccinated on time.
Public-health relevance
The findings suggest that maintaining routine immunization during SIAs and VWs may be important for sustaining population immunity and preventing future measles outbreaks in Madagascar.
Important limitations
The summary is limited to the supplied single-article abstract and metadata; the original paper is needed to assess sample size, data completeness, and confounding, and to confirm generalizability beyond the six districts studied.
GIDS interpretation
The paper provides contextual evidence on drivers of subnational variation in measles vaccination coverage and timing in Madagascar, which could inform searches for immunization-program documentation; no link to a live surveillance signal is made.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.