Reaching hard-to-reach individuals: Nonselective versus targeted outbreak response vaccination for measles

Andrea Minetti, Northan Hurtado, Rebecca F. Grais, Matthew Ferrari

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Current mass vaccination campaigns in measles outbreak response are nonselective with respect to the immune status of individuals. However, the heterogeneity in immunity, due to previous vaccination coverage or infection, may lead to potential bias of such campaigns toward those with previous high access to vaccination and may result in a lower-than-expected effective impact. During the 2010 measles outbreak in Malawi, only 3 of the 8 districts where vaccination occurred achieved a measureable effective campaign impact (i.e., a reduction in measles cases in the targeted age groups greater than that observed in nonvaccinated districts). Simulation models suggest that selective campaigns targeting hard-to-reach individuals are of greater benefit, particularly in highly vaccinated populations, even for low target coverage and with late implementation. However, the choice between targeted and nonselective campaigns should be context specific, achieving a reasonable balance of feasibility, cost, and expected impact. In addition, it is critical to develop operational strategies to identify and target hard-to-reach individuals.

Original languageEnglish (US)
Pages (from-to)245-251
Number of pages7
JournalAmerican journal of epidemiology
Volume179
Issue number2
DOIs
StatePublished - Jan 15 2014

All Science Journal Classification (ASJC) codes

  • Epidemiology

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