title: Measles vaccination coverage in high-incidence areas of the Western Cape, following the mass vaccination campaign.
abstract: BACKGROUND
  Despite significant advances in measles control, large epidemics occurred in many African countries in 2009 - 2011, including South Africa. South Africa's control strategy includes mass vaccination campaigns about every 4 years, the last of which was conducted nationally in April 2010 and coincided with the epidemic.
  
  
  OBJECTIVE
  A community survey was conducted in the Western Cape to assess measles vaccination coverage attained by routine and campaign services, in children aged 6 months to 59 months at the time of the mass campaign, from high-incidence areas.
  
  
  METHODS
  Households were consecutively sampled in high-incidence areas identified using measles epidemic surveillance data. A caregiver history of campaign vaccination and routine vaccination status from the child's Road to Health card were collected. Pre- and post-campaign immunity was estimated by analytical methods.
  
  
  RESULTS
  Of 8 332 households visited, there was no response at 3 435 (41.2%); 95.1% (1 711/1 800) of eligible households participated; and 91.2% (1 448/1 587; 95% confidence interval 86 - 94%) of children received a campaign vaccination. Before the campaign, 33.0% (103/312) of 9 - 17-month-olds had not received a measles vaccination, and this was reduced to 4.5% (14/312) after the campaign. Of the 1 587 children, 61.5% were estimated to have measles immunity before the campaign, and this increased to 94.0% after the campaign.
  
  
  CONCLUSIONS
  Routine services had failed to achieve adequate herd immunity in areas with suspected highly mobile populations. Mass campaigns in such areas in the Western Cape significantly increased coverage. Extra vigilance is required to monitor and sustain adequate coverage in these areas.
authors.affiliation: University of Cape Town, South Africa. ginably@gmail.com
authors.forename: G L
authors.initials: GL
authors.lastname: Bernhardt
authors.forename: N A
authors.initials: NA
authors.lastname: Cameron
authors.forename: B
authors.initials: B
authors.lastname: Willems
authors.forename: A
authors.initials: A
authors.lastname: Boulle
authors.forename: D
authors.initials: D
authors.lastname: Coetzee
mesh_terms: D000328:Adult; D017028:Caregivers / Q000706:statistics & numerical data; D002675:Child, Preschool; D016001:Confidence Intervals; D003625:Data Collection; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D015994:Incidence; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data; D008457:Measles / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D008458:Measles Vaccine / Q000627:therapeutic use*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology
chemical_list: D008458:Measles Vaccine