title: Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination.
abstract: OBJECTIVE
  We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1-9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA).
  
  
  METHODS
  Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster.
  
  
  RESULTS
  Among the 7000 visited households, 75.8% had at least one child aged 1-9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1-4 years had significantly lower MR SIA coverage than those aged 5-9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8-9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001).
  
  
  CONCLUSIONS
  The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1-4 years and in regions with lower coverage.
authors.affiliation: Global Immunization Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Rania A
authors.initials: RA
authors.lastname: Tohme
authors.forename: Jeannot
authors.initials: J
authors.lastname: François
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wannemuehler
authors.forename: Roc
authors.initials: R
authors.lastname: Magloire
authors.forename: M Carolina
authors.initials: MC
authors.lastname: Danovaro-Holliday
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Cavallaro
authors.forename: David L
authors.initials: DL
authors.lastname: Fitter
authors.forename: Nora
authors.initials: N
authors.lastname: Purcell
authors.forename: Amber
authors.initials: A
authors.lastname: Dismer
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: John F
authors.initials: JF
authors.lastname: Vertefeuille
authors.forename: Terri B
authors.initials: TB
authors.lastname: Hyde
mesh_terms: D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006205:Haiti; D019538:Health Care Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D008457:Measles / Q000517:prevention & control*; D008458:Measles Vaccine; D012409:Rubella / Q000517:prevention & control*; D012411:Rubella Vaccine; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008458:Measles Vaccine; D012411:Rubella Vaccine
keywords: Estudio de cobertura; Haiti; Haití; Haïti; Rubeola; actividades suplementarias de inmunización; activité de vaccination supplémentaire; coverage survey; measles; rougeole; rubella; rubéole; sarampión; supplementary immunisation activity; surveillance de la couverture