REDUCED VACCINATION AND THE RISK OF MEASLES AND OTHER CHILDHOOD INFECTIONS POST-EBOLA

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REDUCED VACCINATION AND THE RISK OF MEASLES AND OTHER CHILDHOOD INFECTIONS POST-EBOLA

Takahashi S¹, Metcalf CJ², Ferrari MJ³, Moss WJ⁴, Truelove SA⁴, Tatem AJ⁵, Grenfell BT⁶, Lessler J⁷.

¹Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA.
²Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA. Woodrow Wilson School, Princeton University, Princeton, NJ 08544, USA.
³Centre for Infectious Disease Dynamics, Pennsylvania State University, State College, PA 16801, USA.
⁴Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁵Department of Geography and Environment, University of Southampton, Southampton SO17 1BJ, UK. Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA. Flowminder Foundation, 17177 Stockholm, Sweden.
⁶Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA. Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA.
⁷Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. justin@jhu.edu.

Abstract below; full text is available to journal subscribers.

The Ebola epidemic in West Africa has caused substantial morbidity and mortality. The outbreak has also disrupted health care services, including childhood vaccinations, creating a second public health crisis. We project that after 6 to 18 months of disruptions, a large connected cluster of children unvaccinated for measles will accumulate across Guinea, Liberia, and Sierra Leone. This pool of susceptibility increases the expected size of a regional measles outbreak from 127,000 to 227,000 cases after 18 months, resulting in 2000 to 16,000 additional deaths (comparable to the numbers of Ebola deaths reported thus far). There is a clear path to avoiding outbreaks of childhood vaccine-preventable diseases once the threat of Ebola begins to recede: an aggressive regional vaccination campaign aimed at age groups left unprotected because of health care disruptions.