Targeting zero measles in Pakistan: time to change the EPI schedule

ABSTRACT

Measles is a highly contagious disease with significant morbidity and mortality. Major epidemics have continued to occur over the last decade in many regions of the world. These epidemics have occurred in non-vaccinated and vaccinated children as well as in adults. Low vaccination coverage rates, receipt of less than two doses of measles vaccine, waning immunity and vaccine failures have been the main factors in the resurgence of measles. Health authorities have focused on different ways to reduce the transmission of this vaccine-preventable disease. In most industrialized countries high vaccine coverage [>80-90%], good surveillance and a two-dose vaccine strategy have reduced measles burden. High vaccination coverage and changing to a two-dose measles vaccination will greatly reduce disease transmission in endemic regions. World Health Organization's Expanded Program for Immunization has been modified to include two-dose measles coverage in some regions. In Pakistan the Expanded Program for Immunization also needs to be modified to adopt a 2-dose measles vaccination schedule