Top 5 Takeaways

1. Significant progress in measles vaccination coverage: From 2003 to 2020, estimated coverage for the first and second doses of measles-containing vaccine (MCV1 and MCV2) in the South-East Asia Region (SEAR) increased from 65% to 88% and from 6% to 80%, respectively.
2. Decline in measles incidence and deaths: Reported measles incidence declined by 92%, and measles vaccination averted an estimated 9.3 million deaths. The annual measles death rate decreased by 97%.
3. Five countries achieved measles elimination by 2020: Bhutan, Maldives, North Korea, Sri Lanka, and Timor-Leste were verified as having eliminated measles.
4. Impact of COVID-19 on vaccination coverage: The COVID-19 pandemic led to a decrease in routine measles vaccine (MCV1 and MCV2) coverage and a decline in measles surveillance sensitivity across the region.
5. Urgent efforts needed for 2023 elimination goal: To achieve the revised goal of eliminating both measles and rubella by 2023, intensified efforts are required to strengthen routine immunization services, improve vaccine coverage, conduct high-quality supplementary immunization activities (SIAs), and enhance surveillance and laboratory capacity.

Original Article Author and Citation

Corresponding Author

Sudhir Khanal, khanals@who.int.

Suggested Citation

Khanal S, Kassem AM, Bahl S, et al. Progress Toward Measles Elimination — South-East Asia Region, 2003–2020. MMWR Morb Mortal Wkly Rep 2022;71:1042–1046. DOI: http://dx.doi.org/10.15585/mmwr.mm7133a2.

Summary

During 2003–2020, all countries in SEAR introduced MCV2, with significant increases in MCV1 and MCV2 coverage. The region saw a dramatic decline in reported measles cases and deaths, with five countries eliminating measles by 2020. However, the COVID-19 pandemic negatively impacted measles vaccination coverage and surveillance, highlighting the need for urgent action to meet the 2023 elimination goal.

Methods

This report uses administrative data and surveys from WHO and UNICEF to estimate vaccine coverage, along with case-based surveillance data, to track progress in measles elimination efforts in SEAR. It also utilizes a model for estimating measles cases and deaths to evaluate the impact of vaccination.

Discussion

The report underscores the substantial progress made towards measles elimination in SEAR, thanks to increased vaccine coverage and successful SIAs. However, challenges such as COVID-19’s impact on health services and surveillance, as well as immunity gaps and funding issues, pose significant threats to achieving the 2023 elimination goal.

Conclusion

Achieving measles elimination in SEAR by 2023 demands heightened and timely efforts from all member countries to strengthen immunization services, conduct SIAs, and improve surveillance and laboratory capacity, especially in the aftermath of the COVID-19 pandemic.

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