ArticleVaccine2019
Seasonal gaps in measles vaccination coverage in Madagascar.
Article in Vaccine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 30 citations in OpenAlex.
- Beyond elimination: reframing measles vaccination strategies.BMJ global health · 2026Article
- Health system stakeholders' perceptions of religious and socio-cultural influences on measles vaccine hesitancy in Madagascar: a qualitative study.BMC public health · 2026Article
- Association between ambient temperature and childhood vaccination coverage in low- and middle-income countries.BMC medicine · 2026Article
- Determinants of post-campaign measles vaccination coverage in Madagascar: A geographically stratified analysis.PLOS global public health · 2026Article
- Revealing trends in measles immunity during periods of varying measles circulation in Madagascar.American journal of epidemiology · 2025Article
- Full vaccination coverage for children aged 12-23 months in Madagascar: Analysis of the 2021 Demographic and Health Survey.BMC public health · 2025Article
- Evaluation of the impact of the state of emergency during the COVID-19 pandemic on childhood immunizations in Benguela Province, Angola.Tropical medicine and health · 2025Article
- Starting then stopping: a nationwide register-based study on the magnitude, predictors, and urban-rural patterns of under-vaccination variation across health centers in The Gambia.Global health action · 2024Article
- Resilience of routine childhood immunization services in two counties in Kenya in the face of the COVID-19 pandemic.Vaccine · 2023Article
- Mapping BCG vaccination coverage in Ethiopia between 2000 and 2019.BMC infectious diseases · 2022Article
- Infectious disease in an era of global change.Nature reviews. Microbiology · 2022Review
- Timeliness of routine childhood vaccination in 103 low-and middle-income countries, 1978-2021: A scoping review to map measurement and methodological gaps.PLOS global public health · 2022Article
- Impact of health system strengthening on delivery strategies to improve child immunisation coverage and inequalities in rural Madagascar.BMJ global health · 2022Article
- Assessing the characteristics of un- and under-vaccinated children in low- and middle-income countries: A multi-level cross-sectional study.PLOS global public health · 2022Article
- Estimating population-based coverage of reproductive, maternal, newborn, and child health (RMNCH) interventions from health management information systems: a comprehensive review.BMC health services research · 2021Review
- The Challenge of Achieving Immunity Through Multiple-Dose Vaccines in Madagascar.American journal of epidemiology · 2021Article
- Towards better targeting: lessons from a posthoneymoon measles outbreak in Madagascar, 2018-2019.BMJ global health · 2020Article
- Challenges related to resources mobilization for measles outbreak response: Madagascar experience during the 2018-2019 measles outbreak.The Pan African medical journal · 2020Article
- The Potential Contribution of Supplementary Immunization Activities to Routine Immunization in Kebbi State, Nigeria.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionMeasles elimination depends on the successful deployment of measles containing vaccine. Vaccination programs often depend on a combination of routine and non-routine services, including supplementary immunization activities (SIAs) and vaccination weeks (VWs), that both aim to vaccinate all eligible children regardless of vaccination history or natural infection. Madagascar has used a combination of these activities to improve measles coverage. However, ongoing massive measles outbreak suggests that the country was in a "honeymoon" period and that coverage achieved needs to be re-evaluated. Although healthcare access is expected to vary seasonally in low resources settings, little evidence exists to quantify temporal fluctuations in routine vaccination, and interactions with other immunization activities.
methodsWe used three data sources: national administrative data on measles vaccine delivery from 2013 to 2016, digitized vaccination cards from 49 health centers in 6 health districts, and a survey of health workers. Data were analyzed using linear regressions, analysis of variance, and t-tests.
findingsFrom 2013 to 2016, the footprint of SIAs and VWs is apparent, with more doses distributed during the relevant timeframes. Routine vaccination decreases in subsequent months, suggesting that additional activities may be interfering with routine services. The majority of missed vaccination opportunities occur during the rainy season. Health facility organization and shortage of vaccine contributed to vaccination gaps. Children born in June were the least likely to be vaccinated on time. DISCUSSION: Evidence that routine vaccination coverage varies over the year and is diminished by other activities suggests that maintaining routine vaccination during SIAs and VWs is a key direction for strengthening immunization programs, ensuring population immunity and avoiding future outbreaks.
fundingWellcome Trust Fund, Burroughs Wellcome Fund, Gates Foundation, National Institutes of Health.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.