The proportion of 1 year-old children immunised against measles is the percentage of children under one year of age who have received at least one dose of measles vaccine.
Goal 4. Reduce child mortality.
Target 5. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.
The indicator provides a measure of the coverage and the quality of child health care system in the country. Immunization is an essential component for reducing under-five mortality. Governments in developing countries usually finance immunization against measles and diphtheria, perussis (whooping cough) and tetanus (DPT) as part of the basic health package. Among these vaccine-preventable diseases of childhood, measles is the leading cause of child mortality. Health and other programmes targeted at these specific causes are one practical means of reducing child mortality.
The indicator is estimated as the percentage of children ages 12–23 months who receive at least one dose of measles vaccine either any time before the survey or before the age of 12 months. Estimates of immunization coverage are generally based on two sources of empirical data: administrative data and coverage surveys (see “Data collection and sources”). For estimates based on administrative data, immunization coverage is derived by dividing the total number of vaccinations by the number of children in the target population. For most vaccines, the target population is the national annual number of births or number of surviving infants (this may vary depending on a country’s policies and the specific vaccine). Immunization coverage surveys are frequently used in connection with administrative data.
The two sources available at the national level are reports of vaccinations performed by service providers (administrative data), and household surveys containing information on children’s vaccination history (coverage surveys). The principle types of surveys used as sources of information on immunization coverage are Expanded Programme on Immunization (EPI) 30 cluster surveys, Multiple Indicator Cluster Surveys and Demographic and Health Surveys. Routine data are compiled by national EPI programme managers.
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) compile country data series based on both types of data, gathered through the annual WHO–UNICEF Joint Reporting Form on Vaccine Preventable Diseases.
The State of the World’s Children, annual, United Nations Children’s Fund (www.unicef.org/publications).
United Nations Children’s Fund, www.childinfo.org/eddb/immuni/index.htm and
www.unicef.org/health/index.html.
Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases, 1999, World Health Organization (WHO/EPI/GEN/99012).
World Health Organization, www.who.int/health_topics/measles and www.who.int/vaccines-surveillance.
Administrative data are collected annually. Surveys are generally conducted every three to five years.
Immunization programmes are generally free of charge and should not discriminate between boys and girls. However, in some countries of South Central Asia and Northern Africa, girls’ immunization rates are lower than boys’, probably due to cultural rather than economic reasons.
International data comparisons
WHO and UNICEF compile country data series based on administrative data and household surveys, gathered through the annual WHO–UNICEF Joint Reporting Form on Vaccine-Preventable Diseases.
The State of the World’s Children, annual, United Nations Children’s Fund (www.unicef.org/publications).
World Health Organization, www3.who.int/whosis.
World Development Indicators, annual, World Bank (www.worldbank.org/data).
Human Development Report, annual, United Nations Development Programme (www.undp.org).
The first dose of measles vaccine is supposed to be administered to all children at the age of nine months or shortly after. By 2000, most countries were providing a “second opportunity” for measles vaccination, either through a two-dose routine schedule or through a combined routine schedule and supplementary campaigns. Measles immunization coverage is expressed as the percentage of children who have received at least one dose.
Vaccination coverage for measles needs to be above 90 percent to stop transmission of the virus—not only because measles is so contagious, but also because up to 15 percent of children vaccinated at nine months fail to develop immunity. Some countries in the Latin America and Caribbean region, for example, administer the measles vaccine at 12–15 months of age. This has to be taken into account in calculations of coverage based on household surveys.
In many developing countries, lack of precise information on the size of the cohort of children under one year of age makes immunization coverage difficult to estimate.
Ministries of health.
United Nations Children’s Fund.
World Health Organization.