Zambia Evaluation & Research of 0-Dose (ZER0-D): Strategies to More Effectively Target Measles Zero-Dose Children

Challenge

Countries such as Zambia with high coverage with the first dose of measles-containing vaccine (MCV) and increasing coverage with the second dose of MCV are encouraged to consider moving away from nationwide, non-selective measles and rubella mass vaccination campaigns (supplemental immunization activities or SIAs) toward more targeted and selective vaccination strategies. In such settings, nationwide, non-selective vaccination campaigns can be inefficient in reaching measles zero-dose children and are resource intensive. The goal of this project is to better understand the decision-making processes in implementing targeted and selective measles and rubella vaccination strategies and whether school entry checks could be an additional strategy to identify and vaccinate measles zero-dose and other under-vaccinated children in Zambia.

Approach

The Gavi Zero-Dose project consists of two workstreams to improve the ability to reach measles zero-dose children and close immunity gaps more effectively.

The first workstream on decision-making aims to:

• Identify what factors need to be considered by policy makers and EPI program managers to select appropriate supplementary measles vaccination strategies
• Determine if and how sub-national modeled or triangulated indicators of the risk of measles outbreaks can be used to improve the decision-making process

The second workstream on school entry vaccination aims to:

• Implement a pilot school entry vaccination program in selected rural and urban districts to determine the feasibility of using school entry checks to identify unvaccinated and undervaccinated school children, households, and communities
• Use dynamic modeling to estimate the potential effectiveness of school entry as a point of contact for identifying and filling vaccination gaps among children

Resources

• Supplemental Strategies to Reach Zero-Dose Children (July 2022): Summary Report to Gavi, on Behalf of the Zambia Evaluation & Research of 0-Dose (Zer0-D) Project