Assessing the risk of measles resurgence in a highly vaccinated population: Belgium anno 2013

N Hens; S Abrams; E Santermans; H Theeten; N Goeyvaerts; T Lernout; E Leuridan; K Van Kerckhove; H Goossens; P Van Damme; P Beutels

doi:10.2807/1560-7917.ES2015.20.1.20998

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Assessing the risk of measles resurgence in a highly vaccinated population: Belgium anno 2013
N Hens^1,2 , S Abrams¹ , E Santermans¹ , H Theeten³ , N Goeyvaerts^1,2 , T Lernout³ , E Leuridan³ , K Van Kerckhove¹ , H Goossens⁴ , P Van Damme³ , P Beutels^2,5
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Affiliations: ¹ Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium ² Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute (WHO Collaborating Centre), University of Antwerp, Antwerp, Belgium ³ Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute (WHO Collaborating Centre), University of Antwerp, Antwerp, Belgium ⁴ Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (WHO Collaborating Centre), University of Antwerp, Antwerp, Belgium ⁵ School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia

Correspondence:
N Hens
niel.hens uhasselt.be
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Citation style for this article: Hens N, Abrams S, Santermans E, Theeten H, Goeyvaerts N, Lernout T, Leuridan E, Van Kerckhove K, Goossens H, Van Damme P, Beutels P. Assessing the risk of measles resurgence in a highly vaccinated population: Belgium anno 2013. Euro Surveill. 2015;20(1):pii=20998. https://doi.org/10.2807/1560-7917.ES2015.20.1.20998 Received: 01 Feb 2014

Abstract

Despite long-standing two-dose measles-mumps-rubella (MMR) vaccination, measles outbreaks still occur in highly vaccinated European populations. For instance, large measles outbreaks occurred in France (2008-13), the United Kingdom (2012-13) and the Netherlands (2012). Based on a multicohort model approach, using spatial serological survey data, MMR vaccination coverage data and data on social contacts, we found effective reproduction numbers significantly higher than 1 for measles in Belgium. This indicates that at one of the expected re-introductions, a measles outbreak is likely to spread, especially when it occurs during school term. The predicted average effective reproduction number increased over a 30-year time span from 1.3 to 2.2 and from 1.9 to 3.2 for basic reproduction numbers of 12 and 18, respectively. The expected relative measles incidence was highest in infants under one year of age, in adolescents and young adults. In conclusion, gradually increasing proportions of susceptible adolescents and young adults provide through their highly active social life an avenue for measles to resurge in large outbreaks upon re-introduction in Belgium, especially during school terms. Infants form an important vulnerable group during future measles outbreaks. .