The Knowledge Hub

Reactive vaccination campaigns prevented a large measles outbreak, saving thousands of cases in a refugee camp

A large measles outbreak of 1,700 cases occurred in the Rohingya refugee population in Cox’s Bazar, Bangladesh in 2017. In response, two reactive vaccination campaigns delivered the measles and rubella (MR) vaccine to children aged 6 months to 15 years old. This modeling study found that these reactive vaccination campaigns rapidly curbed outbreak transmission, averting an estimated 77,000 measles cases in the refugee camp. This demonstrates that reactive vaccination campaigns can be highly effective in preventing large measles outbreaks in the context of refugee camps, even when prior vaccination rates are low.

Chin T, Buckee CO, Mahmud AS. 2020. Quantifying the success of measles vaccination campaigns in the Rohingya refugee camps. Epidemics. 30.

Immunization rates are low among pregnant adolescents in rural areas with less education and lower wealth

The use of antenatal care (ANC) services among pregnant adolescents in low- and middle-income countries, including tetanus toxoid vaccination, was lowest among women who lived in rural areas, had completed less education, and who were of poorer wealth quintiles.

Banke-Thomas OE, Banke-Thomas AO, Ameh CA. 2017. Factors influencing ultilisation of maternal health services by adolescent mothers in Low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth. 17(1).

Influenza vaccine for pregnant women in Bangladesh led to fewer respiratory illnesses in their infants

Pregnant women in Bangladesh who received the influenza vaccine had elevated levels of anti-influenza antibody in their breast milk. The infants of mothers who received the vaccine during pregnancy had fewer episodes of respiratory illness with fever than the infants of mothers who did not receive the influenza vaccine during pregnancy. Further, exclusive breastfeeding was found to have a protective effect against respiratory illness with fever in infants.

Maertens K, De Schutter S, Braeckman T et al.. 2014. Breastfeeding after maternal immunization during pregnancy: Providing immunological protection to the newborn: A review. Vaccine. 32(16).

Immunization during pregnancy can increase anti-meningococcal antibodies in breastmilk, providing better protection for infants

The breastmilk of mothers in Bangladesh who received the meningococcal vaccine during pregnancy had anti-meningococcal antibody levels at 3-6 months after delivery of four to five times higher than that of mothers who did not receive the vaccine.

Although this study was published in 2002, the data on this topic are sparse as it is methodologically difficult to conduct studies to evaluate the relationship between anti-meningococcal antibodies in breastmilk and protection.

Shahid NS, Steinhoff MC, Roy E et al.. 2002. Placental and breast transfer of antibodies after maternal immunization with polysaccharide meningococal vaccine: a randomized, controlled evaluation. Vaccine. 20(17-18).

Early measles vaccination in boys in Bangladesh increased school enrollment by 74%, suggesting immunization’s positive impact on education

A study of the staggered roll-out of measles vaccination in Matlab, Bangladesh, which started in the early 1980s, found that boys vaccinated before 12 months of age were 7.4% more likely to be enrolled in school than boys who were never vaccinated or vaccinated later in childhood, while measles vaccination had no effect on girls’ enrolment in school.

This may suggest that poor health, resulting from complications of measles that can lead to deficits in physical and cognitive development, affected schooling decisions for boys in Bangladesh, but not for girls.

Driessen J, Razzaque A, Walker D et al.. 2015. The effect of childhood measles vaccination on school enrolment in Matlab, Bangladesh. Applied Economics. 47(55).

Children of younger Bangladeshi mothers had a higher chance of incomplete vaccination compared to older mothers

Children of Bangladeshi mothers younger than 34 years were more than three times as likely to have incomplete vaccination compared to children of mothers older than 35 years.

Sheikh N, Sultana M, Ali N et al.. 2018. Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh. Tropical Medicine and Infectious Disease. 3(3).

Unemployed mothers in Bangladesh had children with incomplete vaccinations and delays in certain vaccines

Children of unemployed mothers in Bangladesh were 1.5 times as likely to have incomplete vaccination status compared to children of employed mothers. Maternal unemployment was also significantly linked to delays in BCG and measles vaccinations.

Sheikh N, Sultana M, Ali N et al.. 2018. Coverage, Timelines, and Determinants of Incomplete Immunization in Bangladesh. Tropical Medicine and Infectious Disease. 3(3).

Vaccinating children in high-risk slum areas in Bangladesh can effectively control cholera and save lives

A study using local epidemiological and economic data found that vaccinating children 1-14 years old in high-risk slum areas in Dhaka, Bangladesh using a locally-produced oral cholera vaccine provided through periodic campaigns would be a highly cost-effective means of controlling endemic cholera — reducing cholera incidence in the entire population by 45% over 10 years and costing US$440-635 per DALY averted. Vaccinating all persons aged one and above would reduce incidence much further (by 91%) but would be less cost-effective.

Khan AI, Levin A, Chao DL, DeRoeck D et al.. 2018. The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: A disease modeling and economic analysis. PLoS NTD. 12(10).

Immunizing children against rotavirus saves money and prevents hospitalizations and outpatient visits

Vaccinating children against rotavirus in Bangladesh would prevent more than 50,000 outpatient visits and 40,000 hospitalizations in children under five each year, and reduce treatment costs by US$5.8 million over 2 years — nearly all (96%) from fewer hospitalizations. Since this study didn’t take herd effects into account, the actual impact would likely be greater.

Sarker AR, Sultana M, Mahumud RA, et al.. 2018. Cost-effectiveness analysis of introducing universal childhood rotavirus vaccination in Bangladesh. Human Vaccines & Immunotherapeutics. 14(1).

Cholera vaccination programs for children in slums also reduces incidence in adults through herd effects

According to a modeled data study on cholera transmission in Bangladesh, a cholera vaccination program for 1-14 year olds in the slums of Dhaka, Bangladesh involving periodic (every 3 years) campaigns would reduce cholera incidence in adults living in these areas by 40% due to the herd effects of oral cholera vaccines.

Khan IK, Levin A, Chai DL, et al.. 2018. The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: a disease modeling and economic analysis. PLoS NTD. 12(10).