| Abstract |
Measles is a viral infection, highly contagious, caused by measles virus, an RNA virus
of the genus Morbillivirus within the family Paramyxoviridae. The symptoms of
measles are fever, rash and at least one of the following: cough, coryza and
conjunctivitis. Within the complications of the infection are pneumonia, encephalitis
and keratitis, which can be sometimes fatal.
For over 50 years, an effective and safe vaccine against measles virus is licensed, but
the disease has not been eliminated and epidemics continue to occur every 2-5 years.
During the years 2016-2018, measles has re-emerged in European countries, including
Greece, creating the need for vigilance, epidemiological observation and enforcement
of vaccination.
The aim of this study was to identify all children attending primary school in Crete,
who were not fully vaccinated against measles. Families of children with missing doses
were called by telephone and advised on the importance and the practicalities of
fulfilling the vaccination schedule.
The study was realized in collaboration with the regional state health and education
authorities, from November 2017 to May 2018. Photocopies of the vaccination records
were sent through mail from each primary school, which subsequently were carefully
checked. Initial telephone communication with families of poorly vaccinated children
was followed, where the reasons for delayed vaccination were investigated and the need
for immediate vaccination due to the current outbreak was informed. A second
communication with the families took place 6 months later to assess the outcome of the
intervention.
Starting from November 2017, 27,020 vaccination records have been checked from
children attending all primary schools in Crete. 2 doses of measles vaccine were
Vaccines and Prevention of Infectious Diseases in Childhood and Adolescence
School of Medicine – University of Crete
4
documented in 25,111 (94,1%), 1 dose in 1476 (5,53%) and no doses in only 103
(0,39%) children. A total of 1369 families were advised on the missing doses. Medical
contra-indication was confirmed in 18 cases and vaccine hesitancy in 9. In 11 cases
parents asked for more information by an Infectious Disease expert.
In all other cases, the main cause of delay was negligence. From the second telephone
communication, a high rate of post-intervention vaccination (78.9%) resulted, leeding
to a reduction in the proportion of unvaccinated children from 5.9% to 3.9%, achieving
the target of >95% set by the World Health Organization to avoid epidemic outbreaks.
In conclusion, therefore, the results of the study showed that the main cause of delayed
vaccination in the pediatric population is negligence, suggesting that intensive
prevention policies may work well in vaccine-preventable diseases.
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Μέτρα δημόσιας υγείας για την πρόληψη της ιλαράς στον παιδιατρικό πληθυσμό της Κρήτης
