[Successes and challenges in achieving and sustaining the elimination of measles, rubella, and congenital rubella syndrome in the Americas, 2013-2023Conquistas e desafios para alcançar e manter a eliminação do sarampo, da rubéola e da síndrome da rubéola congênita na Região das Américas, 2013-2023].

Objetivo: To document the historical facts and the challenges faced in the Region of the Americas in achieving and sustaining measles, rubella, and congenital rubella syndrome (CRS) elimination between 2013 and 2023.

Method: Special report with a narrative description of the main achievements, challenges, and lessons learned during the period, and an analysis of vaccination coverage, surveillance indicators, and measles outbreaks using data from the Pan American Health Organization and the United Nations Children's Fund, among others.

Results: Between 2003 and 2016, regional vaccination coverage with the first dose of the measles, rubella, and mumps vaccine was between 92% and 94%; after 2017 there was a marked decline due to lower coverage levels in the most populous countries.

[Risk factors and control measures in measles outbreaks in countries of the Region of the Americas, 2017-2023Fatores de risco e medidas de controle em surtos de sarampo em países da Região das Américas, 2017-2023].

Objective: To document and compare risk factors and control measures for the largest measles outbreaks in the post-elimination era in the Region of the Americas.

Methods: Description of risk factors such as vaccination coverage, notification rate of suspected cases, measles incidence, and a summary of control measures for major measles outbreaks in six countries from 2017 to 2023. The analysis also includes a review of outbreak characteristics (time, place, and person).

[Impact of the new intervention model to increase vaccination coverage in Paraguay, 2023Impacto de um novo modelo de ação para aumentar as coberturas vacinais no Paraguai, 2023].

Objective: To describe the impact of the new intervention model implemented by Paraguay across five districts of the Central Region in the last quarter of 2023, consisting of an integrated health services-based strategy to recover coverage with the tracer vaccine (pentavalent until April 2023, hexavalent thereafter) in children under 1 year of age; and the measles, mumps, and rubella (MMR) vaccine for the 1-year-old population.

Methods: Descriptive, cross-sectional study with comparative analysis before (epidemiological weeks [EW] 1 and 34 of 2023) and after (EW35 and EW52 of 2023) the intervention. Three indicators were assessed: a) coverage with all three doses of pentavalent or hexavalent vaccine and first and second doses of MMR; b) productivity, represented by third doses of pentavalent or hexavalent vaccine administered; and c) dropout rates for the pentavalent or hexavalent and MMR vaccines.