[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.

Global Status Report for the Verification of Measles and Rubella Elimination, 2022.

Since the World Health Assembly (WHA) in 2012 endorsed the Global Vaccine Action Plan (GVAP), which included regional measles and rubella elimination goals by 2020, global progress towards verification of measles and rubella elimination has been incremental. Even though the 2020 elimination goals were not achieved, commitment towards achieving measles and rubella elimination has been firmly established in the Immunization Agenda 2030 (IA2030) and the Measles and Rubella Strategic Framework (MRSF) 2021-2030. In 2023, the six Regional Verification Commissions for measles and rubella elimination (RVCs) reviewed data as of 31 December 2022 and confirmed that 82 (42%) Member States have been verified for measles elimination, and 98 (51%) Member States have been verified for rubella elimination.

Sustaining the Elimination of Measles, Rubella and Congenital Rubella Syndrome in the Americas, 2019-2023: From Challenges to Opportunities.

This report reviews national data from all Member States on measles, rubella, and congenital rubella syndrome (CRS) elimination in the Region of the Americas during 2019-2023. It includes an analysis of compliance with vaccination coverage, surveillance indicators, and measles outbreaks, as well as an analysis of the response capacity of the laboratory network and a country case study that meets all indicators. The sources of information were the integrated epidemiological surveillance system for measles and rubella of the Pan American Health Organization (PAHO)/World Health Organization (WHO) and the Joint Reporting Form (eJRF), among others.

Estimating the future global dose demand for measles-rubella microarray patches.

Background: Progress toward measles and rubella (MR) elimination has stagnated as countries are unable to reach the required 95% vaccine coverage. Microarray patches (MAPs) are anticipated to offer significant programmatic advantages to needle and syringe (N/S) presentation and increase MR vaccination coverage. A demand forecast analysis of the programmatic doses required (PDR) could accelerate MR-MAP development by informing the size and return of the investment required to manufacture MAPs.

Using FHIR to Support COVID-19 Vaccine Safety Electronic Case Reports in America.

During the COVID-19 pandemic, the Pan American Health Organization (PAHO) promoted several activities to strengthen the countries' emergency response. Vaccines represented a breakthrough in the pandemic evolution, even though they have not been equitably distributed. As most vaccines have received emergency authorizations for their timely delivery, vaccine safety surveillance has been highlighted for detecting early signals of potential adverse events following immunization (AEFI, also known as ESAVI).

Public health responses during measles outbreaks in elimination settings: Strategies and challenges.

In late September 2016, the Americas became the first region in the world to have eliminated endemic transmission of measles virus. Several other countries have also verified measles elimination, and countries in all six World Health Organization regions have adopted measles elimination goals. The public health strategies used to respond to measles outbreaks in elimination settings are thus becoming relevant to more countries.

Risk analysis for the reintroduction and transmission of measles in the post-elimination period in the Americas.

Objective: .

Methods: P P .

Results: P .

Effectiveness of monovalent rotavirus vaccine in Bolivia: case-control study.

Objective: To evaluate the effectiveness of two doses of a monovalent rotavirus vaccine (RV1) against hospital admission for rotavirus in Bolivia.

Design: Case-control study.

Setting: Six hospitals in Bolivia, between March 2010 and June 2011.

Impact of vaccination against Haemophilus influenzae type b with and without a booster dose on meningitis in four South American countries.

To inform World Health Organization recommendations regarding use of Haemophilus influenzae type b (Hib) vaccines in national immunization programs, a multi-country evaluation of trends in Hib meningitis incidence and prevalence of nasopharyngeal Hib carriage was conducted in four South American countries using either a primary, three-dose immunization schedule without a booster dose or with a booster dose in the second year of life. Surveillance data suggest that high coverage of Hib conjugate vaccine sustained low incidence of Hib meningitis and low prevalence of Hib carriage whether or not a booster dose was used.

Rubella and congenital rubella syndrome elimination activities: Colombia, 2005-2006.

As part of regional commitments in the Americas aimed at elimination of rubella and congenital rubella syndrome, and consolidation of measles elimination, Colombia conducted mass vaccination of males and females aged 14-39 years in 2005-2006. The target population included 18,238< 443 persons (44% of the entire population). Vaccination activities were extended because of limited participation and public concerns about vaccine safety.

Decline in rotavirus hospitalizations and health care visits for childhood diarrhea following rotavirus vaccination in El Salvador.

Background: A recent postlicensure study from El Salvador showed that the monovalent rotavirus vaccine conferred 76% protection against rotavirus hospitalizations. We further examined the impact of rotavirus vaccination on the national burden of childhood diarrhea to help assess the total public health benefits of vaccination.

Methods: We compared all-cause diarrhea and rotavirus-specific hospitalization rates during prevaccine year 2006, with postvaccine years 2008 and 2009 in children < 5 years of age from 7 sentinel surveillance hospitals.

Effectiveness of rotavirus vaccination against childhood diarrhoea in El Salvador: case-control study.

Objective: To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America.

Design: Matched case-control study.

Setting: Seven hospitals in cities across El Salvador, January 2007 to June 2009.

[The economic costs of pneumonia in children under 2 years of age in Colombia].

Objective: To analyze the costs of pneumonias presumed to be of viral or bacterial origin, as diagnosed by chest X ray, in four reference center hospitals in three cities in Colombia.

Methods: A total of 128 cases of pneumonia (64 bacterial cases and 64 viral cases) that had consecutively entered the hospitals in the study between July 2001 and January 2003 were investigated. The diagnosis of pneumonia was based on chest X rays.

Effectiveness of Haemophilus influenzae type b vaccination against bacterial pneumonia in Colombia.

Aims: To assess the effectiveness of a Hib vaccination program against X-ray defined bacterial pneumonia in children <2 years in Colombia.

Methods: 389 cases of radiologically confirmed pneumonia were recruited from hospitals in Bogota and Medellin, Colombia. Two controls per case, matched on age, sex, and socio-economic level, were selected from children attending child health services at the hospitals where pneumonia cases were admitted.