Real Time Surveillance and Gap Analysis

This presentation describes identification of age groups and areas with low MMR coverage, interventions applied during the 2012-13 measles outbreak to reduce the gap between pre-existing coverage levels and the 95% herd immunity target, and the importance of real-time surveillance data in monitoring effectiveness of these interventions.

Using routine vaccine uptake data, older children and teenagers were identified as most at risk of having missed scheduled MMR vaccinations. The proportions of children requiring vaccination varied across Wales, with as many as a quarter of all children not fully immunized in parts of the outbreak area.

Interventions were established to increase MMR coverage nationwide, with particular attention paid to those aged 10 to 18 years. Existing surveillance systems were enhanced to record and report increases in patients accessing immunization through primary care; and new reporting systems were implemented to capture information from secondary care drop-in clinics and school-based MMR catch-up sessions.

Real-time analysis and feedback of surveillance data directly informed both the outbreak's Senior Response Team and Welsh Government in recommending courses of action. Similarly, feedback to local implementation teams helped prioritize and evaluate local efforts. Measurable success was achieved across Wales in reducing the proportion of children and teenagers not fully vaccinated, especially in the outbreak area, where the number of unvaccinated 10-18 year olds was reduced by approximately 50%. This presentation demonstrates the importance of real-time surveillance and reporting of immunisation coverage in documenting gaps, setting goals and evaluating success of interventions during an outbreak.