Online Program

Real Time Surveillance and Gap Analysis

Monday, November 4, 2013 : 11:10 a.m. - 11:20 a.m.

Simon Cottrell, Public Health Wales, Cardiff, CF10 3NW, Wales
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.

Learning Areas:

Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Demonstrate the importance of real-time, reliable epidemiological surveillance data in setting up, directing and evaluating interventions to control an outbreak of measles.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Since 2005, I have worked for Public Health Wales as the epidemiologist for vaccine preventable disease and influenza. I currently manage the surveillance and reporting of vaccination uptake and coverage in Wales. During the 2012-13 outbreak of measles in Wales, I set in place surveillance systems to provide real-time reports to assist in control of the outbreak and coordinated collection, analysis and reporting of MMR vaccination uptake data for the outbreak Senior Response Team.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.