2.2 Immunization schedule

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    2.2.1 Primary vaccination

    In countries where transmission is high and continuous, children should be vaccinated starting at 9 months of age. Any child not vaccinated before age 1 year should be vaccinated as soon as possible.


    In countries where transmission is low or non-existent, primary vaccination is given later, at 12 to 15 months of age, because the risk of contact with the virus before that age is low.


    In certain high-risk situations where children are heavily exposed before 9 months of age, it is recommended that they be given an early dose at or after age 6 months (dose 0), and then the Expanded/Essential Programme on Immunization (EPI) recommended dose at or after age 9 months, with at least 4 weeks between the two doses. 


    These situations include:

    • Measles epidemics

    • Population concentrations (refugee/IDP camps, precarious urban zones)

    • Paediatric inpatient units

    • Children born to HIV-positive mothers (increased risk of severe measles and little protection conferred by maternal antibodies)

    • Malnourished children (increased risk of complications)
       

    2.2.2 Second dose

    Since 2009, the WHO recommends that all countries update their immunisation schedule with a second dose of the measles vaccine (MCV2) during the child’s second year, regardless of the level of coverage by the first dose of measles vaccine (MCV1). Adding MCV2 reduces the susceptible cohort by immunising children who did not respond to MCV1 or did not receive the first dose. For catch-up vaccination, the recommended time between doses is 4 weeks.


    By 2022, 97% of countries had added the second measles dose to their immunisation schedule. The estimated MCV2 vaccination coverage is 74% and varies by region [45 to 91%] [1]Citation 1.Weekly Epidemiological Record (WER), 17 November 2023, Vol. 98, No. 46, pp. 583-598 [EN/FR] - World | ReliefWeb [Internet]. 2023 [cited 2024 Apr 15]. Progrès accomplis dans le monde en vue de l’élimination régionale de la rougeole, 2000-2022. 
    https://reliefweb.int/report/world/weekly-epidemiological-record-wer-17-november-2023-vol-98-no-46-pp-583-598-enfr      .

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