{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:52:32Z","timestamp":1790315552802,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Countries with moderate to high measles-containing vaccine coverage face challenges in reaching the remaining measles zero-dose children. There is growing interest in targeted vaccination activities to reach these children. We developed a framework for prioritizing districts for targeted measles and rubella supplementary immunization activities (<jats:italic>SIA<\/jats:italic>s) for Zambia in 2020, incorporating the use of the WHO\u2019s Measles Risk Assessment Tool (<jats:italic>MRAT<\/jats:italic>) and serosurveys. This framework was used to build a model comparing the cost of vaccinating one zero-dose child under three vaccination scenarios: standard nationwide SIA, targeted subnational SIA informed by MRAT, and targeted subnational SIA informed by both MRAT and measles seroprevalence data. In the last scenario, measles seroprevalence data are acquired via either a community-based serosurvey, residual blood samples from health facilities, or community-based IgG point-of-contact rapid diagnostic testing. The deterministic model found that the standard nationwide SIA is the least cost-efficient strategy at 13.75 USD per zero-dose child vaccinated. Targeted SIA informed by MRAT was the most cost-efficient at 7.63 USD per zero-dose child, assuming that routine immunization is just as effective as subnational SIA in reaching zero-dose children. Under similar conditions, a targeted subnational SIA informed by both MRAT and seroprevalence data resulted in 8.17\u20138.35 USD per zero-dose child vaccinated, suggesting that use of seroprevalence to inform SIA planning may not be as cost prohibitive as previously thought. Further refinement to the decision framework incorporating additional data may yield strategies to better target the zero-dose population in a financially feasible manner.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0412","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T14:59:55Z","timestamp":1716303595000},"page":"121-128","source":"Crossref","is-referenced-by-count":5,"title":["Modeling the Cost of Vaccinating a Measles Zero-Dose Child in Zambia Using Three Vaccination Strategies"],"prefix":"10.4269","volume":"111","author":[{"given":"Joshua","family":"Mak","sequence":"first","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan N.","family":"Patenaude","sequence":"additional","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Mutembo","sequence":"additional","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica E.","family":"Pilewskie","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K.","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, University of Georgia College of Public Health, Athens, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Moss","sequence":"additional","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea C.","family":"Carcelen","sequence":"additional","affiliation":[{"name":"International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"2490","article-title":"Measles","volume":"390","author":"Moss","year":"2017"},{"key":"b2","series-title":"Vaccine","first-page":"170","article-title":"Impact of measles supplementary immunization activities on reaching children missed by routine programs","volume":"36","author":"Portnoy","year":"2018"},{"key":"b3","series-title":"BMC Public Health","first-page":"1","article-title":"Spatial clustering of measles vaccination coverage among children in sub-Saharan Africa","volume":"17","author":"Brownwright","year":"2017"},{"key":"b4","series-title":"J Infect Dis","first-page":"355","article-title":"Benefits and challenges in using seroprevalence data to inform models for measles and rubella elimination","volume":"218","author":"Winter","year":"2018"},{"key":"b5","series-title":"Lancet Lond Engl","first-page":"728","article-title":"Use of serological surveys to generate key insights into the changing global landscape of infectious disease","volume":"388","author":"Metcalf","year":"2016"},{"key":"b6","series-title":"PLoS One","first-page":"e0149970","article-title":"Immunization coverage surveys and linked biomarker serosurveys in three regions in Ethiopia","volume":"11","author":"Travassos","year":"2016"},{"key":"b7","author":"de Swart","year":"2020"},{"key":"b8","series-title":"Vaccine","first-page":"5154","article-title":"Economic evaluation and budget impact analysis of dengue vaccination following pre-vaccination serological screening in India","volume":"38","author":"Krishnamoorthy","year":"2020"},{"key":"b9","series-title":"PLoS One","first-page":"e0240734","article-title":"How much does it cost to measure immunity? 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