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. 2025 Jul 3:13:1625514.
doi: 10.3389/fpubh.2025.1625514. eCollection 2025.

Bridging immunization gaps: lessons from Zambia's 2024 measles-rubella supplementary immunisation activity

Moses Mwale  1 , Penelope Masumbu  1 , Peter Jay Chipimo  1 , Patrick Sakubita  1 , Andrew Phiri  1 , Kennedy Matanda  2 , Kelvin Mwangilwa  3 , Andrea Carcelen  4 , Simon Mutembo  4 , Freddie Masaninga  1 , Jackob Sakala  2 , Peter Clement Lugala  1
Affiliations

Bridging immunization gaps: lessons from Zambia's 2024 measles-rubella supplementary immunisation activity

Moses Mwale et al. Front Public Health. .

Abstract

Zambia's 2024 Measles-Rubella Supplementary Immunization Activity (SIA), conducted from 23 to 28 September across all 116 districts, targeted children aged 9-59 months to address immunization gaps exacerbated by COVID-19 disruptions and responding to ongoing measles outbreaks. This community case study evaluates the effectiveness of microplanning, the feasibility of real-time digital monitoring, and the equity of reaching zero-dose children during Zambia's 2024 Measles-Rubella SIA, using a mixed-method approach to inform scalable immunization strategies in resource-limited settings. Through comprehensive microplanning, strategic community engagement, and real-time digital monitoring, the campaign achieved 97% national coverage and reached 165,000 previously zero-dose children in underserved communities. Implementation utilized Google Sheets and Open Data Kit tools, with quality assurance through over 7,500 supervisory visits. Despite achieving high overall coverage, several challenges emerged: funding delays, logistical constraints in remote areas, and data quality issues. Key lessons include the necessity of timely funding disbursement, strengthened cold chain infrastructure, and rigorous data verification processes. Community involvement through local leadership engagement and radio campaigns proved essential to success, while digital monitoring enabled rapid adaptation to emerging challenges. This case study provides actionable insights for designing equitable immunization campaigns in resource-limited settings, supporting global measles and rubella elimination goals through evidence of effectively tailored, data-driven strategies.

Keywords: Zambia immunization; community engagement; digital monitoring; low-resource settings; measles-rubella campaign; supplementary immunization; zero-dose children.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Routine MCV1 and MCV2 administrative coverage rates by year 1998 to 2024. Number of suspected measles and confirmed cases from 2019 to 2024.
Figure 2
Figure 2
Subnational readiness assessments for Zambia’s 2024 MR SIA, highlighting improvements from 2 weeks before (left) to 1 week before (right) the campaign.
Figure 3
Figure 3
Provincial and district coverage of Zambia’s 2024 measles-rubella SIA (19).
See this image and copyright information in PMC

References

    1. Hachiya M, Vynnycky E, Mori Y. Age-specific prevalence of IgG against measles/rubella and the impact of routine and supplementary immunization activities: a multistage random cluster sampling study with mathematical modelling. Int J Infect Dis. (2024) 144:107053. doi: 10.1016/j.ijid.2024.107053, PMID: - DOI - PubMed
    1. Shibeshi M, Shibeshi ME, Masresha BG, Smit SB, Biellik RJ, Nicholson JL, et al. Measles resurgence in southern Africa: challenges to measles elimination. Vaccine. (2014) 32:1798–807. doi: 10.1016/j.vaccine.2014.01.089, PMID: - DOI - PMC - PubMed
    1. Prosperi C, Thangaraj JWV, Hasan AZ, Kumar MS, Truelove S, Kumar VS, et al. Added value of the measles-rubella supplementary immunization activity in reaching unvaccinated and under-vaccinated children, a cross-sectional study in five Indian districts, 2018-20. Vaccine. (2023) 41:486–95. doi: 10.1016/j.vaccine.2022.11.010, PMID: - DOI - PMC - PubMed
    1. WHO . (2024). WOrld health organization (WHO) n.d. measles. Available online at: https://www.who.int/news-room/fact-sheets/detail/measles [Accessed 10 February 2025].
    1. Minta AA. Progress toward measles elimination — worldwide, 2000–2023. MMWR Morb Mortal Wkly Rep. (2024) 73:1036–42. doi: 10.15585/mmwr.mm7345a4, PMID: - DOI - PMC - PubMed

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