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Disclosures: Valery Blot works for Institut Haïtien de l’Enfance, the institution that was funded through a cooperative agreement between CDC and the Haiti Ministry of Health and Population to implement the survey. The findings of this survey were presented in part at the IDWeek 2019 conference October 2–6, 2019, Washington, DC.
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily reflect the position of the Centers for Disease Control and Prevention nor the Pan American Health Organization. Abstract: A. A. Minta, J. Andre-Alboth, L. Childs, D. Nace, G. Rey-Benito, J. Boncy, P. Adrien, J. François, N. Charles, V. Blot, J. Vanden Eng, J. W. Priest, E. Rogier, R. A. Tohme. Seroprotection against Measles, Rubella, Tetanus, and Diphtheria Among Children in Haiti—2017. Open Forum Infectious Diseases, Volume 6, Issue Supplement_2, October 2019, Pages S977–S978, https://doi.org/10.1093/ofid/ofz360.2448 (accessed November 4, 2019).
Financial support: This survey was supported by a cooperative agreement between the CDC and the Haiti Ministry of Public Health and Population and a cooperative agreement between the CDC and PAHO.
Authors’ addresses: Anna A. Minta, Lana Childs, Douglas Nace, Jodi Vanden Eng, Jeffrey W. Priest, Eric Rogier, and Rania A. Tohme, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: [email protected], [email protected], [email protected], [email protected], [email protected], and [email protected]. Gloria Rey-Benito, Pan American Health Organization, Washington, DC, E-mail: [email protected]. Jocelyne Andre-Alboth, Jacques Boncy, Paul Adrien, and Jeannot Francois, Ministry of Public Health and Population, Port-au-Prince, Haiti, E-mails: [email protected], [email protected], [email protected], and [email protected]. Valery Blot, Institut Haitien de L’Enfance, Petion-Ville, Haiti, E-mail: [email protected].
Abstract.
In Haiti, measles, rubella, and maternal and neonatal tetanus have been eliminated, but a diphtheria outbreak is ongoing as of 2019. We conducted a nationally representative, household-based, two-stage cluster survey among children aged 5–7 years in 2017 to assess progress toward maintenance of control and elimination of selected vaccine-preventable diseases (VPDs). We stratified Haiti into West region (West department, including the capital city) and non-West region (all other departments). We obtained vaccination history and dried blood spots, and measured antibody concentrations to VPDs on a multiplex bead assay. Among 1,146 children, national seropositivity was 83% (95% CI: 80–86%) for tetanus, 83% (95% CI: 81–85%) for diphtheria, 87% (95% CI: 85–89%) for measles, and 84% (95% CI: 81–87%) for rubella. None of the children had long-term immunity to tetanus or diphtheria (IgG concentration ≥ 1 international unit/mL). Seropositivity in the West region was lower than that in the non-West region. Vaccination coverage was 68% (95% CI: 61–74%) for ≥ 3 doses of tetanus- and diphtheria-containing vaccine (DTP3), 84% (95% CI: 80–87%) for one dose of measles–rubella vaccine (MR1), and 20% (95% CI: 16–24%) for MR2. The seroprevalence of measles, rubella, and diphtheria antibodies is lower than population immunity levels needed to prevent disease transmission, particularly in the West region; reintroduction of these diseases could lead to an outbreak. To maintain VPD control and elimination, Haiti should achieve DTP3 and MR2 coverage ≥ 95%, and include tetanus and diphtheria booster doses in the routine immunization schedule.