Abstract：
In 2020, National Immunization Programme (NIP) of Nepal implemented a measles outbreak response immunization (ORI) campaign, which was additional to an ongoing preventive measles-rubella SIA campaign. Both campaigns were implemented during ongoing COVID-19 transmission. By April, 220 measles cases and two deaths were confirmed from eight districts of Nepal. The NIP triangulated information from surveillance (measles and COVID-19), measles immunization performance and immunity profile, programme capacities and community engagement and applied a logical decision-making framework to the collated data to inform \'Go/No-Go\' decisions for ORI interventions. This was reviewed by the National Immunization Advisory Committee (NIAC) for endorsement. Outbreak response with non-selective immunization (ORI), vitamin-A administration and case management were implemented in affected municipalities of four districts, while in the remaining districts outbreak response without ORI were undertaken. The structure and iterative application of this logical framework has been described. ORI was implemented without interrupting the ongoing measles-rubella vaccination campaign which had targeted children from 9 to 59 months of age. The age group for ORI was same as SIA in one sub-district area, while for the other three sub-district areas it was from 6 months to 15 years of age. More than 32,000 persons (97% coverage) were vaccinated in ORI response. Overall measles incidence decreased by 98% after ORI. The daily incidence rate of measles was 94 times higher (95% confidence interval: 36.11 - 347.62) before the ORI compared to two weeks after ORI until year end. Close attention to surveillance and other data to inform actions and seamless collaboration between NIP and core immunization partners (WHO, UNICEF), with guidance from NIAC were key elements in successful implementation. This was an example of feasible application of the global framework for implementation of a mass vaccination campaign during COVID-19 through application of a simple decision-making logical framework.
摘要：
2020年，尼泊尔国家免疫计划（NIP）实施了麻疹暴发应对免疫（ORI）运动。这是对正在进行的预防麻疹-风疹SIA运动的补充。这两项运动都是在正在进行的COVID-19传播期间实施的。到四月,尼泊尔八个地区确认了220例麻疹病例和2例死亡。NIP对来自监测（麻疹和COVID-19）的信息进行了三角测量，麻疹免疫性能和免疫概况，方案能力和社区参与，并将合乎逻辑的决策框架应用于整理的数据，为ORI干预的“去/不去”决策提供信息。国家免疫咨询委员会（NIAC）对此进行了审查，以进行认可。非选择性免疫（ORI）的爆发反应，在四个地区的受影响城市实施了维生素A管理和病例管理，而在其余地区，在没有ORI的情况下进行了疫情应对。已经描述了该逻辑框架的结构和迭代应用。ORI的实施没有中断正在进行的麻疹-风疹疫苗接种运动，该运动针对9至59个月大的儿童。ORI的年龄组与一个分区区域的SIA相同，而其他三个分区地区则为6个月至15岁。超过32,000人(覆盖率97%)在ORI应答中接种了疫苗。ORI后麻疹总发病率下降了98%。与ORI后两周直到年底相比，ORI前麻疹的每日发病率高94倍（95％置信区间：36.11-347.62）。密切关注监测和其他数据，为国家实施计划和核心免疫伙伴之间的行动和无缝合作提供信息(世卫组织，UNICEF),在NIAC的指导下是成功实施的关键要素。这是通过应用简单的决策逻辑框架，在COVID-19期间实施大规模疫苗接种运动的全球框架的可行应用实例。
