Progress toward measles elimination — Nepal, 2007–2014

What is already known about this topic? Before 2007, estimated coverage with the routine first dose of measles-containing vaccine (MCV1) in Nepal was ≤85% nationally; no districts had ≥95% MCV1 coverage, and measles was one of the major causes of childhood death. What is added by this report? During 2007–2014, MCV1 coverage increased from 71% to 88%; approximately 3.9 and 9.7 million children were vaccinated during supplemental immunization activities (SIAs) in 2008 and 2014, respectively; and annual suspected measles incidence declined 13%, from 54 to 47 cases per 1 million population. In 2013, a goal was set for measles elimination in Nepal by 2019. Challenges to achieving elimination include suboptimal MCV1 coverage at national and subnational levels and a low-performing measles case-based surveillance system. What are the implications for public health practice? Achieving ≥95% 2-dose measles vaccination coverage in all districts will require strengthening routine immunization services through innovative approaches, such as the “fully immunized village” approach, and implementing periodic high-quality SIAs. Improved measles case-based surveillance performance and sensitivity are needed for rapid case detection and outbreak preparedness and response.