Until the last child: Costa Rica strengthens vaccination against measles, mumps, and rubella

The vaccine hurt a little," 8 year-old, Angel Fabian said, smiling with relief after receiving a booster dose of the measles, mumps, and rubella (MMR) vaccine. The boy, who lives in the neighborhood of San Juan in the Aguas Zarcas district, three hours from the capital, San José, was one the children reached by a vaccination campaign to prevent the resurgence of measles, implemented by the Ministry of Health, the Costa Rican Social Security Fund and the Pan American Health Organization (PAHO).

— April 2024 —

Jacinto Arroyo, primary care technical assistant (PCTA), administers the vaccine.

Jacinto Arroyo, primary care technical assistant (PCTA), administered the vaccine, ensuring that each child received the necessary protection. The goal of the health teams is to vaccinate 563,000 children, between the ages of 15 months 10 years of age, throughout the country between April and May.

While Costa Rica has historically maintained a high level of vaccination coverage, this campaign aims to close any gaps and ensure that 100% of the target population is protected. Coverage currently stands at 93% for the first dose of the vaccine against measles, mumps, and rubella, slightly below the 95% threshold recommended by PAHO.

Authorities estimate that more than 88,000 children have not received one or two doses of the MMR vaccine and would therefore be susceptible to infection in the event of an imported case of measles. This is why it is crucial that local health teams reach every last child in every district of the country.

For Arroyo, a trusted local figure for the past 17 years, "being known really helps a lot. I know this community inside out and can even tell you the names of the dogs," he joked.

Ángela Benavides, Ángel’s mother, appreciates the door-to-door vaccination and recognizes the value of vaccines in protecting her children: "They haven't had measles, thank God, because of the availability of doctors and vaccines." For her, it is essential that her children are protected from all diseases. "I'm always on time. They never miss any vaccine," she assures.

In 2023, large measles outbreaks were reported in 51 countries worldwide. In the Americas, 92 cases were reported in seven countries, mostly in the United States and Canada. Costa Rica reported one imported case that, thanks to follow-up efforts, did not spread to anyone else.

PAHO continues to warn about the real risk of reintroduction of measles in the region due to low immunization coverage. Vaccination Week in the Americas, April 20-27, is an opportunity for millions of people of all ages to ensure they are up to date with their vaccinations.

"The measles virus is a constant threat to unvaccinated children," PAHO/WHO representative in Costa Rica, Alfonso Tenorio, said. That is why this vaccination campaign "is fundamental to provide all children with the protection they need to keep them free of measles."

In an effort to reach the entire target population of children, health teams implement a comprehensive strategy that includes vaccination in health centers, home visits and campaigns in schools and care centers.

Collaboration between educational and health institutions, as well as with other members of the community, is also essential to ensure that every child receives the vaccine. For Marta Eugenia Arce, director of a school in Aguas Zarcas, our contribution is to raise awareness among parents and students, because we believe in vaccination as a preventive measure".

Another essential tool used by the health teams of the Costa Rican Social Security Fund is the Integrated Vaccine System (SIVA), which facilitates the follow-up of those who have not yet received their dose, as well as actions to reach them.

Dr. Mary Munive, Vice President and Minister of Health of Costa Rica, highlights that the population is well-versed in disease prevention and aware of the country's robust and effective vaccination schedule. However, during the COVID-19 pandemic, fears were generated that affected routine vaccination. "Now the message is clear: the pandemic is over and we must continue with the education and vaccination that have been proven to prevent disease and save lives," she said.

Despite the challenges of misinformation, protecting Costa Rica's young population remains a priority, and at the end of a day of vaccination, the atmosphere is festive at the Aguas Zarcas Social Security Clinic. A clown paints faces and makes balloon animals, while the children leave the vaccination area with smiles and donuts in their hands.

At the Social Security clinic in Aguas Zarcas, a clown paints faces and makes figures out of balloons, while children exit the vaccination area.

One mother expresses her confidence in the vaccines: "I trust them completely. They have been well studied and do not exist by chance," she says. "I consider them fundamental to prevent diseases and avoid complications. In the past, many people lost their lives because they didn't have access to what we have now. That is why it is important to make the most of them," she concludes.

Trabajadores de salud llegando a la población

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United States of America

Immunization

Rubella

Measles