The outbreak likely resulted from failure to vaccinate rather than vaccine failure. Susceptible persons likely accumulated due to the long absence of large outbreaks and decreased coverage after the collapse of Soviet Union. To interrupt measles and rubella transmission in Georgia and achieve disease elimination goals by 2010, supplementary immunization activities should target children and young adults.
Limitations of the study include the observational design, the small number of participants from a single center, and the inability to adjust for confounding characteristics; hence, results may not generalize to other settings with different demographic characteristics. The period of risk for infection was slightly later for the vaccinated cohort than the unvaccinated cohort. However, the study encompassed a sustained period of high community transmission. 2 Black HCWs constituted a higher percentage of the SARS-CoV-2-positive unvaccinated cohort, although these data were not statistically significant. Finally, these findings address primarily the short-term effects of a single dose of mRNA-1273 vaccine.
The CFR among children aged <2 years in India is high compared with previously published CFRs for young children, in part because of improved case finding through enhanced surveillance techniques. Fatal cases emphasize the lethal nature of the disease and the importance of achieving polio eradication in India.
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