Impact of measles vaccination on clinical characteristics and outcomes in children in Ramadi, Iraq.

Background: Measles is a highly contagious disease that caused by a measles virus. While measles vaccination is highly effective in preventing the disease, those who are unvaccinated or have not completed the vaccine series are at significant risk.

Aim: To assess the clinical characteristics and outcomes of measles in vaccinated vs unvaccinated children in Ramadi city.

Methods: Clinically confirmed cases of measles at Al-Ramadi Teaching Hospital for Maternity and Children, identified between June and December 2023, were enrolled in this prospective cohort study. The cases were divided into two groups (vaccinated and unvaccinated). The clinical characteristics and outcomes were compared between unvaccinated and vaccinated children.

Results: Of 289 kids, there were 222 (76.8%) children under 5 years old, and 161 (55.7%) boys. Around 2/3^rd children were unvaccinated. Besides, only 5 (4.9%) kids from the vaccinated group received three doses. Fever, maculopapular rashes, and cough were the most common manifestations. Unvaccinated children had higher rate of developing complications (pneumonia and diarrhea with P values 0.001 and 0.01 respectively), longer hospital admission period (P value = 0.008), and the need for respiratory care unit (RCU) admission comparing with the vaccinated children (4 cases for unvaccinated group vs 1 case for vaccinated group).

Conclusion: Unvaccinated kids were associated with more complications, longer admission hospital stays, and RCU admission. We recommend that public health directors utilize artificial intelligence tools to help control future measles epidemics.