The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs) 1 – 4 . Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19) 5 – 8 . Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km 2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children. Although progress in the coverage of routine measles vaccination in children in low- and middle-income countries was made during 2000–2019, many countries remain far from the goal of 80% coverage in all districts by 2019.

中文翻译：

---

绘制低收入和中等收入国家的常规麻疹疫苗接种地图

安全、高效的麻疹疫苗自 1974 年开始在全球范围内被推荐使用，但 2017 年麻疹病例超过 1700 万例，5 岁以下儿童死亡 83400 人，其中 99% 以上发生在中低端收入国家 (LMIC) 1 - 4 . 对常规首剂麻疹疫苗 (MCV1) 覆盖率进行全球可比的年度本地估计对于了解地理上精确的免疫模式、实现全球疫苗行动计划 (GVAP) 目标的进展以及中断中的高风险区域至关重要2019 年冠状病毒病 (COVID-19) 5 - 8 引起的疫苗接种计划。在这里，我们生成了 2000 年至 2019 年 101 个 LMIC 中 5 × 5-km 2 像素和二级行政级别的常规儿童 MCV1 覆盖率的年度估计值，量化地理不平等并通过地理偏远评估疫苗接种状况。在 2000 年至 2010 年 MCV1 广泛增长后，2010 年至 2019 年间，一半以上地区的覆盖率出现倒退，许多 LMIC 远未实现到 2019 年在所有地区实现 80% 覆盖率的 GVAP 目标。农村地区的 MCV1 覆盖率低于城市地点，尽管总体上较大比例的未接种疫苗儿童生活在城市地区；提供基本疫苗接种服务的战略应针对这两种地理环境。这些结果为决策者加强常规 MCV1 免疫计划和为所有儿童提供公平的疾病保护提供了一个工具。尽管在 2000-2019 年期间，低收入和中等收入国家儿童常规麻疹疫苗接种的覆盖率取得了进展，