Decreasing measles burden by optimizing campaign timing

Measlesremains a major contributor to preventable child mortality, and bridging gaps in measlesimmunity is a fundamental challenge to global health. In high-burden settings, mass vaccinationcampaigns are conducted to increase access to vaccine and address this issue. Ensuring that campaigns are optimally effective is a crucial step toward measleselimination; however, the relationship between campaign impact and disease dynamics is poorly understood. Here, we study measlesin Pakistan, and we demonstrate that campaign timing can be tuned to optimally interact with local transmission seasonality and recent incidence history. We develop a mechanistic modeling approach to optimize timing in general high-burden settings, and we find that in Pakistan, hundreds of thousands of infections can be averted with no change in campaign cost.