Because measles-specific antibody titer after vaccination is lower than after natural infection, there is concern that vaccinated persons may gradually lose protection from measles. To examine the persistence of vaccine-induced antibody, participants of a vaccine study in 1971, with documentation of antibody 1-7 years after vaccination, were followed up in 1997-1999 to determine the presence and titer of measles antibody. Of the 56 participants (77% were 2-dose recipients), all had antibodies detected by the plaque reduction neutralization (PRN) antibody assay an average of 26-33 years after the first or second dose of measles vaccine; 92% had a PRN titer considered protective (>1 : 120). Baseline hemagglutination inhibition antibody titer in 1971 strongly predicted follow-up PRN antibody titer (P<.001). Persistence of antibody in these primarily 2-dose recipients supports the current elimination strategy to achieve and sustain high population immunity with a 2-dose schedule.

Purpose of the review This paper reviews the recent literature in burnout and compassion fatigue focusing on institutional factors influencing burnout where providers work as well as the individual factors affecting providers. In this review, there is an evaluation of the causes and interventions of burnout and compassion fatigue and areas for intervention. Recent findings The percentage of those suffering from burnout is decreasing for the first time in several years, and there are interventions to help decrease the impact of burnout and compassion fatigue. For an individual provider, mindfulness, cognitive behavioral therapy, and improved communication appear to be productive approaches to help with burnout. Institutional approaches that mitigate the impact of burnout in healthcare include assessing provider needs and returning some autonomy and control over workload to the provider. Summary Burnout and compassion fatigue remain a significant problem in healthcare and impact patient care as well as the well-being of providers. There are approaches that are working to decrease this impact in both the individual provider as well as the institutions in which providers are working. The research in this area from an individual perspective and a business perspective is only beginning.

Our findings demonstrate that a requirement for a second dose of measles vaccine at either primary or secondary school entrance is effective in lowering measles incidence, with a greater reduction occurring in states where the second dose is required for both age groups.