Field Effectiveness of Live Attenuated Measles-Containing Vaccines: A Review of Published Literature

Uzicanin, Amra; Zimmerman, Laura

doi:10.1093/infdis/jir102

Cited by 145 publications

(136 citation statements)

References 46 publications

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“…We found a two-dose VE of 97·1% which corresponds with the two-dose VE of 99·4% (95% CI 97-100) reported from a large school outbreak in Germany in 2006 [20] and a VE found in a review of field effectiveness of MCVs (two-dose VE 94·1%, 95% CI 88·3-98·3) [21]. The MCV1 VE estimation was limited by the low number of children with one vaccination resulting in a wide 95% CI.…”

Section: Discussionsupporting

confidence: 64%

Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Lassen

Schuster

Stemmler³

et al. 2013

Epidemiol. Infect.

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was an outbreak of measles virus, genotype D4, in Berlin, Germany. We identified 73 case-patients from the community and among students of an anthroposophic school, who participated in a 4-day school trip, as well as their family and friends. Overall, 27% were aged 520 years, 57% were female and 15% were hospitalized. Of 39 community case-patients, 38% were aged 520 years, 67% were female and 63% required hospitalization. Unvaccinated students returning from the school trip were excluded from school, limiting transmission. Within the group of 55 school-trip participants, including 20 measles case-patients, a measles vaccine effectiveness of 97·1% (95% confidence interval 83·4-100) for two doses was estimated using exact Poisson regression. Our findings support school exclusions and the recommendation of one-dose catch-up vaccination for everyone born after 1970 with incomplete or unknown vaccination status, in addition to the two-dose routine childhood immunization recommendation.

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Section: Discussionsupporting

confidence: 64%

Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Lassen

Schuster

Stemmler³

et al. 2013

Epidemiol. Infect.

View full text Add to dashboard Cite

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“…5 The greater vulnerability of those vaccinated at 12 months was reasoned to be caused by interference from maternal antibodies, addressed through second-dose administration. [9][10][11]21 Measles vaccine protection thereafter was considered to provide lifelong immunity. 8 Increasing the age of the first dose to 15 months in a 2-dose program was therefore assumed unnecessary.…”

Section: Discussionmentioning

confidence: 99%

“…In guiding the optimal timing of primary immunization, it is necessary to weigh our findings against the recognized severity of measles in infants and VE in protecting against that, especially in the context of an outbreak. 21 Currently, measles has been eliminated from the Americas, and global experience overwhelmingly supports durable immunity from 2 doses of measles vaccine. However, the unexpected vulnerability we have identified in twice-vaccinated people during the epidemic in Quebec should be considered a signal warranting additional investigation.…”

Section: Discussionmentioning

confidence: 99%

Measles in Children Vaccinated With 2 Doses of MMR

et al. 2013

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OBJECTIVE: A previous measles outbreak investigation in a high school in Quebec, Canada identified 2-dose vaccine effectiveness of 94%. The risk of measles in 2-dose recipients was significantly higher (2–4 times) when measles vaccine was first administered at 12 versus ≥15 months of age, with no significant effect of the age at second dose. Generalizability of this association was also assessed in the expanded provincial data set of notified cases. METHODS: This matched case–control study included only 2-dose recipients. All confirmed (laboratory or epidemiologically linked) cases in patients aged 5 to 17 years were included. Each case was matched to 5 controls. RESULTS: A total of 102 cases and 510 controls were included; 89% of cases were in patients 13 to 17 years old. When the first dose was administered at 12 to 13 months compared with ≥15 months of age, the risk of measles in participants outside the outbreak school was 6 times higher (95% confidence interval, 1.33–29.3) and was 5.2 times higher (95% confidence interval, 1.91–14.3) in the pooled estimate (participants from the outbreak school + outside that school). CONCLUSIONS: A significantly greater risk of measles among 2-dose recipients whose first dose was given at 12 to 13 months rather than ≥15 months of age is confirmed in the larger Quebec data set. The mechanism remains unknown, but vaccine failures in 2-dose recipients could have substantial implications for measles elimination efforts through 2-dose vaccination. The optimal age at first dose may warrant additional evaluation.

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“…4 Widespread use of measles vaccine led to the elimination of endemic measles in the Americas in 2002. 5 Measles cases in the United States occur by importation from countries with high measles disease rates or exposure to imported or outbreak-associated cases.…”

mentioning

confidence: 99%

An Outbreak of Measles in an Undervaccinated Community

et al. 2014

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Measles is readily spread to susceptible individuals, but is no longer endemic in the United States. In March 2011, measles was confirmed in a Minnesota child without travel abroad. This was the first identified case-patient of an outbreak. An investigation was initiated to determine the source, prevent transmission, and examine measles-mumpsrubella (MMR) vaccine coverage in the affected community. Investigation and response included case-patient follow-up, post-exposure prophylaxis, voluntary isolation and quarantine, and early MMR vaccine for non-immune shelter residents .6 months and ,12 months of age. Vaccine coverage was assessed by using immunization information system records. Outreach to the affected community included education and support from public health, health care, and community and spiritual leaders. Twenty-one measles cases were identified. The median age was 12 months (range, 4 months to 51 years) and 14 (67%) were hospitalized (range of stay, 2-7 days). The source was a 30-monthold US-born child of Somali descent infected while visiting Kenya. Measles spread in several settings, and over 3000 individuals were exposed. Sixteen case-patients were unvaccinated; 9 of the 16 were age-eligible: 7 of the 9 had safety concerns and 6 were of Somali descent.

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Field Effectiveness of Live Attenuated Measles-Containing Vaccines: A Review of Published Literature

Cited by 145 publications

References 46 publications

Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011

Measles in Children Vaccinated With 2 Doses of MMR

An Outbreak of Measles in an Undervaccinated Community

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