Measles Vaccine Failure

Abanamy, Ahmed; Khalil, Mohammed Rohi; Salman, Hussein; Abdulazeem, Mahmoud

doi:10.5144/0256-4947.1991.311

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…A substantial number of cases were still occurring in children younger than 9 months, and measles infection shifted to older age groups, with a large proportion of cases occurring in vaccinated children. 8 Epidemics were still occurring, but with a lower epidemic peak and a longer inter-epidemic period. A follow-up study for measles maternal antibody showed that 33% of children at 6 months of age and 36% at 9 months of age were negative for measles maternal antibody.…”

Section: Control Phasementioning

confidence: 99%

Measles in Saudi Arabia: from control to elimination

Khalil

Al-Mazrou

Al-Howasi

et al. 2005

Annals of Saudi Medicine

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This article describes the tremendous efforts made in the field of measles immunization in Saudi Arabia in the past 20 years, from the control phase to the elimination phase. Mandatory measles vaccination with one-dose Schwartz vaccine was introduced in 1982 by a royal decree, a step aimed at increasing vaccine coverage. In 1991, a two-dose schedule was implemented using Edmonston-Zagreb measles vaccine, with a first dose at 6 months to protect children younger than 9 months and a second dose of MMR at 12 months of age to protect those who did not respond to the first dose. A marked reduction in the epidemic peak and a shift of infection to older age were noticed. But the same data showed that 50% of measles cases in the 1- to 4-year age group occurred in vaccinated children. In 1998, with the start of elimination phase, an MMR campaign was launched in two phases, targeting school children in 1998 (secondary schools) and in 2000 (primary and intermediate schools). Evaluation of the MMR campaign and surveillance data was reflected in the measles immunization policy by shifting the age of measles immunization to 12 months and to preschool using the two-dose MMR schedule.

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Section: Control Phasementioning

confidence: 99%

Measles in Saudi Arabia: from control to elimination

Khalil

Al-Mazrou

Al-Howasi

et al. 2005

Annals of Saudi Medicine

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“…All cases of measles were clinically diagnosed at PHCCs by utilizing the diagnostic criteria as laid down in previous studies. 6,7 These cases were later referred to the general hos itals for diagnostic confirmation. To determine the immunological response of attenuated measles vaccine, 3 mL of blood were collected from each child (n=3022) at their homes in a randomized fashion by a PHC physician during the last six months of 1992.…”

Section: Methodsmentioning

confidence: 99%

A Seroepidemiological Study of Measles: Some Practical Implications for Measles Immunization Program, Kingdom of Saudi Arabia

Hegazy

Al-Beyari

Al-Amri

et al. 1994

Annals of Saudi Medicine

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It was hypothesized that the recent outbreaks of measles in a geographically defined area of Al-Qassim might reflect significant changes in the epidemiology of measles and cast doubt upon the real protective value of measles vaccines. Therefore, the two objectives of this research were to study some epidemiological parameters of cases of measles (n=993) and the current immunological status of immunized children (n=2810). The crossmatched data about measles patients were collected on an official proforma and 3 mL of blood were extracted from each child for determining the measles IgG and IgM antibodies. The results showed that female patients were significantly overrepresented (51.3%). The majority of patients encountered at primary health care centers (PHCCs) (81.3%) were more than five years of age (76.5%). Among nonvaccinated measles cases, 54.9% (n=402) were from rural/desert areas. The measles vaccine failure rate was 26.3%. The results of the surveyed children showed that 2% of them were not vaccinated. The measles IgM levels were detected significantly in recently vaccinated females (n=29/51, 56.9%). The measles IgG positivity unaffected by age, sex, and residence was found in 87.4% of children. A significant portion of children from rural/desert areas were not vaccinated (n=44/57, 77.2%). Though there were apparently high seroconversion rates in children under two years of age following Edmonston-Zagreb vaccine, overall it did not achieve any statistical significance when compared with seroconversion rates in all children following Schwartz vaccine. We conclude that besides at age six months, and MMR containing measles vaccine at 12 months, children at school entry (six years) should also be considered for measles vaccination. Ann Saudi Med 1994;14(5):399-404.

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Vaccination of Saudi Children Against Measles with Edmonston-Zagreb

Abanamy¹,

Khalil²,

Salman³

et al. 1992

Ann Saudi Med

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A Abanamy, M Khalil, H Salman, MA Azeem, Vaccination of Saudi Children Against Measles with EdmonstonZagreb. 1992; 12(1): 110-111 To the Editor: Measles vaccine failure due to persistent maternal antibodies is well known, especially in children vaccinated before the age of one year.A recent study has shown that about two thirds of Saudi children at the age of six months have maternal antibodies [1], In Saudi Arabia, the incidence of measles is still high and many cases are reported in children under six months. Measles among vaccinated children is also common [2].In order to protect the young susceptible children against measles, early vaccination at the age of six months was recently introduced by the Ministry of Health. A booster dose is given at the age of 12 months.The use of Edmonston-Zagreb strain in measles vaccine has generated considerable interest because theoretically it may offer better protection to young infants against measles [3]. This strain has not been used before in Saudi Arabia.This study compares the seroconversion rate following vaccination with the current vaccine (Schwartz vaccine) versus Edmonston-Zagreb strain at the age of six months in Saudi children. This is a randomized controlled trial where six month old children were allocated into two groups to receive Edmonston-Zagreb (27 children) or Schwartz measles vaccine (25 children). A control group of 53 children age nine months, which is the usual age of vaccination in Saudi Arabia, was vaccinated using Schwartz vaccine.For children to be vaccinated with Schwartz, we used Rimevax (Smith Kline) live attenuated vaccine. Each dose contains not less than 1000 TCID50 of measles virus. In the Edmonston group, we used Moraten Berna, the attenuated Edmonston-Zagreb virus strain. Each dose from Moraten also contains no less than 1000 TCID50 live measles virus. Both vaccines were tested for potency before starting the trial using Reed and Meunch formula titration for TCID50/dose.In all children, 3 ml blood in a plain tube was taken prior to the vaccination and two months later to measure the measles antibodies in their sera using an indirect flourescent technique using a kit from Virgo Electro-Nucleonic, Inc. A titer of 1/8 or more is considered positive according to the kit. Seroconversion was defined as fourfold rise in the antibody titer in the second sample.Before vaccination, 22 children out of 52 (42.3%) at the age of six months did not have evidence of maternal antibodies compared with 35 of 53 (66%) at nine months of age.After vaccination, 26 of 27 children (96.3%) had seroconversion after vaccination with Edmonston-Zagreb compared with 14 of 25 (56%) vaccinated with Schwartz vaccine. The difference was significant (P = .0018). Eight children from those with seroconversion failure after Schwartz vaccine were followed up to the age of 15 months and another blood sample was taken after giving measles, mumps, and rubella (MMR), all of which showed seroconversion after MMR vaccination. The seroconversion in those vaccinated with Schwartz...

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Measles Vaccine Failure

Cited by 4 publications

References 19 publications

Measles in Saudi Arabia: from control to elimination

Measles in Saudi Arabia: from control to elimination

A Seroepidemiological Study of Measles: Some Practical Implications for Measles Immunization Program, Kingdom of Saudi Arabia

Vaccination of Saudi Children Against Measles with Edmonston-Zagreb

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