The role of secondary vaccine failures in measles outbreaks.

Mathias, Richard G.; Meekison, William; Arcand, Teri; Schechter, Miriam

doi:10.2105/ajph.79.4.475

Cited by 163 publications

(74 citation statements)

References 22 publications

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“…It is reasonable, therefore, to assume that such individuals with marginal levels of anti-MV immunity can be infected with MV although they may not necessarily exhibit typical clinical symptoms. Since secondary vaccine failure could contribute to the occurrence of measles cases in an epidemic (16), revaccination of such individuals needs to be considered in order to sustain an antimeasles immune status (2).…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Titers of Antibody against Measles Virus in Sera of Vaccinated and Naturally Infected Japanese Individuals of Different Age Groups

2002

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The anti-measles virus (MV) antibody titers in the sera of vaccinees and naturally infected individuals of different age groups were measured to help assess the efficacy of the current MV vaccination in Japan. Neutralizing (NT) antibody titers induced by vaccination were 2 3.2 times lower than those induced by natural infection and declined significantly by age 20. The once-decreased NT antibody titers of the vaccinees increased 2 3.6 times during their twenties to titers comparable to those of naturally infected individuals of the same age, implying the possible occurrence of natural infection in vaccinees with decreased anti-MV immunity. Although the current field strains in Japan, types D3 and D5, were reported to differ antigenically from each other and from vaccine strains (type A) to some extent, as demonstrated by different reactivities to monoclonal antibodies, the sera of vaccinees neutralized the two types of field strains and the vaccine strain with the same efficiency. This result suggests that the current vaccine strain would be suitable to elicit protection against types D3 and D5, as long as viral antigenicity is concerned. However, when compared at given hemagglutination inhibition titers, NT antibody titers of vaccinees were 2 1.1 to 2 3.2 times lower than those of naturally infected individuals, suggesting a qualitative difference(s) of anti-MV antibodies between the two groups. It should be emphasized that protective immunity induced by the one-dose vaccination currently implemented in Japan may not be strong enough to ensure lifelong immunity. A two-dose vaccination program with higher vaccination coverage needs to be considered in order to effectively control measles in Japan.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Titers of Antibody against Measles Virus in Sera of Vaccinated and Naturally Infected Japanese Individuals of Different Age Groups

2002

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“…The worldwide emergence of large-scale measles epidemics in many developed countries during 1988-91 is alarming. New findings have changed our understandings of measles, including the occurrence of subclinical infection [14,38,39] at immunized individuals may transmit the virus [38][39][40], the lack of life-long immunity in certain individuals [41][42], the genetic variability of the virus [43] and the significance of air-borne transmission [44][45][46]. Future measles control, in Taiwan and globally, should include: (1) increasing the timeliness and completeness of surveillance, (2) prospective immunological evaluation of vaccinees, (3) reassessment of the roles of immunized and asymptomatic individuals in the dynamics of transmission, and (4) utilization of local seroepidemiological data as well as residual maternal antibody levels for optimizing age and doses of immunization programmes.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

et al. 1995

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SUMMARYWe analysed nation-wide reported measles cases during the 1988-9 epidemic and found that longer duration and wider spread were two major characteristics of the outbreak. All the 22 county/city index cases were reported with a delay of > 4 days and 64% were aged 5-14 years. This epidemic occurred mainly among 5-14-year-old school-children (59 % ), infants under 1 year (19%), and pre-school children ( 18 %). The overall attack rate was 0-63 cases per 10000 population, with the highest attack rate (7 4 cases per 10000 population) occurring in infants. Among 280 confirmed cases < 15 months of age, 9-month-old infants (42 cases) had a higher risk of measles and peaked at 10 months (49 cases). This epidemic started in March 1988 among 5-9-year-old children in the northern suburban area, then spread to Taipei City and neighbouring counties or cities. It continued to spread from the northern to southern and western areas during the summer vacation and New Year holidays. Multiple logistic regression analysis showed that the delay of measles reporting was strongly associated with the cases infected early in the epidemic (OR = 6-9, P < 0.001) and reported from teaching hospitals (OR = 2 6, P < 0-001). The reappearance of high attack rates among 5-9-year-old children in the 1985 and 1988-9 measles epidemics in Taiwan indicated the persistence of pockets of susceptible individuals even after mass immunization.

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“…The sporadic outbreak of measles could be explained either by primary vaccination failure attributed to persistent maternal antibodies, impotent vaccine, improper vaccine storage and administration techniques 2,22 or secondary vaccination failure which might be due to other reasons; for example, lack of continuous antigenic stimulation, because of which lifelong immunity is not produced. 5,22,23 Alternatively, the outbreaks of measles could be due to accumulated unvaccinated cases. The finding of IgG seronegativity of randomized vaccinated population under 10 years of age (n=282 out of 2692, 10.48%) further warns that future outbreaks of measles would appear.…”

Section: Discussionmentioning

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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The role of secondary vaccine failures in measles outbreaks.

Cited by 163 publications

References 22 publications

Comparative Analysis of Titers of Antibody against Measles Virus in Sera of Vaccinated and Naturally Infected Japanese Individuals of Different Age Groups

Comparative Analysis of Titers of Antibody against Measles Virus in Sera of Vaccinated and Naturally Infected Japanese Individuals of Different Age Groups

Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

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

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