Vaccines for measles, mumps, rubella, and varicella in children

Pietrantonj, Carlo Di; Rivetti, Alessandro; Marchione, Pasquale; Debalini, Maria Grazia; Demicheli, Vittorio

doi:10.1002/14651858.cd004407.pub5

Cited by 29 publications

(57 citation statements)

References 343 publications

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“…Cross-reactive serology occurs reasonably uncommonly using the ELISA methodology, however, the influence of false-positive serology can form a large proportion of cases when overall measles numbers are low and rubella numbers Using the narrow case definition, which excluded the rubella positive cases, measles vaccine effectiveness in South Africa was determined as 80% among children aged between 1-4 years old. This is low compared to other studies that reported vaccine effectiveness of 95%, using large datasets [24,25]. Our results also showed that the odds of being vaccinated and having measles was lower prior to 2016, when children received vaccine at 9 months and 18 months, compared to post 2016 when children receive the vaccine at 6 months and 12 months.…”

Section: Discussioncontrasting

confidence: 92%

Measles incidence in South Africa: a six-year review, 2015—2020

et al. 2022

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In 2012 the World Health Organization (WHO) aimed to eliminate measles in five regions by 2020. This retrospective descriptive study reviewed measles surveillance data in South Africa for the period 2015—2020 to document the epidemiology of measles and the progress made towards meeting the 2020 measles elimination goal.A total of 22,578 specimens were tested over the period 2015—2020 yielding 401 (1.8%) confirmed measles cases, 321 (1.4%) compatible and 21,856 (96.8%) discarded cases. The most affected age group was 0–4 year olds. At the provincial level, South Africa achieved adequate surveillance, defined as more than two cases of febrile rash notified annually per 100 000 popoulation, except for KwaZulu-Natal and Limpopo in 2020, probably due to COVID-19 lockdown restrictions. Of confirmed cases, only 26% were vaccinated, 3% were too young to receive vaccines, 5% were not vaccinated, and 65% had unknown vaccination status. Measles vaccine effectiveness amongst 1–4 year olds was 80%. Using the standard case definition, South Africa achieved the measles elimination target of less than one case per one million nationally in years 2015, 2016 and 2020. The years 2017 to 2019 had incidence rates exceeding one per million nationally. Using a narrow case definition, that excluded positive rubella cases, improved the indicators with only the year 2017 having an incidence rate of more than one per million.South Africa displays intermittent measles outbreaks approximately six-yearly interspersed by inter-epidemic periods in which the country meets measles elimination targets. Intense effort is needed to increase the vaccine coverage to avoid periodic outbreaks. Enhanced molecular testing of each case will be required as measles incidence declines regionally.

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Section: Discussioncontrasting

confidence: 92%

Measles incidence in South Africa: a six-year review, 2015—2020

et al. 2022

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“…The most recent specified end search date within the reviews was November 2020 23 . Of the 17 reviews, one review included randomised controlled trials (RCTs) only, 24 six reviews included RCTs and observational studies 23,25–29 of which one also included two previously published systematic reviews, 26 two included RCTs and other study types that were unclear, 30,31 five included observational studies only, 32–36 two included case reports only 37,38 and the study types were not clear in one review 39 . Of the two systematic reviews that were themselves included in an eligible systematic review for this overview, 26 neither met the pre‐defined eligibility criteria (Table 1) for a systematic review and were therefore not included in this overview; one included a search of one database only and search terms were not provided in the other.…”

Section: Resultsmentioning

confidence: 99%

Safety of varicella vaccination strategies: An overview of reviews

Ahern

Walsh

Paone

et al. 2022

Reviews in Medical Virology

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The safety of new vaccines under development as well as existing vaccines is a key priority for national and international public health agencies. A number of countries have implemented universal childhood varicella vaccination programmes over the past 30 years. However, strategies differ in terms of the number of doses, type of vaccine(s) recommended, age at vaccination and interval between doses for a twodose schedule. An overview of reviews was undertaken to assess the existing systematic review evidence of the safety of varicella vaccination strategies. The review was restricted to immunocompetent children aged 9 months to 6 years inclusive. A comprehensive search of databases, registries and grey literature was conducted up to 2 February 2022. Two reviewers independently screened, extracted data and assessed the methodological quality of included reviews. Overlap of included reviews was also assessed. A total of 17 reviews, incorporating both the monovalent varicella only and quadrivalent measles-mumps-rubella-varicella (MMRV) vaccines were included in the overview; six assessed the safety of one-dose strategies, four assessed the safety of two-dose strategies and 14 reviews did not specify the dosing strategy. The evidence suggests that mild local and systemic reactions are relatively common with varicella vaccination. Febrile seizures are also possible adverse effects of both the monovalent and quadrivalent MMRV vaccine, but serious adverse reactions are rare. While most reviews contained methodological flaws, and analysis by vaccine type and dosing strategy was restricted due to lack of detail in reporting of the reviews, there was clear and consistent evidence from a substantial evidence base, comprising 34 randomised controlled trials and 62 other primary studies/reviews, that varicella vaccination is safe.

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“…Comparison of results of non-serious outcomes among adolescents and adults to those experienced by younger children is challenging. Most data on safety of MMR in children are derived from clinical trials and other studies in which adverse events were prospectively solicited and did not require seeking medical attention [3] , [5] . It is therefore difficult to conclude whether or not non-serious outcomes after MMR, namely local and systemic reactogenicity, are less common in adolescents and adults than children.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have found that MMR-containing vaccines are generally well tolerated [3] , [4] , [5] ; however, these studies have primarily been conducted among young children. Data on the safety of MMR administered to adolescents or adults are mainly from vaccination campaigns during outbreaks [6] , [7] , [8] , [9] , [10] and an assessment of events reported to the U.S.…”

Section: Introductionmentioning

confidence: 99%