Epidemic Measles and Rubella in Air Force Recruits: Impact of Immunization

Abstract

The safety of attenuated viral vaccines against measles and rubella and their efficacy in controlling a massive outbreak of these two diseases in air force recruits at Lackland Air Force Base, Texas, were studied. Recorded cases of measles declined from a high of 1,345 in 1976 to a low of 227 in 1979. Similarly, rubella cases declined from a peak before the immunization program of 1,361 in 1977 to a low of 67 in 1979. A controlled study of morbidity related to immunization revealed that there is less immediate local morbidity from immunizations against measles and rubella than with other routine immunizations. Recruits who received the attenuated viral vaccines reported fever, myalgias, and diarrhea only slightly more frequently than did recruits in the concurrent control group. The present data indicate that measles and rubella, increasingly consequential diseases among young adults, can be safely and effectively controlled with attenuated viral vaccines.

Seroprevalence of measles, mumps and rubella among young adults, after 20 years of universal 2-dose MMR vaccination in Israel

“…This evidence is especially important to determine measles control policy in the IDF, as the military settings, especially in training camps, is prone to outbreaks which risk the individual and the readiness of the unit due to high communicability and crowded settings. 16 Accordingly, the medical corps takes proactive measures to prevent measles outbreak in the IDF by intensified surveillance efforts (any suspected measles case requires immediate reporting), vaccination and/or active monitoring of exposed susceptibles or units, similarly to proactive approach taken to prevent mumps and other infectious diseases. 17 This intense control measures in the military, coupled with the logistical capability to carry intense surveillance and rapid response by vaccination, might aided the success of measles control in the IDF in 2007-8 measles outbreak in Israel.…”

Twice vaccinated recipients are better protected against epidemic measles than are single dose recipients of measles containing vaccine

“…The superiority of the two dose over the one dose strategy has been indirectly predicted from ecological, 44 and quasi experimental data, 45 and indirect individual level immunological data. 37 Conclusive evidence that revaccinated individuals have lower measles attack rates has so far been lacking, 1 though many outbreak reports suggest this interpreta-tion.…”

A measles outbreak at a college with a prematriculation immunization requirement.

“…Experience from the military suggests that a second dose of measlesvaccine should be effective in preventing outbreaks. 29 Measles elimination has proved more difficult than previously predicted.30 A single dose strategy, while highly effective, has not been able to totally prevent measles outbreaks. The full implementation of a routine two-dose measles vaccination schedule, however, should help reduce measles outbreaks in highly vaccinated populations.…”