Measles vaccination policy

Williams, Brian G.; Cutts, Felicity; Dye, Christopher

doi:10.1017/s0950268800058763

Cited by 32 publications

(25 citation statements)

References 26 publications

(37 reference statements)

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“…However, there is need to carry out a follow up evaluation survey to assess the impact of the measles vaccination conducted in 2001 on measles morbidity and mortality in the pilot sites before contemplating on changing the current immunisation schedules in Tanzania. The reason for this viewpoint is that the optimal age for measles vaccination has been a subject for debate among vaccine experts for many years (1,(7)(8)(9)(10)(11)(12)(13). The recommended optimal age for measles vaccination in Tanzania has been 9 months for many years (1).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of measles in Tanzania: A hospital-based survey of measles morbidity and mortality

Mnyika

Akim

2007

East Afr. J. Pub. Health

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Objective: To estimate measles morbidity and mortality in selected regions on mainland Tanzania Design: Cross-sectional study Setting: Hospital-based review of existing records on measles morbidity and mortality in the selected district hospitals on mainland Tanzania. Methods: Review of records on measles morbidity and mortality was performed using a standard instrument adopted from the Ministry of Health. The instrument was pre-tested before use. Researchers were recruited from the Muhimbili University College of Health Sciences and were trained on how to collect data from the hospital records. Ethical clearance was obtained from the Ministry of Health in Dar es Salaam. Upon arrival in the respective regions, the researchers recruited and trained local research assistants on methods of data collection. Completed questionnaire forms were entered into a computer and data cleaning was done before data analysis. Results: Measles was found to occur in individuals of over 15 years of age and beyond. Overall 35% (N=2277) of all measles cases were reported from the Iringa region while Mara region had the lowest number of cases. On the other hand Shinyanga had the highest case fatality rate (6%) compared with other regions. Mortality was higher in children below two years of age and among individuals who had no history of measles vaccination. Conclusion: We conclude that despite high measles vaccination coverage, measles is still a public health problem in Tanzania. Efforts should be made to give several booster doses up to the age of 15 years.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of measles in Tanzania: A hospital-based survey of measles morbidity and mortality

Mnyika

Akim

2007

East Afr. J. Pub. Health

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“…In general, uptake of the second MMR vaccine has been low in Germany so that the vaccine e cacy r(t) should only be slightly overestimated by our model. Various ideas have been discussed concerning the degree and duration of maternal protection [10][11][12]. Among the cases with known vaccination age, there is only one child who was vaccinated before one year of age (see Figure 7).…”

Section: Discussionmentioning

confidence: 99%

Estimation of the time‐dependent vaccine efficacy from a measles epidemic

Eichner

Diebner

Schubert

et al. 2002

Statistics in Medicine

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We present a method to estimate the time-dependent vaccine efficacy from the cohort-specific vaccination coverage and from data on the vaccination status of cases and apply it to a measles epidemic in Germany which involved 529 cases, 88 of whom were vaccinated and 370 unvaccinated (for the remaining 71 cases the vaccination status is unknown). Our epidemiological model takes into account that maternal antibodies prevent successful vaccination and that vaccine immunity may be lost over time. Model parameters are estimated from the data using maximum likelihood. Vaccination coverage, as determined in school surveys, ranged from 27.6 per cent for the cohort born in 1974 to 85 per cent for the 1986 cohort, which is far too low to prevent measles transmission. Cohorts for which no school surveys were performed are omitted from analysis. Thus, sufficient data are available for only 282 cases, 69 of whom are vaccinated. According to our estimates, measles vaccinations provided no immunity before 1978 (95 per cent CI: 0 to 47 percent), for the period 1978-1982, the estimated vaccine efficacy was 80 percent (95 percent CI: 67 to 89 percent), and for 1982-1990 it was 97 percent (95 percent CI: 93 to 99 percent). After 1990, the estimated value dropped to 89 per cent, but its confidence interval widely overlaps with that of the previous period (95 percent CI: 74 to 97 percent). Loss of immunity was estimated to be zero (95 percent CI: 0 to 0.003/year). Several sensitivity analyses were performed with respect to the model assumptions. A modified model which assumed constant efficacy at all vaccination times yielded a high estimate of 96 per cent (95 percent CI: 92 to 98 percent) for primary vaccine efficacy but also a high loss rate of immunity of 0.007/year (95 percent CI: 0.001 to 0.012) to explain the high fraction of vaccinated cases among older individuals. The likelihood score value is however significantly inferior compared to the score value of the model with time-dependent vaccine efficacy.

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“…Finally, epidemiological investigations have shown that a single MV vaccination may not protect efficiently against a MV infection. Therefore, a second administration of the vaccine has been recommended since 1991 [50] .…”

Section: And Otosclerosis: Consistency Of Associationmentioning

confidence: 99%

Otosclerosis and Measles Virus – Association or Causation?

Niedermeyer

Arnold²

2008

ORL

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Otosclerosis is a frequent condition which occurs exclusively in the human temporal bone. This peculiar disease affects mainly Caucasians and Indians and may cause conductive, mixed conductive-sensorineural or occasionally merely sensorineural hearing loss. Morphological investigations of the otosclerotic focus show all three phases of a chronic inflammation with bone resorption, formation of new bone and finally eburnation. Various hypotheses about the cause of inflammation were proposed in the past. Immunological reactivity to collagen, the existence of otosclerosis genes (OTSC 1–5) including mutations of the collagen gene 1A1 and 1A2 or a measles virus (MV) infection were suggested. The existence of the MV proteins and RNA within the otosclerotic tissue has been shown by several authors. However, due to mainly technical problems, no further progress to elucidate the role of the virus could be made. Epidemiological studies revealed a dramatic decrease of measles and related diseases such as the subacute sclerosing panencephalitis since the introduction of MV vaccination programs in USA and Europe. Indeed, some surgeons reported decreasing numbers of stapes surgery and a shift towards elder patients. Our epidemiological survey of all patients hospitalized with otosclerosis in Germany between 1993 and 2004 demonstrates a highly significant decrease in otosclerosis among the population vaccinated against the MV. The strong correlation makes it most plausible that the MV is at least one triggering factor for the development of otosclerosis.

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Measles vaccination policy

Cited by 32 publications

References 26 publications

Epidemiology of measles in Tanzania: A hospital-based survey of measles morbidity and mortality

Epidemiology of measles in Tanzania: A hospital-based survey of measles morbidity and mortality

Estimation of the time‐dependent vaccine efficacy from a measles epidemic

Otosclerosis and Measles Virus – Association or Causation?

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