Rapid Effect on Endemic Measles, Mumps, and Rubella of Nationwide Vaccination Programme in Finland

Peltola, Heikki; Kurki, Tapio; Virtanen, Martti; Nissinen, Mikko; Karanko, Viena; Hukkanen, Veijo; Penttinen, K; Op, Heinonen

doi:10.1016/s0140-6736(86)92270-1

Cited by 91 publications

(42 citation statements)

References 4 publications

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“…An alternative strategy to the outlined in the previous section, is to adopt two stages of vaccination targeted simultaneously at two different age classes. This type of approach has been adopted recently in Finland, where children are targeted for vaccination at 4-18 months of age and at 6 years of age (Peltola et al 1986). …”

Section: Resultsmentioning

confidence: 99%

Measles in developing countries. Part II. The predicted impact of mass vaccination

1988

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SummaryA mathematical model is developed to mimic the transmission dynamics of the measles virus in communities in the developing world with high population growth rates and high case fatality rates. The model is used to compare the impacts of different mass vaccination programmes upon morbidity and mortality arising from infection by measles virus. Analyses identify three conclusions of practical significance to the design of optimal vaccination programmes. First, there is no single optimum age at which to vaccinate children for all urban and rural communities in developing countries. For a given community the best age at which to vaccinate depends critically on the age distribution of cases of infection prior to the introduction of control measures. Second, numerical studies predict that the introduction of mass vaccination will induce a temporary phase of very low incidence of infection before the system settles to a new pattern of recurrent epidemics. Mass vaccination acts to lengthen the inter-epidemic period in the postvaccination period when compared with that prevailing prior to control. Third, numerical simulations suggest that two-phase and two-stage vaccination programmes are of less benefit than one-stage programmes (achieving comparable coverage) aimed at young children. The paper ends with a discussion of the needs for: improved programmes of data collection; monitoring of the impact of current vaccination programmes; and the development of models that take account of viral transmission dynamics, host demography and economic factors.

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Section: Resultsmentioning

confidence: 99%

Measles in developing countries. Part II. The predicted impact of mass vaccination

1988

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“…The new MMR (measles-mumps-rubella) vaccination was introduced in the early 1980s nationwide in Finland [36]. Another vaccination programme against Haemophilus influenzae was initiated at the end of 1985 [37].…”

Section: Discussionmentioning

confidence: 99%

Record-high incidence of Type I (insulin-dependent) diabetes mellitus in Finnish children

Tuomilehto¹,

Karvonen²,

Pitkäniemi³

et al. 1999

Diabetologia

134

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“…15 Over the years, only 1 type of vaccine (MMR II , Merck and Co, Inc, West Point, PA)-consisting of the more attenuated Enders-Edmonston strain of measles virus, 1,4 the Jeryl Lynn strain of mumps virus, 8 and the Wistar 27/3 strain of rubella virus 10 -has been used in the 2-dose schedule. The first dose is administered at 14 to 18 months of age and the second at 6 years of age.…”

Section: Vaccinementioning

confidence: 99%

Day-to-Day Reactogenicity and the Healthy Vaccinee Effect of Measles-Mumps-Rubella Vaccination

et al. 2000

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ABSTRACT.Objective. Revaccination policies adopted in many countries to control measles have raised various safety issues including those concerning the second vaccine dose. We performed a prospective, double-blind, crossover trial among twins receiving a measles-mumpsrubella (MMR) vaccine.Study Design. The study comprised 1162 monozygous and heterozygous twins, each of whom randomly received placebo and then vaccine, or vice versa, 3 weeks apart, at 14 to 83 months of age. Most of the oldest children had previously been vaccinated against measles, and one half of the remainder of children had had the disease. Symptoms and signs were recorded daily on structured forms. Statistical methods included a complex analysis of the vaccine attributability of the symptoms and conditional logistic regression.Results. Vaccination-attributable events occurred in 6% overall. At 14 to 18 months of age, reactions developed between days 6 and 14, peaking at day 10. The clearest vaccine-attributable effect was fever exceeding 101.3°F (38.5°C; odds ratio: 3.28; 95% confidence interval: 2.23-4.82; P < .001), but the same trend was found for rash, arthralgia, conjunctivitis, staying in bed, drowsiness, and irritability. At 6 years of age, systemic reactions occurred 5 to 15 times less frequently, only arthralgia being associated with vaccination. Zygocity, gender, history of allergy, or infections did not modify reactions. Instead, respiratory symptoms developed within days postinjection to a level of 15% to 20% without subsequent decline and with no difference between vaccinees and placebo recipients.Conclusion. Vaccination was avoided during infections, but many small children became mildly ill within a week or so with no relation to vaccination (the healthy vaccinee effect). MMR vaccine was virtually nonreactogenic when given at 6 years of age. Pediatrics 2000;106(5). URL: http://www.pediatrics.org/cgi/content/full/106/5/ e62; vaccine, measles, mumps, rubella, reactogenicity, adverse events, zygocity, healthy vaccinee effect.ABBREVIATIONS. MMR, measles-mumps-rubella; OR, odds ratio; VA, vaccine attributability.T he measles components 1-3 used in various measles-mumps-rubella (MMR) vaccines 4,5 have been associated with various short-term and long-term adverse events. This is also true to a lesser extent for the rubella antigen, 6,7 whereas the mumps component (particularly the Jeryl Lynn strain) is deemed virtually harmless. 8 Controlled studies on vaccine reactogenicity are rare, 9 and uncontrolled studies 10 -12 exaggerate findings because of a temporal rather than a causal association with vaccination. Very little is known about factors modifying adverse reactions. 13 We performed a randomized, double-blind, placebo-controlled, and crossover vaccination trial in twins using the MMR vaccine in widest use internationally; the early results were published shortly after the trial. 14 Here we report a thorough analysis of the day-to-day symptoms and signs in 2 age groups with or without previous measles vaccination, and we examine ...

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Rapid Effect on Endemic Measles, Mumps, and Rubella of Nationwide Vaccination Programme in Finland

Cited by 91 publications

References 4 publications

Measles in developing countries. Part II. The predicted impact of mass vaccination

Measles in developing countries. Part II. The predicted impact of mass vaccination

Record-high incidence of Type I (insulin-dependent) diabetes mellitus in Finnish children

Day-to-Day Reactogenicity and the Healthy Vaccinee Effect of Measles-Mumps-Rubella Vaccination

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