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

Abstract

Objective-To study measles risk after revaccination. Design-A population-based case-control study during an epidemic season. Main outcome measure-Relative serologically confirmed measles risk. Participants and methods-153 vaccinated cases, mostly from rural areas, were serologically confirmed as measles at the central laboratory in 1988-89. A randomly selected group of 453 controls from either municipalities of vaccinated cases or from areas where measles attack rate was >600/ 10 5 , was identified via the population registry. Vaccination and measles histories of cases and controls were determined from oYcial vaccination cards. Results-Once and twice vaccinated had crude relative risk 15.6 and 2.3 compared with thrice vaccinated. When cases who had received their first vaccination at less than 14 months of age were omitted from analysis, once vaccinated had 4.0 (95% CI 1.2, 16.6) times higher age adjusted measles risk compared with twice vaccinated. When, omission was extended to cases from one particular municipality where even revaccinees had high measles risk during an explosive outbreak the corresponding risk ratio was 17.8 (2.8, 67.8). Conclusions-Twice vaccinated have better protection against epidemic measles compared with single dose recipients. (J Epidemiol Community Health 1999;53:173-178) Indisputable individual level evidence that measles revaccinations increase protection is still lacking, and there is little information upon which to base optimised revaccination schedules, 1 though it has recently even internationally been recommended that there is a need to implement revaccinations against measles.

Relationship between Self-Reported Vaccination History and Measles and Rubella Antibody Titers in Medical and Nursing Students

“…The CDC also considers one dose of the MMR vaccine as approximately 97% (range, 94% -100%) effective at preventing rubella; in the investigation cited by the CDC, approximately 91% -100% of individuals who had received two MMR doses had a detectable antibody level [13]. Comparing our data with those of the CDC report, the immunity level for measles is nearly the same and the immunity level for rubella is slightly lower.…”

“…According to CDC reports, a two-dose MMR vaccine is about 97% effective at preventing measles, and 91% -100% effective at preventing rubella [13]. This indicates that, even if the individual who had received two doses of a vaccine, there is a possibility that some individuals do not have sufficient IgG antibody.…”

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

“…28 Our experience in Finland is that the documented interruption in the circulation of MMR viruses 29,30 has led to much higher figures for secondary vaccine failures. 31,32 We predict that waning immunity will be a growing problem in countries at or close to the elimination of MMR. The virtual nonreactogenicity of the second dose of MMR vaccine in previously immunized children should encourage other countries to proceed to the 2-dose regimen.…”

“…The trial participants were recruited between November 1, 1982 and October 31,1983. Public health nurses explained the design to parents of twins attending the child health center and asked for their consent to participate in this prospective study.…”

Human leukocyte antigen and interleukin 2, 10 and 12p40 cytokine responses to measles: Is there evidence of the HLA effect?

“…Vaccine failure has historically been defined in terms of antibody response. Primary vaccine failure is mainly accounted by the lack of antibody response and appears to occur in 2-10% of vaccinated individuals [31][32][33]. The secondary vaccine failure rate (development of the disease upon exposure despite vaccination) was estimated to be less than 0.2% [6,34].…”