An evaluation of measles revaccination among school-entry-aged children.
BACKGROUND
A two dose measles vaccination schedule is recommended routinely for all school-entry-aged children. We evaluated this recommendation by determining both measles antibody seroprevalence and the response to revaccination in seronegative children in this age group.


METHODS
Children 4 to 6 years of age who had received a single dose of measles vaccine between the ages of 15 to 17 months were tested for measles antibody by using enzyme-linked immunosorbent assay (ELISA) microneutralization technique. Seronegative children were revaccinated and again tested for measles antibody (immunoglobulin M [IgM] and neutralizing).


RESULTS
Of 679 children tested, 37 (5.4%) were seronegative. Seronegativity was not significantly associated with age, sex, race, age at initial vaccination, time since vaccination, or maternal year of birth. However, children mothers with a college degree were 12 times more likely to be seronegative than children of mothers who never attended college (P < .01). Of the 37 seronegative children, 36 seroconverted after revaccination--33 producing IgM measles antibody, suggestive of a primary immune response. The cost per seroconversion would have been an estimated $415 if all 679 children had been revaccinated.


CONCLUSIONS
Revaccination reduces the pool of children who are susceptible to measles. Although the cost per seroconversion is high, a two-dose schedule should reduce the substantial costs of controlling measles out breaks by reducing the number of outbreaks.
Watson
J C
JC
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Pearson
J A
JA
Markowitz
L E
LE
Baughman
A L
AL
Erdman
D D
DD
Bellini
W J
WJ
Baron
R C
RC
Fleming
D W
DW
D000914:Antibodies, Viral / Q000096:biosynthesis / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks / Q000517:prevention & control; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary / Q000191:economics; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage* / Q000191:economics; D008459:Measles virus / Q000276:immunology; D009035:Mothers; D009500:Neutralization Tests; D014611:Vaccination / Q000191:economics
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008458:Measles Vaccine