Protecting the vaccinating population in the face of a measles epidemic: assessing the impact of adjusted vaccination schedules.
We investigated which vaccination schedule gives best protection to the vaccinating population, in case there is a measles epidemic in an area with low vaccine coverage. We considered combinations of an early measles vaccination (none, at 6 months or at 9 months), a measles-mumps-rubella (MMR) vaccination around the first birthday (at either 11 or 14 months), and MMR vaccination at an older age (at either 4 or 9 years). The different estimates on measures of protection (percentage of susceptibles, number of reported cases in an epidemic year, percentage of lifetime spent susceptible) relied on a mathematical model of decline of maternal antibody levels with age, and the impact of that antibody level on seroconversion and immunity. Model parameters were estimated from a Dutch population-based serological survey on measles antibodies. Different measures of protection favoured different vaccination schedules, but dropping the age of second MMR vaccination prevents considerably more cases than an extra early measles vaccination or dropping the age of first MMR vaccination.
van den Hof
S
S
National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, Bilthoven, The Netherlands.
Wallinga
J
J
Widdowson
M A
MA
Conyn-van Spaendonck
M A E
MA
D000367:Age Factors; D000914:Antibodies, Viral; D000917:Antibody Formation; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005544:Forecasting; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D022542:Measles-Mumps-Rubella Vaccine; D008962:Models, Theoretical
D000914:Antibodies, Viral; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine