Protecting infants against measles in England and Wales: a review.
OBJECTIVE
To establish the most appropriate age ranges for the use of human normal immunoglobulin and MMR vaccine as postexposure prophylaxis.


METHODS
Review of literature and of laboratory confirmed measles cases.


METHODS
England and Wales and countries with a similar measles epidemiological profile.


METHODS
Women of childbearing age and infants.


METHODS
The risk of measles, maternally derived measles antibody levels and the response to measles containing vaccines in infants.


RESULTS
By 4 to 5 months of age, only 28-45% of infants born to women from highly vaccinated populations have protective levels of measles antibody. In the postvaccine era, between 74% and 80% of infants vaccinated between 6 and 9 months respond to vaccine, and around 67% have clinical protection from measles vaccination.


CONCLUSIONS
This study suggests that many infants being born in the UK will become susceptible to measles before 6 months and will be able to respond to vaccine between 6 and 9 months of age. It is proposed that current guidance is changed to recommend passive immunisation with human normal immunoglobulin for most infants exposed to measles below 6 months of age. For infants aged 6 months or over exposed to measles, vaccination with MMR may be given.
Manikkavasagan
G
G
HPA Centre for Infections, London NW9 5EQ, UK. gayatri.manikkavasagan@hpa.org.uk
Ramsay
M
M
D000328:Adult; D000367:Age Factors; D019049:Developed Countries; D004739:England; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D008459:Measles virus / Q000276:immunology*; D011247:Pregnancy; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods; D014852:Wales; D055815:Young Adult
D008458:Measles Vaccine