title: Effectiveness and timing of vaccination during school measles outbreak.
abstract: Despite high vaccination coverage in most European countries, large community outbreaks of measles do occur, normally clustered around schools and resulting from suboptimal vaccination coverage. To determine whether or when it is worth implementing outbreak-response vaccination campaigns in schools, we used stochastic outbreak models to reproduce a public school outbreak in Germany, where no vaccination campaign was implemented. We assumed 2 scenarios covering the baseline vaccination ratio range (91.3%-94.3%) estimated for that school and computed outbreaks assuming various vaccination delays. In one scenario, reacting (i.e., implementing outbreak-response vaccination campaigns) within 12-24 days avoided large outbreaks and reacting within 50 days reduced outbreak size. In the other scenario, reacting within 6-14 days avoided large outbreaks and reacting within 40 days reduced the outbreak size. These are realistic time frames for implementing school outbreak response vaccination campaigns. High baseline vaccination ratios extended the time needed for effective response.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment-RIVM, PO Box 1, 3720 BA Bilthoven, the Netherlands. axel.bonacic.marinovic@rivm.nl
authors.forename: Axel Antonio
authors.initials: AA
authors.lastname: Bonačić Marinović
authors.forename: Corien
authors.initials: C
authors.lastname: Swaan
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.forename: Jim
authors.initials: J
authors.lastname: van Steenbergen
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kretzschmar
mesh_terms: D004196:Disease Outbreaks; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008458:Measles Vaccine / Q000276:immunology*; D008962:Models, Theoretical; D012189:Retrospective Studies; D012574:Schools; D013997:Time Factors; D014611:Vaccination
chemical_list: D008458:Measles Vaccine