title: Tolerability of Early Measles-Mumps-Rubella Vaccination in Infants Aged 6-14 Months During a Measles Outbreak in The Netherlands in 2013-2014.
abstract: BACKGROUND
  In 2013-2014, a measles outbreak spread through the Netherlands. To protect young infants, measles-mumps-rubella (MMR) vaccination was offered to those aged 6-14 months in municipalities with routine first-dose MMR vaccine coverage of <90%. We assessed the tolerability of this early administration of MMR vaccine.
  
  
  METHODS
  After study entry (n = 1866), parents of eligible infants (n = 10 097) completed a questionnaire (n = 1304). For infants who received an early MMR vaccine dose (n = 962), we asked for information about adverse events (AEs) associated with the dose. AE frequencies were compared between infants aged 6-8, 9-11, and 12-14 months. Using multivariable logistic regression, we assessed the association between the risk of AEs and age at early MMR vaccination.
  
  
  RESULTS
  The response rate was 13%. Parents of 59 infants (6.1%) and 350 infants (36.4%) who received early MMR vaccination reported local and systemic AEs, respectively. Parents of infants vaccinated at 6-8 months of age reported systemic AEs less frequently (32%) than parents of children vaccinated at 9-11 months (45%) and 12-14 months (43%) of age (P= <.001). For local AEs, there were no differences (5%, 7%, and 10%, respectively;P= .08). Compared with vaccination at 6 months, all older infants except those aged 14 months showed an increased risk for any AE and for systemic AEs starting 5-12 days after vaccination.
  
  
  CONCLUSIONS
  Early MMR vaccination is well tolerated, with the lowest AE frequencies found in infants aged 6-8 months. It is a safe intervention for protecting young infants against measles.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: Nicoline A T
authors.initials: NA
authors.lastname: van der Maas
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Woudenberg
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: S J M
authors.initials: SJ
authors.lastname: Hahné
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D008457:Measles / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D009426:Netherlands / Q000453:epidemiology
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: 6 months; early MMR; infants; measles; outbreak; tolerability; vaccination