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Protecting the vaccinating population in the face of a measles epidemic: assessing the impact of adjusted vaccination schedules

Published online by Cambridge University Press:  22 March 2002

S. van den HOF ,
J. WALLINGA ,
M.-A. WIDDOWSON  and
M. A. E. CONYN-VAN SPAENDONCK
S. van den HOF
Affiliation:
National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
J. WALLINGA
Affiliation:
National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
M.-A. WIDDOWSON
Affiliation:
National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, P.O. Box 1, 3720 BA Bilthoven, The Netherlands European Programme for Intervention Epidemiology
M. A. E. CONYN-VAN SPAENDONCK
Affiliation:
National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
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Abstract

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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.

Type
Research Article
Information
Epidemiology & Infection , Volume 128 , Issue 1 , February 2002 , pp. 47 - 57
Copyright
2002 Cambridge University Press