American Journal of Epidemiology Vol. 154, No. 11 : 1064-1071
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Evaluation of an Early Two-Dose Measles Vaccination Schedule
1 Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA.
2 Measles Elimination Activity, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA.
3 Special Immunization Program, Dade County Department of Public Health, Miami, FL.
4 ABT Associates, Inc., Cambridge, MA.
5 Measles Virus Section, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
6 Laboratory of Pediatric and Respiratory Virus Diseases, Food and Drug Administration, Bethesda, MD.
7 Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA.
Vaccination at 6 months of age followed by routine revaccination is recommended when exposure of infants to measles is likely. Dade County, Florida, began this early two-dose schedule during a large epidemic in 1986–1987 (i.e., 22% of cases occurred in infants aged 6–11 months). This schedule was continued routinely in high-risk areas. The effect of an early two-dose schedule on measles prevention in the county was examined by comparing measles vaccination coverage and epidemiology before (1985–1987) and after (1988–1996) the schedule became routine. To assess serologic response, seroprevalence of measles antibody among children aged 4–6 years in 1995 was examined. To evaluate vaccine effectiveness, a case-control study was conducted among preschool-aged children. Among those aged 2 years, vaccination coverage with 
1 dose increased from 75% to 94% in 1996. The number of annual cases declined, and endemic measles transmission reportedly ended after 1993. Seroprevalence of plaque reduction neutralization antibody (titer > 1:120) among those receiving vaccination according to an early two-dose schedule and a single dose at age 12 months was 94% (95% confidence interval: 89, 98) and 98% (95% confidence interval: 95, 100). In these groups, vaccine effectiveness was comparably high. Early two-dose measles vaccination is associated with improved coverage and a comparably high level of humoral immunity and clinical protection as a single dose at age 12 months. This strategy can be useful in areas at high risk for measles among infants.
antibodies; immunity; infant; measles; measles vaccine; serologic tests; vaccines
Abbreviations: CDC, Centers for Disease Control and Prevention; EIA, enzyme immunoassay; MN, microneutralization; PRN, plaque reduction neutralization
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