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American Journal of Epidemiology Vol. 138, No. 3: 182-195
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Efficacy of Measles Vaccines after Controlling for Exposure

Michel Garenne1,, Odile Leroy2, Jean-Pierre Beau3 and Ibrahima Sene4

1Harvard School of Public Health, Harvard University Boston, MA
2Pasteur-Mérieux Sérums et Vaccins Paris, France
3Institut Français de Recherche Scientifique pour le Développement en Coopération (ORSTOM), Unité de Recherche Population et Santé Dakar, Senegal
4Circonscription Médicale de Fatick Fatick, Senegal

Reprint requests to Dr. Michel Garenne, Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA 02138

The clinical efficacy of measles vaccines was investigated in Niakhar, a rural area of Senegal under demographic surveillance in 1987–1990. Three measles vaccines were tested: a standard Schwarz, a high-titer Edmonston-Zagreb, and a high-titer Schwarz. The two high-titer vaccines were administered at 5 months of age and the standard Schwarzvaccine at 10 months. In addition to a formal randomized vaccine trial, data from national campaigns using the standard Schwarz vaccine were also analyzed. Clinical efficacy was estimated after controlling for exposure. In the randomized trial, the estimate of the efficacy of the standard Schwarz vaccine was 97.2% (95% confidence interval (CI) 91.3–98.1). In the 1986–1987 national campaign, the efficacy of the standard Schwarz vaccine was lower: 92.5% (95% CI 88.8–94.6). In the randomized trial, the efficacy of the high-titer vaccines was lower than that of the standard vaccine. High-titer vaccines were not used in national campaigns. Other factors associated with vaccine efficacy were age at exposure, intensity of exposure, and age at vaccination. Controlling for the intensity of exposure did not change the relative ranking of the efficacy of the three vaccination strategies. The theoretical efficacy of the standard measles vaccine for a single unit of exposure was estimated at 98.0%.

child; measles; measles vaccine; multivariate analysis; population surveillance; prospective studies; rural population


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