The role of secondary vaccine failures in measles outbreaks

• Published in: American journal of public health (1971) Vol. 79; no. 4; pp. 475 - 478
• Main Authors: Mathias, R G, Meekison, W G, Arcand, T A, Schechter, M T
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.04.1989; American Public Health Association
• Subjects: Adolescent; Adult; Antibodies, Viral - analysis; Antibodies, Viral - biosynthesis; Biological and medical sciences; British Columbia; Child; Child, Preschool; Disease Outbreaks - prevention & control; Effectiveness; Health care; Hemagglutination Inhibition Tests; Human viral diseases; Humans; Immunization; Immunoglobulin M - analysis; Immunoglobulin M - biosynthesis; Infectious diseases; Measles; Measles - epidemiology; Measles - immunology; Measles - prevention & control; Measles Vaccine - immunology; measles virus; Medical sciences; Neutralization Tests; Public health; Vaccines; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; British Columbia; Canada; Infection; Epidemic; Skin disease; Viral disease; Measles; Vaccination; Failure
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.79.4.475

An outbreak of measles in 1985-86 in a community where measles vaccine trials had been carried out from 1974-76 allowed the assessment of the role of secondary vaccine failures in previously immunized children. A total of 188 children from the vaccine trial were followed. Of these, 175 seroconverted initially while 13 (6 per cent) required re-immunization (primary failure). A total of 13 cases of measles, eight of which were laboratory and/or physician-confirmed, were reported in this cohort. Of these, nine cases occurred in the 175 subjects who had hemagglutination inhibition test (HI) and neutralizing antibody responses following the initial immunization. These nine cases represent secondary vaccine failures. An additional four cases occurred in the 13 subjects with primary vaccine failure. We conclude that secondary vaccine failures occur and that while primary failures account for most cases, secondary vaccine failures contribute to the occurrence of measles cases in an epidemic. A booster dose of measles vaccine may be necessary to reduce susceptibility to a sufficiently low level to allow the goal of measles elimination to be achieved.