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Measles vaccine efficacy during an outbreak in a highly vaccinated population: Incremental increase in protection with age at vaccination up to 18 months

Published online by Cambridge University Press:  15 May 2009

G. De Serres
Affiliation:
Centre de santé publique de Québec, 2400 D'estimauville, Beauport, Québec, Canada, G1E 7G9
N. Boulianne
Affiliation:
Centre de santé publique de Québec, 2400 D'estimauville, Beauport, Québec, Canada, G1E 7G9
F. Meyer
Affiliation:
Groupe de recherche en épidémiologie de l'Université Laval and Département de médecine sociale et préventive, Université Laval. Hôpital du St-Sacrement, 1050 chemin Ste-Foy, Québec, CanadaG1S 4L8
B. J. Ward
Affiliation:
Center for the study of host resistance. McGill University, Montreal General Hospital, 1650 Cedar Avenue, room B.7118, Montréal. Québec, CanadaH3G 1A4
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Summary

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During a large measles outbreak in Quebec City in 1989, two investigations conducted in parallel evaluated the relative risk of measles and measles vaccine effectiveness with respect to age at vaccination. The study was a school-based case-control study including 563 cases and 1126 classmate controls. The second was a cohort study of the siblings of school cases including 493 siblings aged between 1 and 19 years. The relative risks (RR) of measles were similar in both settings and the trend towards increased vaccine efficacy with increasing age at vaccination was highly significant (P < 0·001). Vaccine efficacy rose from 85% in children vaccinated at 12 months of age to ≥ 94% in those vaccinated at 15 months and older. Even for children vaccinated at or after 18 months of age. the RR of measles was reduced when compared with children vaccinated between 15 and 17 months of age (RR 0·61. CI 95% 0·33–1·15). Small changes in the timing of initial measles vaccination can have a major impact on vaccine efficacy.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1995

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