Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1991 Mar;81(3):360–364. doi: 10.2105/ajph.81.3.360

A measles outbreak at a college with a prematriculation immunization requirement.

B S Hersh 1, L E Markowitz 1, R E Hoffman 1, D R Hoff 1, M J Doran 1, J C Fleishman 1, S R Preblud 1, W A Orenstein 1
PMCID: PMC1405017  PMID: 1994745

Abstract

BACKGROUND. In early 1988 an outbreak of 84 measles cases occurred at a college in Colorado in which over 98 percent of students had documentation of adequate measles immunity (physician diagnosed measles, receipt of live measles vaccine on or after the first birthday, or serologic evidence of immunity) due to an immunization requirement in effect since 1986. METHODS. To examine potential risk factors for measles vaccine failure, we conducted a retrospective cohort study among students living in campus dormitories using student health service vaccination records. RESULTS. Overall, 70 (83 percent) cases had been vaccinated at greater than or equal to 12 months of age. Students living in campus dormitories were at increased risk for measles compared to students living off-campus (RR = 3.0, 95% CI = 2.0, 4.7). Students vaccinated at 12-14 months of age were at increased risk compared to those vaccinated at greater than or equal to 15 months (RR = 3.1, 95% CI = 1.7, 5.7). Time since vaccination was not a risk factor for vaccine failure. Measles vaccine effectiveness was calculated to be 94% (95% CI = 86, 98) for vaccination at greater than or equal to 15 months. CONCLUSIONS. As in secondary schools, measles outbreaks can occur among highly vaccinated college populations. Implementation of recent recommendations to require two doses of measles vaccine for college entrants should help reduce measles outbreaks in college populations.

Full text

PDF
360

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amler R. W., Kim-Farley R. J., Orenstein W. A., Doster S. W., Bart K. J. Measles on campus. J Am Coll Health. 1983 Oct;32(2):53–57. doi: 10.1080/07448481.1983.9936141. [DOI] [PubMed] [Google Scholar]
  2. Chen R. T., Goldbaum G. M., Wassilak S. G., Markowitz L. E., Orenstein W. A. An explosive point-source measles outbreak in a highly vaccinated population. Modes of transmission and risk factors for disease. Am J Epidemiol. 1989 Jan;129(1):173–182. doi: 10.1093/oxfordjournals.aje.a115106. [DOI] [PubMed] [Google Scholar]
  3. Collins M., Smith D. S. Prematriculation immunization requirements on college campuses: current status. J Am Coll Health. 1987 May;35(6):247–251. doi: 10.1080/07448481.1987.9939640. [DOI] [PubMed] [Google Scholar]
  4. Crawford G. E., Gremillion D. H. Epidemic measles and rubella in air force recruits: impact of immunization. J Infect Dis. 1981 Nov;144(5):403–410. doi: 10.1093/infdis/144.5.403. [DOI] [PubMed] [Google Scholar]
  5. Davis R. M., Whitman E. D., Orenstein W. A., Preblud S. R., Markowitz L. E., Hinman A. R. A persistent outbreak of measles despite appropriate prevention and control measures. Am J Epidemiol. 1987 Sep;126(3):438–449. doi: 10.1093/oxfordjournals.aje.a114675. [DOI] [PubMed] [Google Scholar]
  6. Frank J. A., Jr, Orenstein W. A., Bart K. J., Bart S. W., el-Tantawy N., Davis R. M., Hinman A. R. Major impediments to measles elimination. The modern epidemiology of an ancient disease. Am J Dis Child. 1985 Sep;139(9):881–888. doi: 10.1001/archpedi.1985.02140110035024. [DOI] [PubMed] [Google Scholar]
  7. Gustafson T. L., Lievens A. W., Brunell P. A., Moellenberg R. G., Buttery C. M., Sehulster L. M. Measles outbreak in a fully immunized secondary-school population. N Engl J Med. 1987 Mar 26;316(13):771–774. doi: 10.1056/NEJM198703263161303. [DOI] [PubMed] [Google Scholar]
  8. Hull H. F., Montes J. M., Hays P. C., Lucero R. L. Risk factors for measles vaccine failure among immunized students. Pediatrics. 1985 Oct;76(4):518–523. [PubMed] [Google Scholar]
  9. Hutchins S. S., Markowitz L. E., Mead P., Mixon D., Sheline J., Greenberg N., Preblud S. R., Orenstein W. A., Hull H. F. A school-based measles outbreak: the effect of a selective revaccination policy and risk factors for vaccine failure. Am J Epidemiol. 1990 Jul;132(1):157–168. doi: 10.1093/oxfordjournals.aje.a115627. [DOI] [PubMed] [Google Scholar]
  10. Markowitz L. E., Preblud S. R., Orenstein W. A., Rovira E. Z., Adams N. C., Hawkins C. E., Hinman A. R. Patterns of transmission in measles outbreaks in the United States, 1985-1986. N Engl J Med. 1989 Jan 12;320(2):75–81. doi: 10.1056/NEJM198901123200202. [DOI] [PubMed] [Google Scholar]
  11. Marks J. S., Halpin T. J., Orenstein W. A. Measles vaccine efficacy in children previously vaccinated at 12 months of age. Pediatrics. 1978 Dec;62(6):955–960. [PubMed] [Google Scholar]
  12. Nkowane B. M., Bart S. W., Orenstein W. A., Baltier M. Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures. Am J Public Health. 1987 Apr;77(4):434–438. doi: 10.2105/ajph.77.4.434. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Orenstein W. A., Bernier R. H., Dondero T. J., Hinman A. R., Marks J. S., Bart K. J., Sirotkin B. Field evaluation of vaccine efficacy. Bull World Health Organ. 1985;63(6):1055–1068. [PMC free article] [PubMed] [Google Scholar]
  14. Orenstein W. A., Markowitz L., Preblud S. R., Hinman A. R., Tomasi A., Bart K. J. Appropriate age for measles vaccination in the United States. Dev Biol Stand. 1986;65:13–21. [PubMed] [Google Scholar]
  15. Robbins K. B., Brandling-Bennett D., Hinman A. R. Low measles incidence: association with enforcement of school immunization laws. Am J Public Health. 1981 Mar;71(3):270–274. doi: 10.2105/ajph.71.3.270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Shasby D. M., Shope T. C., Downs H., Herrmann K. L., Polkowski J. Epidemic measles in a highly vaccinated population. N Engl J Med. 1977 Mar 17;296(11):585–589. doi: 10.1056/NEJM197703172961102. [DOI] [PubMed] [Google Scholar]
  17. Williams W. W., Markowitz L. E., Cochi S. L., Hawkins C. E., Rovira E. Z., Davis R. M., Hickson M. A., Preblud S. R. Immunizations in college health: the remaining tasks. J Am Coll Health. 1987 May;35(6):252–260. doi: 10.1080/07448481.1987.9939641. [DOI] [PubMed] [Google Scholar]
  18. Williams W. W., Sosin D. M., Kaplan K. M., Hersh B. S., Preblud S. R. Vaccine-preventable diseases on college campuses: the emergence of mumps. J Am Coll Health. 1989 Mar;37(5):197–203. doi: 10.1080/07448481.1989.9939060. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES