Skip to main content
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1993;71(1):93–103.

Measles control in developing and developed countries: the case for a two-dose policy.

T H Tulchinsky 1, G M Ginsberg 1, Y Abed 1, M T Angeles 1, C Akukwe 1, J Bonn 1
PMCID: PMC2393424  PMID: 8440043

Abstract

Despite major reductions in the incidence of measles and its complications, measles control with a single dose of the currently used. Schwarz strain vaccine has failed to eradicate the disease in the developed countries. In developing countries an enormous toll of measles deaths and disability continues, despite considerable efforts and increasing immunization coverage. Empirical evidence from a number of countries suggests that a two-dose measles vaccination programme, by improving individual protection and heard immunity can make a major contribution to measles control and elimination of local circulation of the disease. Cost-benefit analysis also supports the two-dose schedule in terms of savings in health costs, and total costs to society. A two-dose measles vaccination programme is therefore an essential component of preventive health care in developing, as well as developed countries for the 1990s.

Full text

PDF
94

Selected References

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

  1. Aaby P., Knudsen K., Jensen T. G., Thårup J., Poulsen A., Sodemann M., da Silva M. C., Whittle H. Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage. J Infect Dis. 1990 Nov;162(5):1043–1048. doi: 10.1093/infdis/162.5.1043. [DOI] [PubMed] [Google Scholar]
  2. Aaby P., Leeuwenburg J. Patterns of transmission and severity of measles infection: a reanalysis of data from the Machakos area, Kenya. J Infect Dis. 1990 Feb;161(2):171–174. doi: 10.1093/infdis/161.2.171. [DOI] [PubMed] [Google Scholar]
  3. Allen R., Tan B., Duclos P., Pless R. Measles outbreak--Baffin region, Northwest Territories. Can Dis Wkly Rep. 1991 Oct 19;17(42):225–228. [PubMed] [Google Scholar]
  4. Axnick N. W., Shavell S. M., Witte J. J. Benefits due to immunization against measles. Public Health Rep. 1969 Aug;84(8):673–680. [PMC free article] [PubMed] [Google Scholar]
  5. Boulianne N., De Serres G., Duval B., Joly J. R., Meyer F., Déry P., Alary M., Le Hénaff D., Thériault N. Epidémie majeure de rougeole dans la région de Québec malgré une couverture vaccinale de 99%. Can J Public Health. 1991 May-Jun;82(3):189–190. [PubMed] [Google Scholar]
  6. Centers for Disease Control (CDC) International Task Force for Disease Eradication. MMWR Morb Mortal Wkly Rep. 1990 Apr 6;39(13):209-12, 217-8. [PubMed] [Google Scholar]
  7. Centers for Disease Control (CDC) Measles outbreak--New York City, 1990-1991. MMWR Morb Mortal Wkly Rep. 1991 May 10;40(18):305–306. [PubMed] [Google Scholar]
  8. Centers for Disease Control (CDC) Measles--United States, 1988. MMWR Morb Mortal Wkly Rep. 1989 Sep 8;38(35):601–605. [PubMed] [Google Scholar]
  9. Centers for Disease Control (CDC) Measles--United States, 1990. MMWR Morb Mortal Wkly Rep. 1991 Jun 7;40(22):369–372. [PubMed] [Google Scholar]
  10. 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]
  11. Chen R. T., Markowitz L. E., Albrecht P., Stewart J. A., Mofenson L. M., Preblud S. R., Orenstein W. A. Measles antibody: reevaluation of protective titers. J Infect Dis. 1990 Nov;162(5):1036–1042. doi: 10.1093/infdis/162.5.1036. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. De Serres G., Boulianne N. Measles outbreak--Ungava region, Quebec. Can Dis Wkly Rep. 1991 Oct 19;17(42):229–231. [PubMed] [Google Scholar]
  14. Edmonson M. B., Addiss D. G., McPherson J. T., Berg J. L., Circo S. R., Davis J. P. Mild measles and secondary vaccine failure during a sustained outbreak in a highly vaccinated population. JAMA. 1990 May 9;263(18):2467–2471. [PubMed] [Google Scholar]
  15. 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]
  16. Garenne M., Leroy O., Beau J. P., Sene I. Child mortality after high-titre measles vaccines: prospective study in Senegal. Lancet. 1991 Oct 12;338(8772):903–907. doi: 10.1016/0140-6736(91)91771-l. [DOI] [PubMed] [Google Scholar]
  17. 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]
  18. Hersh B. S., Markowitz L. E., Hoffman R. E., Hoff D. R., Doran M. J., Fleishman J. C., Preblud S. R., Orenstein W. A. A measles outbreak at a college with a prematriculation immunization requirement. Am J Public Health. 1991 Mar;81(3):360–364. doi: 10.2105/ajph.81.3.360. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hinman A. R., Orenstein W. A. Immunisation practice in developed countries. Lancet. 1990 Mar 24;335(8691):707–710. doi: 10.1016/0140-6736(90)90814-l. [DOI] [PubMed] [Google Scholar]
  20. Hinman A. R. World eradication of measles. Rev Infect Dis. 1982 Sep-Oct;4(5):933–939. doi: 10.1093/clinids/4.5.933. [DOI] [PubMed] [Google Scholar]
  21. Holt E. A., Boulos R., Halsey N. A., Boulos L. M., Boulos C. Childhood survival in Haiti: protective effect of measles vaccination. Pediatrics. 1990 Feb;85(2):188–194. [PubMed] [Google Scholar]
  22. Kambarami R. A., Nathoo K. J., Nkrumah F. K., Pirie D. J. Measles epidemic in Harare, Zimbabwe, despite high measles immunization coverage rates. Bull World Health Organ. 1991;69(2):213–219. [PMC free article] [PubMed] [Google Scholar]
  23. Kiepiela P., Coovadia H. M., Loening W. E., Coward P., Botha G., Hugo J., Becker P. J. Lack of efficacy of the standard potency Edmonston-Zagreb live, attenuated measles vaccine in African infants. Bull World Health Organ. 1991;69(2):221–227. [PMC free article] [PubMed] [Google Scholar]
  24. Markowitz L. E., Sepulveda J., Diaz-Ortega J. L., Valdespino J. L., Albrecht P., Zell E. R., Stewart J., Zarate M. L., Bernier R. H. Immunization of six-month-old infants with different doses of Edmonston-Zagreb and Schwarz measles vaccines. N Engl J Med. 1990 Mar 1;322(9):580–587. doi: 10.1056/NEJM199003013220903. [DOI] [PubMed] [Google Scholar]
  25. Mast E. E., Berg J. L., Hanrahan L. P., Wassell J. T., Davis J. P. Risk factors for measles in a previously vaccinated population and cost-effectiveness of revaccination strategies. JAMA. 1990 Nov 21;264(19):2529–2533. [PubMed] [Google Scholar]
  26. Mathias R. G., Meekison W. G., Arcand T. A., Schechter M. T. The role of secondary vaccine failures in measles outbreaks. Am J Public Health. 1989 Apr;79(4):475–478. doi: 10.2105/ajph.79.4.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. McLean M. E., Walsh P. J., Carter A. O., Lavigne P. M. Measles in Canada-1989. Can Dis Wkly Rep. 1990 Oct 20;16(42):213–218. [PubMed] [Google Scholar]
  28. Rabo E., Taranger J. Scandinavian model for eliminating measles, mumps, and rubella. Br Med J (Clin Res Ed) 1984 Nov 24;289(6456):1402–1404. doi: 10.1136/bmj.289.6456.1402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Schlenker T. L., Bain C., Baughman A. L., Hadler S. C. Measles herd immunity. The association of attack rates with immunization rates in preschool children. JAMA. 1992 Feb 12;267(6):823–826. doi: 10.1001/jama.267.6.823. [DOI] [PubMed] [Google Scholar]
  30. Slater P. E. Measles containment in Israel. Isr J Med Sci. 1991 Jan;27(1):19–21. [PubMed] [Google Scholar]
  31. Smith T. Measles and the government. Br Med J (Clin Res Ed) 1987 Apr 18;294(6578):989–990. doi: 10.1136/bmj.294.6578.989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Subbarao E. K., Amin S., Kumar M. L. Prevaccination serologic screening for measles in health care workers. J Infect Dis. 1991 Apr;163(4):876–878. doi: 10.1093/infdis/163.4.876. [DOI] [PubMed] [Google Scholar]
  33. Sutter R. W., Markowitz L. E., Bennetch J. M., Morris W., Zell E. R., Preblud S. R. Measles among the Amish: a comparative study of measles severity in primary and secondary cases in households. J Infect Dis. 1991 Jan;163(1):12–16. doi: 10.1093/infdis/163.1.12. [DOI] [PubMed] [Google Scholar]
  34. Swartz T. A. Epidemiology of measles in the vaccination era: implications for an effective prevention of the disease. Isr J Med Sci. 1991 Jan;27(1):48–50. [PubMed] [Google Scholar]
  35. Tulchinsky T. H., Abed Y., Ginsberg G., Shaheen S., Friedman J. B., Schoenbaum M. L., Slater P. E. Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for a new eradication strategy. Rev Infect Dis. 1990 Sep-Oct;12(5):951–958. doi: 10.1093/clinids/12.5.951. [DOI] [PubMed] [Google Scholar]
  36. Tulchinsky T. H. Prevention of measles in Israel: short- and long-term intervention strategies. Isr J Med Sci. 1991 Jan;27(1):22–29. [PubMed] [Google Scholar]
  37. White C. C., Koplan J. P., Orenstein W. A. Benefits, risks and costs of immunization for measles, mumps and rubella. Am J Public Health. 1985 Jul;75(7):739–744. doi: 10.2105/ajph.75.7.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Whittle H. C., Campbell H., Rahman S., Armstrong J. R. Antibody persistence in Gambian children after high-dose Edmonston-Zagreb measles vaccine. Lancet. 1990 Oct 27;336(8722):1046–1048. doi: 10.1016/0140-6736(90)92501-8. [DOI] [PubMed] [Google Scholar]
  39. Witte J. J., Axnick N. W. The benefits from 10 years of measles immunization in the United States. Public Health Rep. 1975 May-Jun;90(3):205–207. [PMC free article] [PubMed] [Google Scholar]
  40. Wong T., Lee-Han H., Bell B., Daley J., Bailey N., Vanderpol M. Measles epidemic in Waterloo region, Ontario, 1990-1991. Can Dis Wkly Rep. 1991 Oct 12;17(41):219–224. [PubMed] [Google Scholar]
  41. Yach D. Re: "The epidemiology of measles in a partially vaccinated population in an African city: implications for immunization programs". Am J Epidemiol. 1990 Jul;132(1):193–194. doi: 10.1093/oxfordjournals.aje.a115631. [DOI] [PubMed] [Google Scholar]
  42. Zilber N., Rannon L., Alter M., Kahana E. Measles, measles vaccination, and risk of subacute sclerosing panencephalitis (SSPE). Neurology. 1983 Dec;33(12):1558–1564. [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES