Modelling the first dose of measles vaccination: the role of maternal immunity, demographic factors, and delivery systems.

Journal article

Measles vaccine efficacy is higher at 12 months than 9 months because of maternal immunity, but delaying vaccination exposes the children most vulnerable to measles mortality to infection. We explored how this trade-off changes as a function of regionally varying epidemiological drivers, e.g. demography, transmission seasonality, and vaccination coverage. High birth rates and low coverage both favour early vaccination, and initiating vaccination at 9-11 months, then switching to 12-14 months can reduce case numbers. Overall however, increasing the age-window of vaccination decreases case numbers relative to vaccinating within a narrow age-window (e.g. 9-11 months). The width of the age-window that minimizes mortality varies as a function of birth rate, vaccination coverage and patterns of access to care. Our results suggest that locally age-targeted strategies, at both national and sub-national scales, tuned to local variation in birth rate, seasonality, and access to care may substantially decrease case numbers and fatalities for routine vaccination.

Authors: Metcalf, C; Klepac, P; Ferrari, M; Grais, R; Djibo, A

• Publication status: Published
• Journal: Epidemiology and infection
• Volume: 139
• Issue: 2
• Pages: 265-274
• Publication date: 2011-02-01
• DOI: 10.1017/s0950268810001329
• EISSN: 1469-4409
• ISSN: 0950-2688
• Language: English
• Keywords: Female; Infant; Seasons; Measles; Immunization Schedule; Pregnancy; Aging; Vaccination; Delivery of Health Care; Humans; Measles Vaccine; Immunity, Maternally-Acquired; Models, Theoretical