Immunogenicity and efficacy of one dose measles-mumps-rubella (MMR) vaccine at twelve months of age as compared to monovalent measles vaccination at nine months followed by MMR revaccination at fifteen months of age

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http://www.elsevier.nl/gej-ng/10/42/35/40/47/43/abstract.html

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Vaccine, Vol. 19 (31) (2001) pp. 4473 - 4478

=A9 2001 Published by Elsevier Science Ltd. All rights reserved.=20

PII: S0264-410X(01)00207-9

Immunogenicity and efficacy of one dose measles-mumps-rubella (MMR) vaccine

at twelve months of age as compared to monovalent measles vaccination at

nine months followed by MMR revaccination at fifteen months of age

Mehmet Ceyhan a * mceyhan@... , Guler Kanra a, Guliz

Erdem b and Berkand Kanra c

a Division of Pediatric Infectious Diseases, Hacettepe University School of

Medicine, Ankara, 06100 Turkey

b Department of Pediatrics, Kapiolani Medical Center for Women and

Children, University of Hawaii A. Burns School of Medicine, Honolulu,

HI, USA

c Division of Pediatric Infectious Diseases, Hacettepe University School of

Medicine, Ankara, Turkey=20

Received 11 September 2000; received in revised form 14 May 2001; accepted

21 May 2001

Abstract

Background and methods: measles is a common cause of morbidity and

mortality in developing countries. Although the measles-mumps-rubella

vaccine (MMR) is currently in use in developed countries, monovalent

measles vaccine (MV) is routinely recommended by World Health Organization

(WHO) at 9 months of age in Turkey, as in many other developing countries.

In this study, 442 Turkish children received MV at 9 months of age and were

revaccinated with MMR vaccine at 15 months of age. In the second group 495

children received MMR at 12 months of age with no earlier measles

vaccination. Antibodies were measured before the first vaccination and 6

weeks after the MMR. All children had been followed for occurrence of

measles infection for 60 months. Two vaccination schedules were compared

for immunogenicity and protection rates. Conclusions: seroconversion and

clinical protection rates were significantly higher in children who

received only MMR at 12 months of age than in children revaccinated at 15

months of age. Seroconversion rate for measles was 69.9% in children who

received MMR at 12 months of age and 90.3% in children revaccinated at 15

months of age (P=3D0.0003). While there was no measles case in children who

were revaccinated, 12 (2.7%) children in the first group acquired measles

during the follow-up period. Vaccination at 12 months of age appeared to be

better than the current national standard. The late elimination of maternal

antibodies and the inhibitory effect of a weak antibody response after the

first dose of vaccine at 9 months may explain the better immunogenicity and

efficacy of the MMR vaccine given at 12 months of age.

Keywords: Monovalent measles vaccine; MMR vaccine; Developing countries

*Corresponding author. Tel.: +90-312-311-4963; fax: +90-312-324-3284=20

[Full text] (PDF 74.4 Kb)=20

=A9 Copyright 2001, Elsevier Science, All rights reserved.

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Sheri Nakken, R.N., MA=09

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http://www.nccn.net/~wwithin/vaccine.htm

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