Immunization of six-month-old infants with different doses of Edmonston-Zagreb and Schwarz measles vaccines

Article Abstract:

Measles causes extensive disability and death among children in developing countries, killing an estimated two million annually. Live vaccines are most effective in infants older than nine months, since the presence of maternal antibodies in younger babies reduces the vaccine's effect. But many infants lose these antibodies before they reach nine months of age and are then susceptible to measles. It is possible that a different type of measles vaccine from the commonly used Schwarz strain would be more effective in this young group. Randomized trials of three different doses of both the Edmonston-Zagreb and Schwarz vaccines were given to a total of 1,081 six-month-old infants, while a group of 299 nine-month-old babies (299) received a standard dose of each vaccine. Blood samples were taken before inoculation and again eight and 18 weeks later. Presence of measles antibody in infants who had not had antibody before vaccination (seroconversion) and the amount of that antibody (seropositivity) were noted in all three samples. For six-month-old babies, the Edmonston-Zagreb vaccine at all doses produced higher seroconversion rates and seropositivity than did comparable doses of the Schwarz vaccine. Antibody response, for the most part, increased with higher doses. For nine-month-olds, the Edmonston-Zagreb vaccine produced higher seroconversion rates than the Schwarz vaccine, but it did not produce more seropositivity. Since the Schwarz vaccine is so widely used that it constitutes a sort of standard, it was of interest to compare its effectiveness in the older group with the effects of the Edmonston-Zagreb vaccine in the younger. The response at all doses of the latter vaccine was greater than the response to the Schwarz vaccine according to both seroconversion and seropositivity measures. Two strains of the Edmonston-Zagreb vaccine were used - one produced in Yugoslavia, one in Mexico - and the Mexican vaccine was the most potent in these trials. In addition to suggesting that the Edmonston-Zagreb vaccine is safe and effective for infants six months of age, the results also indicate that dose level of a vaccine can make a difference in the magnitude of the antibody response, something generally not held to be true. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Vaccination of children, Vaccination

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Measles among the Amish: a comparative study of measles severity in primary and secondary cases in households

Article Abstract:

In developed countries, measles is usually mild, but in developing countries, it is often severe, and death may follow. Risk factors include poor nutrition, lack of medical care, and low resistance due to a weak immune system. Recently, it has been suggested that secondary measles cases (a second family member becoming infected) develop more severe illness, regardless of risk factors. It is thought that the newly infected individual is exposed to more disease by virtue of the infected member of the household. Most case studies have been conducted in Africa. A measles outbreak began in Pennsylvania in December 1987, and by May 1988 the first cases were reported among the Amish population. The Amish, due to religious and ethical considerations, are allowed exemption from Pennsylvania school immunization laws, which require measles vaccination. The outbreak spread to Amish settlements throughout the eastern half of the United States, and all cases could be linked to the outbreak in Pennsylvania. Severity of disease was assessed by determining the frequency and duration of symptoms, length of any hospitalization, and number of days in bed. Analysis of data indicated that there were no significant differences in measles severity among primary and secondary cases within households. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Pennsylvania, Amish

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Monitoring progress toward US preschool immunization goals

Article Abstract:

Ninety-seven percent of preschool children are vaccinated, and the incidence of vaccine-preventable diseases has decreased by 90% since the availability of vaccines. The US has established the goal of vaccinating 90% of infants under 24 months old by the year 2000, and to eliminate several vaccine-preventable diseases. More effort has been directed towards assessing outbreaks of vaccine-preventable diseases than the number of children reached by vaccination programs. Many preschoolers are not vaccinated on time, and this may have lead to outbreaks of measles in urban areas. Both the government and private physicians need to become involved in insuring that children are vaccinated on time. Health care workers need to be educated about vaccinations, and vaccines need to be made easily available to children. Research is needed to provide information for planning new vaccination programs, and to evaluate the success of these efforts.

Statistics, Preschool children, Immunization of children, Immunization, Communicable diseases in children, Pediatric communicable diseases

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