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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.31 no.5 São Paulo Oct. 1989

http://dx.doi.org/10.1590/S0036-46651989000500005 

ORIGINAL ARTICLES

 

Measles vaccination: influence of age on its efficacy

 

Vacinação contra o sarampo: influência da idade em sua eficácia

 

 

Marta Heloísa LopesI; João Silva de MendonçaIII; Cláudio Sérgio PannutiI, IV; Paul AlbrechtII; Maria Lúcia Neves BiancalanaIII; Orlando César ManteseIII; José Fábio CorreaIII; Vicente Amato NetoI

IDepartamento de Doenças Infecciosas e Parasitárias - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
IIDivision of Virology - Center for Biologics Evaluation & Research Food and Drug Administration, Bethesda, Maryland, USA
IIIHospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
IVLaboratório de Virologia - Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brazil

Address for correspondence

 

 


SUMMARY

The authors compare the serologic efficacy and the clinical protection afforded by three different measles vaccination schemes in adequately nourished children in São Paulo city, Brazil.
Two hundred forty two children were divided into three groups. Group A, comprising 117 children who had received the vaccine before 12 months of age and a second dose at 12 months of age or more. Group B, comprising 46 children who had received only one dose, before 12 months of age. Group C, comprising 79 children who had received only one dose, at 12 months of age or more.
The geometric mean titer of antibodies in Group A was 790.1; in Group B, 251.1; and in Group C, 550.3. There was no statistically significant difference between Groups A and C.
The exposure to the measles virus was probably similar in all groups, and the children in Groups A and C had similar chances of acquiring the disease after vaccination whereas in Group B the chances were higher when compared to the other two groups.
The results obtained in this study favor the use, in developing countries, of a vaccination program against measles that includes an early first dose at eight months of age and revaccination after 12 months of age.

Key words: Measles vaccine; Measles; Children immunization.


RESUMO

Os autores comparam a eficácia sorológica e a proteção clinica obtidas com três esquemas diferentes de vacinação contra o sarampo, em crianças eutróficas, na cidade de São Paulo, Brasil.
Duzentas e quarenta e duas crianças foram divididas em três grupos. Grupo A, compreendendo 117 crianças primovacinadas antes dos 12 meses de idade e revacinadas com 12 ou mais meses de idade. Grupo B, compreendendo 46 crianças vacinadas com dose única, antes dos 12 meses de idade. Grupo C, compreendendo 79 crianças vacinadas com dose única, aos 12 ou mais meses de idade.
A média geométrica do título de anticorpos no grupo A foi 790,1; no grupo B, 251,1; e no grupo C, 550,3. Não houve diferença estatisticamente significante entre os grupos A e C.
A exposição ao vírus do sarampo foi provavelmente semelhante em todos os grupos. As crianças dos grupos A e C apresentaram risco de adoecimento semelhante após vacinação, enquanto que tal risco foi maior no grupo B quando comparado aos outros dois grupos.
Os resultados obtidos neste estudo falam a favor do uso, em países em desenvolvimento, de um programa de vacinação contra o sarampo que inclua uma primeira dose àos oito meses de idade e revacinação após os 12 meses de idade.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

REFERENCES

1. ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES OF THE U. S. PUBLIC HEALTH SERVICE - Measles vaccines. Ann. intern. Med., 67: 1055-1058, 1967.         [ Links ]

2. ALBRECHT, P.; ENNIS, F. A.; SALTZMAN, E. J. & KRUGMAN, S. - Persistence of maternal antibody in infants beyond 12 months: mechanism of measles vaccine failure. J. Pediat., 91: 715-718, 1977.         [ Links ]

3. ALBRECHT, P.; HERRMAN, K. & BURNS, G. R. - Role of virus strain in conventional and enhanced measles plaque neutralization test. J. virol. Meth., 3: 251-260, 1981.         [ Links ]

4. BORGONO, J. M. & GREIBER, R. - Sarampión. Cinco anos de experiencia con el programa de vacunación en Chile. Rev. méd. Chile, 99: 502-506, 1971.         [ Links ]

5. BURROWES, J. & CRUICKSHANK, J. G. - At what age should measles vaccine be given? Cent. Afr. J. Med., 22: 45-47, 1976.         [ Links ]

6. COLLABORATIVE STUDY BY THE MINISTRY OF HEALTH OF KENYA AND THE WORLD HEALTH ORGANIZATION - Measles immunity in the first year after birth and the optimum age for vaccination in Kenyan children. Bull. Wld. Hlth. Org., 55: 21 30, 1977.         [ Links ]

7. DICK, B.; SMITH, T. & KIPPS, A. - A minimum age for measles vaccine administration to coloured children. S. Afr. med. J., 49: 1951-1954, 1975.         [ Links ]

8. FUNDAÇÃO SESP, MINISTÉRIO DA SAÚDE -Investigação sobre a vacina anti-sarampo. Bol. epidem. (Rio de J.), 11: 129-131, 1979.         [ Links ]

9. HALSEY, N. A.; BOULOS, R.; MODE, F.; ANDRÉ, J.; BOWMAN, L.; YAEGER, R. G.; TOUREAU, S.; ROHDE, J. & BOULOS, C. - Response to measles vaccine in Haitian infants 6 to 12 months old. New Engl. J. Med., 313: 544-549, 1985.         [ Links ]

10. HAYDEN, R.I, - The epidemiology and nature of measles in Nairobi before the impact of measles immunization. East Afr. med. J., 51: 199, 1974.         [ Links ]

11. KRUGMAN, R. D.; ROSENBERG, R.; McINTOSH, K.; HERRMAN, K.; WITTE, J. J.; ENNIS, F. A. & MEYER, B. C. - Further attenuated live measles vaccines: the need for revised recommendations. J. Pediat., 91: 766-767, 1977.         [ Links ]

12. LEE, Y. L.; BLACK, F. L.; CHEN, C. L.; WU, C. L. & BERMAN, L. L. - The optimal age for vaccination against measles in an Asiatic city, Taipei, Taiwan: reduction of vaccine induced title by residual transplacental antibody. Int. J. Epidem., 12: 340-343, 1983.         [ Links ]

13. LINNEMAN JR., C. C; ROTTE, T. C; SCHIFF, G. M. & YOUTSEY, J. L. - A seroepidemiologic study of a measles epidemic in a highly immunized population. Amer. J. Epidem., 95: 238 246, 1972.         [ Links ]

14. LINNEMAN JR., C. C. - Measles vaccine: Immunity, reinfection and revaccination. Amer. J. Epidem., 97: 365-371, 1973.         [ Links ]

15. LINNEMAN JR., C. O; DINE, M. S.; ROSELLE, G. A. & ASKEY, P. A. - Measles immunity after revaccination: results in children vaccinated before 10 months of age. Pediatrics, 69: 332-335, 1982.         [ Links ]

16. LOENING, W. E. K. & COOVADIA, H. M. - Age-specific occurrence rates of measles in urban, peri-urban, and rural environments: implications for time of vaccination. Lancet, 2: 324-326, 1983.         [ Links ]

17. MACGRAW, T. T. - Reimmunization following early immunization with measles vaccine: a prospective study. Pediatrics, 22: 45-48, 1986.         [ Links ]

18. MEYER, H. M. - Response of Volta children to live attenuated measles-virus vaccine. Bull. Wld. Hlth. Org:., 30: 769-781, 1964.         [ Links ]

19. MINISTRIES OF HEALTH OF BRAZIL, CHILE, COSTA RICA, AND ECUADOR AND THE PAN AMERICAN HEALTH ORGANIZATION - Seroconversion rates and measles antibody titers induced by measles vaccination in Latin American children six to 12 months of age. Rev. infect. Dis., 5: 596-605, 1983.         [ Links ]

20. MIRCHAMSY, J. - Measles immunization in Iran. Rev. infect. Dis., 5: 491-494, 1983.         [ Links ]

21. MORLEY, D. - Severe measles in the Tropics. Part I. Brit. med. J., 1: 297-300, 1969.         [ Links ]

22. MORLEY, D. - Severe measles in the Tropics. Part II. Brit. med. J., 1: 363-365, 1969.         [ Links ]

23. PANNUTI, C. S.; SOUZA, V. A. U. F.; TAKAOKA, N.; LEME, S. T. S.; PEREIRA, C. R.: CARVALHO, R. P. S. & AMATO NETO, V. - Interferencia entre as vacinas anti-sarampo e anti-poliomielite. Bol. Ofic. sanit. panamer., 103: 227-232, 1987.         [ Links ]

24. PAREDES, J. A. - El impacto del sarampión en Centro America. Bol. Ofic. sanit. panamer., 76: 503 511, 1974.         [ Links ]

25. PRAL, M. M.; WOE FANG, F. L. & DE RIZZO, E. - Potency control of live, attenuated vaccines against measles used in children vaccinations in the State of São Paulo, Brazil (1976-1980). Rev. Inst. Med. trop. S. Paulo, 24: 1-5, 1982.         [ Links ]

26. PUFFER, R. R. & SERRANO, C. V. - Características de la mortalidad en la niñez. Washington, Organización Panamericana de la Salud, Organización Mundial de la Salud, 1973. (Publicación Científica no. 262).         [ Links ]

27. RECOMMENDATION OF THE PUBLIC HEALTH SERVICE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES - Measles vaccine. MMWR, 25: 359-360, 1976.         [ Links ]

28. REYNOLDS, D. W. & START, A. - Immunity to measles in children vaccinated before and after 1 year of age. Amer. J. Dis. Child., 124: 848-850, 1972.         [ Links ]

29. RISI JR., J. B. - Control of measles in Brazil. Rev. infect. Dis., 5: 583-587, 1983.         [ Links ]

30. SCHLUEDERBERG, A.; LAMM, S. H.; LANDRIGAN, P. J. & BLACK, F. L. - Measles immunity in children vaccinated before one year of age. Amer. J. Epidem., 97: 402-409, 1973.         [ Links ]

31. SHELTON, J. D.; JACOBSEN, J. E.; ORENSTEIN, W. A.; SCHULZ, K. F. & DONNEL Jr., H. D. - Measles vaccine efficacy: influence of age at vaccination vs. duration of time since vaccination. Pediatrics, 62: 961-964, 1978.         [ Links ]

32. SOERENSEN, B.; TAKEDA, A. K.; NAKANDAKARE, I. K.; CURI, L. O; UMERITA, L. F.; ZUCCAS, W. A.; GUIDONI, R.; MAGALHÃES, E.; BRITTO, S. S. & FEIJÓ, I. C. - Sarampo: Idade ótima e número de doses recomendadas para a vacinação no Brasil. Rev. Inst. Med. trop. S. Paulo, 27: 55-65, 1985.         [ Links ]

33. STETLER, H. O; ORENSTEIN, W. A.; BERNIER, R. H.; HERRMANN, K. L.; SIROTKIN, B.; HOPFENSPERGER, D.; SCHUH, R.; ALBRECHT, P.; LIEVENS, A. W. & BRUNELL, P. A. - Impact of revaccinating children who initially received measles vaccine before 10 months of age. Pediatrics, 22: 471-476, 1986.         [ Links ]

34. VERONESI, R.; SCHMID, A. W.; MOURA, R. A.: CARVALHO, R. P. S.; ZUCCAS, W. A. & CAMARGO, M. - Revisão de dados da epidemiologia e etiologia do sarampo e subsídios para a vacinação contra a doença. Arq. Fac. Hig. S. Paulo, 17: 135-204, 1963.         [ Links ]

35. WALSH, J. A. - Selective primary health care: Strategies for control of disease in developing world. IV. Measles. Rev. infect Dis., 5: 330-340, 1983.         [ Links ]

36. WEIBEL, R. E.; BUYNAK, E. B. & McLEAN, A. A. - Persistence of antibody in human subjects for 7 to 10 years following administration of combined live attenuated measles, mumps, and rubella virus vaccines. Proc. Soc. exp. Biol. (N. Y.), 165: 260-263, 1980.         [ Links ]

37. WILKINS, J. & WEHRLE, P. F. - Additional evidence against measles vaccine administration to infants less than 12 months of age: Altered immune response following active/passive immunization. J. Pediat., 94: 865-869, 1979.         [ Links ]

38. YEAGER, A. S.; DAVIS, J. H.; ROSS, L. A. & HARVEY, B. - Measles immunization. Successes and failures. J. Amer. med. Ass., 237: 347-351, 1977.         [ Links ]

 

 

Address for correspondence:
Marta Heloísa Lopes
Faculdade de Medicina da Universidade de São Paulo
Secretaria do Departamento de Doenças Infecciosas e Parasitárias
Av. Dr. Arnaldo, 455 - 2º andar - sala 99
01246 São Paulo, SP, Brazil

Recebido para publicação em 03/05/1989.

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