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Options for improvement of the Dutch measles vaccination schedule
S van den Hof1, J Wallinga, M-A Widdowson
1Department of Infectious Diseases Epidemiology, National Institute for Public Health and The Environment, PO Box 1, Bilthoven BA 3720, The Netherlands. susan.van.den.hof@rivm.nl
Abstract:
We investigated which vaccination schedule gives best protection to the vaccinating population, in case of a measles epidemic in pockets of unvaccinated individuals. We explored the effect of an additional measles vaccination (at 6 or 9 months), advancing the first measles-mumps-rubella (MMR) vaccination from 14 to 11 months, and advancing the second MMR from 9 to 4 years. Measures of protection among vaccinees (percentage of susceptibles, number of reported cases, percentage of lifetime spent susceptible) were estimated with a mathematical model of the impact of antibody level on seroconversion and immunity. Advancing the age of second MMR vaccination prevents considerably more cases among vaccinees than an extra early measles vaccination or advancing the age of first MMR vaccination.