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Will the current measles vaccines ever eradicate measles?
1Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK. john.stephenson@lshtm.ac.uk
Abstract:
Measles virus is the most infectious transmissible agent causing human disease and has probably been responsible for the deaths of more children than any other single cause. In addition, infection with the natural virus causes many severe complications, including encephalitis, deafness and pneumonia. The introduction of live attenuated vaccines, either singly or as the measles-mumps-rubella combined vaccine, has dramatically reduced the occurrence of disease and in countries where vaccine uptake is high, indigenous disease has been virtually eliminated. Even though the current vaccines are very efficient, they do have their limitations. Children are most at risk during the first year of life and for most of this period, maternal antibodies prevent effective immunization. In addition, the current measles vaccines are relatively heat labile which causes difficulty in tropical areas. In recent years, vaccination rates in some industrial countries have been adversely affected by fears that measles vaccines are linked to inflammatory bowel diseases and autism. Although there is no conclusive evidence to support these fears, they still remain and probably contribute to poor vaccine uptake in some regions and sections of society. Although severe complications from vaccination are extremely rare, mild local reactions are more common. Consequently, in countries where measles is declining or has been eliminated, the fear of side effects of vaccination may encourage the development of vaccines that do not rely on virus replication to take effect.
Insights
Measles vaccines have dramatically reduced disease, but limitations like maternal antibodies and heat sensitivity persist. Concerns about side effects are impacting uptake, driving research into alternative vaccine technologies.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Measles virus is highly contagious, causing severe complications and historically high child mortality.
- Live attenuated measles vaccines have significantly reduced disease incidence globally.
- High vaccine uptake has led to the near elimination of indigenous measles in many regions.
Purpose of the Study:
- To review the efficacy and limitations of current measles vaccines.
- To discuss challenges including maternal antibodies, heat lability, and public concerns.
- To explore the need for novel vaccine approaches in response to these limitations.
Main Methods:
- Literature review of measles epidemiology and vaccine development.
- Analysis of vaccine efficacy, safety profiles, and public perception.
- Examination of factors affecting vaccine uptake and challenges in diverse settings.
Main Results:
- Current measles vaccines are highly effective but face challenges with infant immunization and heat stability.
- Public concerns regarding vaccine safety, though unsubstantiated, impact vaccination rates.
- Severe vaccine complications are rare, but mild reactions are more common.
Conclusions:
- Despite high efficacy, limitations of current measles vaccines necessitate ongoing research.
- Addressing public concerns and improving vaccine accessibility are crucial for sustained measles control.
- Development of non-replicating measles vaccines may offer future solutions, particularly in low-resource settings.
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