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Measles, mumps and rubella: control by vaccination
Developments in Biological Standardization
|January 1, 1986
Summary
Implementing a measles, mumps, and rubella (MMR) vaccination strategy can paradoxically increase congenital rubella syndrome (CRS) cases if coverage is low. Mathematical models show this risk, especially in populations with high rubella infection rates.
Area of Science:
- Epidemiology
- Mathematical Modeling
- Vaccinology
Background:
- The Netherlands introduced a combined measles, mumps, and rubella (MMR) vaccination strategy in 1984.
- Mathematical models predicted high vaccine efficacy for disease elimination.
Purpose of the Study:
- To analyze the potential adverse effects of MMR vaccination strategies on congenital rubella syndrome (CRS) incidence.
- To evaluate the impact of vaccine coverage levels on disease dynamics and complication rates.
Main Methods:
- Utilized mathematical modeling to simulate disease transmission and vaccination impacts.
- Analyzed the relationship between vaccine coverage, force of infection, and incidence of severe outcomes like CRS.
Main Results:
- Low MMR vaccine coverage (<50%) can lead to an increased incidence of CRS in the long term.
- High pre-vaccination rubella infection rates exacerbate this risk, potentially requiring 80-90% uptake to prevent increased CRS.
Conclusions:
- MMR vaccination programs require sufficient intensity to prevent disease eradication, otherwise, they may increase the risk of severe complications in unvaccinated individuals.
- The strategy's success is contingent on achieving high and sustained vaccine coverage to mitigate risks like increased CRS incidence.