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Measles vaccine: a 27-year follow-up
M E Ramsay1, D Moffatt, M O'Connor
1Immunisation Division, PHLS Communicable Disease Surveillance Centre, London.
Insights
Long-term studies show that live measles vaccination provides high protection for up to 27 years. Current UK measles immunization policies remain effective due to persistent immunity from the live measles vaccine.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- The Medical Research Council conducted a large-scale measles vaccine trial in the UK in 1964.
- The trial involved over 36,000 children, with groups receiving live vaccine, inactivated followed by live vaccines, or serving as unvaccinated controls.
Purpose of the Study:
- To assess the long-term protection afforded by the live measles vaccine.
- To determine if there is evidence of waning immunity over an extended period.
Main Methods:
- Longitudinal follow-up of participants from the 1964 measles vaccine trial.
- Analysis of measles case data over distinct 5-year and 15-year periods (1986-1990 and 1976-1990).
- Calculation of protective efficacy and assessment of trends in immunity over time.
Main Results:
- Between 1986-1990, the protective efficacy of the live measles vaccine was 87%.
- From 1976-1990 (15 years), overall live vaccine efficacy was 92%, with no statistically significant decline observed (P=0.13).
- Follow-up data indicated persistent protection for up to 27 years post-vaccination.
Conclusions:
- Live measles vaccine confers durable protection, persisting for at least 27 years.
- There is no evidence of waning immunity necessitating changes to current UK measles immunization policy.
- The findings support the continued efficacy of the established measles vaccination strategy.
Abstract:
In 1964, the Medical Research Council undertook a trial of measles vaccine in over 36,000 United Kingdom children; 9577 of whom received live vaccine, 10,625 received inactivated followed by live vaccines, and 16,328 acted as unvaccinated controls. Participants in this study have been followed to determine the long term protection from measles vaccine and follow-up data were available on 4194, 4638 and 274 respectively. During the 5-year period 1986-90, the protective efficacy of live measles vaccine has remained high at 87%, but the 95% confidence interval was wide (-43 to 99%) due to the small numbers of cases. Between 1976 and 1990, however, the overall efficacy of the live vaccine was 92% (95% confidence interval 86 to 95%) and there was no evidence of a decline in efficacy (P = 0.13) over the 15-year period. This study suggests that the protection from live measles vaccine persists for up to 27 years after vaccination, and that no change in the current United Kingdom measles immunization policy should be made on the grounds of waning immunity.