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The effect of epidemic measles on immunization rates
K P Goldstein1, T J Philipson, H Joo
1Department of Pediatrics, University of Chicago, IL, USA.
Objective:
To evaluate whether immunization against a vaccine-preventable disease is sought to avoid the naturally occurring disease itself, we hypothesized that the rate of "on-time" measles immunization would increase during an epidemic of that disease. If such an effect occurred, we wondered whether it would have an impact on on-time administration of other recommended immunizations.
Design:
Retrospective evaluation of immunization rates of children at their second birthday with the use of computerized health records of children entering kindergarten in an 8-year interval spanning the onset of epidemic measles in Chicago, Ill, in 1989 and 1990.
Setting:
Children entering Chicago public schools.
Main Outcome Measures:
Rates of receipt of measles-containing vaccine (MCV), 1 to 4 doses of a diptheria toxoid-tetanus toxoid-pertussis (DTP) or diphtheria toxoid-tetanus toxoid (DT) vaccine, 1 to 3 doses of oral or inactivated polio vaccine (OPV/IPV), and the full series of these vaccines (4:3:1) that are required to be "up-to-date" by the second birthday.
Results:
The rate of on-time MCV receipt increased from 56% to 58% in the years prior to 70% during the epidemic (1989 and 1990). A similar increase did not occur to DTP/DT 4 or OPV/IPV 3. Moreover, among older children delayed in MCV receipt, evidence of catch-up immunization also occurred during the epidemic years; similar catch-up for delayed DTP/DT 4 or OPV/IPV 3 immunization did not occur.
Conclusions:
Dramatic increases in one-time and catch-up MCV receipt occurred during the Chicago measles epidemic of 1989 and 1990. The lack of similar increases in DTP/DT 4 and OPV/IPV 3 suggests MCV receipt was not associated with receipt of other recommended immunizations during that time.
Insights
During a measles epidemic, parents increased on-time measles-containing vaccine (MCV) administration. However, this surge in MCV uptake did not influence the timely receipt of other routine childhood immunizations.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Measles epidemics can influence parental decisions regarding vaccination.
- Understanding vaccination behavior during outbreaks is crucial for public health strategies.
Purpose of the Study:
- To determine if measles immunization rates increase during a measles epidemic.
- To assess if this increase impacts the administration of other routine vaccines.
Main Methods:
- Retrospective analysis of computerized health records for children entering kindergarten.
- Evaluation of immunization rates at the second birthday over an 8-year period, including epidemic years (1989-1990).
- Assessed rates for measles-containing vaccine (MCV), diphtheria-tetanus-pertussis (DTP)/diphtheria-tetanus (DT), and oral/inactivated polio vaccine (OPV/IPV).
Main Results:
- On-time MCV receipt increased from 56-58% to 70% during the 1989-1990 measles epidemic.
- No similar increase was observed for DTP/DT or OPV/IPV immunizations.
- Catch-up immunizations for MCV also increased during the epidemic, but not for other vaccines.
Conclusions:
- Measles epidemics prompt significant increases in both on-time and catch-up MCV administration.
- The uptake of MCV during an epidemic was not associated with the timely receipt of other recommended childhood vaccines.