Efficacy of Measles Vaccines after Controlling for Exposure

The clinical efficacy of measles vaccines was investigated in Niakhar, a rural area of Senegal under demographic surveillance in 1987–1990. Three measles vaccines were tested: a standard Schwarz, a high-titer Edmonston-Zagreb, and a high-titer Schwarz. The two high-titer vaccines were administered a...

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Bibliographic Details
Published in:American journal of epidemiology 1993-08, Vol.138 (3), p.182-195
Main Authors: Garenne, Michel, Leroy, Odile, Beau, Jean-Pierre, Sene, Ibrahima
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child
Child, Preschool
Human viral diseases
Humans
Incidence
Infant
Infectious diseases
measles
Measles - epidemiology
Measles - prevention & control
measles vaccine
Measles Vaccine - immunology
Medical sciences
multivariate analysis
Population
population surveillance
Prospective Studies
rural population
Senegal - epidemiology
Viral diseases
Viral diseases of the respiratory system and ent viral diseases
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Summary:The clinical efficacy of measles vaccines was investigated in Niakhar, a rural area of Senegal under demographic surveillance in 1987–1990. Three measles vaccines were tested: a standard Schwarz, a high-titer Edmonston-Zagreb, and a high-titer Schwarz. The two high-titer vaccines were administered at 5 months of age and the standard Schwarzvaccine at 10 months. In addition to a formal randomized vaccine trial, data from national campaigns using the standard Schwarz vaccine were also analyzed. Clinical efficacy was estimated after controlling for exposure. In the randomized trial, the estimate of the efficacy of the standard Schwarz vaccine was 97.2% (95% confidence interval (CI) 91.3–98.1). In the 1986–1987 national campaign, the efficacy of the standard Schwarz vaccine was lower: 92.5% (95% CI 88.8–94.6). In the randomized trial, the efficacy of the high-titer vaccines was lower than that of the standard vaccine. High-titer vaccines were not used in national campaigns. Other factors associated with vaccine efficacy were age at exposure, intensity of exposure, and age at vaccination. Controlling for the intensity of exposure did not change the relative ranking of the efficacy of the three vaccination strategies. The theoretical efficacy of the standard measles vaccine for a single unit of exposure was estimated at 98.0%.
ISSN:0002-9262
1476-6256
DOI:10.1093/oxfordjournals.aje.a116844