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Journal Article
|Research

Modelling the first dose of measles vaccination: the role of maternal immunity, demographic factors, and delivery systems

Metcalf CJ, Klepac P, Ferrari MJ, Grais RF, Djibo A, Grenfell BT
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Modelling the first dose of measles vaccination: the role of maternal immunity, demographic factors, and delivery systems | Journal Article / Research | MSF Science Portal
Abstract
Measles vaccine efficacy is higher at 12 months than 9 months because of maternal immunity, but delaying vaccination exposes the children most vulnerable to measles mortality to infection. We explored how this trade-off changes as a function of regionally varying epidemiological drivers, e.g. demography, transmission seasonality, and vaccination coverage. High birth rates and low coverage both favour early vaccination, and initiating vaccination at 9-11 months, then switching to 12-14 months can reduce case numbers. Overall however, increasing the age-window of vaccination decreases case numbers relative to vaccinating within a narrow age-window (e.g. 9-11 months). The width of the age-window that minimizes mortality varies as a function of birth rate, vaccination coverage and patterns of access to care. Our results suggest that locally age-targeted strategies, at both national and sub-national scales, tuned to local variation in birth rate, seasonality, and access to care may substantially decrease case numbers and fatalities for routine vaccination.

Countries

none

Subject Area

women's healthvaccinationmeasles

Languages

English
DOI
10.1017/S0950268810001329
Published Date
01 Jun 2010
PubMed ID
20525415
Journal
Epidemiology and Infection
Volume | Issue | Pages
Volume 139, Issue 2
Issue Date
2010-06-07
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