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

C. J.E. Metcalf, P. Klepac, M. Ferrari, R. F. Grais, A. Djibo, B. T. Grenfell

Research output: Contribution to journalArticle

17 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)265-274
Number of pages10
JournalEpidemiology and Infection
Volume139
Issue number2
DOIs
StatePublished - Feb 2011

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Infectious Diseases

Keywords

  • Mathematical modelling
  • measles (rubeola)
  • vaccine policy development

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