Abstract
BackgroundMeasles (rubeola) is a highly contagious disease with significant morbidity/mortality. Measles-Mumps-Rubella (MMR) is a live-attenuated vaccine used in the United States (US) since the early 1970s to prevent measles infection. This retrospective longitudinal cohort study examined childhood MMR vaccination effectiveness (VE) on preventing diagnosed measles cases.MethodsThe Independent Healthcare Research Database (IHRD) is composed of non-identifiable linked eligibility and claim healthcare records prospectively generated from the Florida Medicaid system. The SAS system was utilized to examine a cohort of 101,736 persons eligible for Florida Medicaid from 1990 to 2009 and continuously eligible with ≥10 outpatient office visits during the 120-month period following birth. There were 32,870 persons (224,492 person-years) in the cohort receiving a single dose of childhood MMR vaccine (vaccinated) and 43,538 persons (434,637 person-years) in an unvaccinated cohort (no exposures to measles-containing vaccine). The frequency of diagnosed measles (ICD-9 code: 055xxx) was examined. Cox proportional hazards models evaluated MMR vaccination and diagnosed measles over time.ResultsMMR vaccinated cohort members were at significantly reduced risk of measles in the unadjusted (VE = 83.6, 95% CI = 67.2–91.8%) and adjusted (VE = 80.7, 95% CI = 61.5–83.9%) models as compared to the unvaccinated cohort. VE = 80% among younger MMR recipients (12–15 months), whereas VE = 90% among older MMR recipients (16–20 months) as compared to the unvaccinated cohort.ConclusionRoutine childhood MMR vaccination significantly reduced the incidence rate of childhood measles infections, and the VE was greater in the older recipients (16–20 months) than in the younger recipients (12–15 months).
Highlights
Measles is a highly contagious disease with significant morbidity/mortality
As described by the United States (US) Centers for Disease Control and Prevention (CDC), measles is highly contagious (90% of exposed susceptible persons develop measles) rash illness that is transmitted by direct contact with respiratory droplets or airborne spread between person to person [1]
The MMR vaccine used in the US since the 1980s is the M-M-R® II vaccine (Merck & Co, Inc., Whitehouse Station, New Jersey (NJ)), and is a sterile lyophilized preparation of (1) ATTENUVAX® (Measles Virus Vaccine Live), a more attenuated line of measles virus, derived from Enders’ attenuated Edmonston strain and propagated in chick embryo cell culture; (2) MUMPSVAX® (Mumps Virus Vaccine Live), the Jeryl LynnTM (B level) strain of mumps virus propagated in chick embryo cell culture; and (3) MERUVAX® II (Rubella Virus Vaccine Live), the Wistar RA 27/3 strain of live attenuated rubella virus propagated in WI-38 human diploid lung fibroblasts [5]
Summary
Measles (rubeola) is a highly contagious disease with significant morbidity/mortality. Measles-MumpsRubella (MMR) is a live-attenuated vaccine used in the United States (US) since the early 1970s to prevent measles infection. This retrospective longitudinal cohort study examined childhood MMR vaccination effectiveness (VE) on preventing diagnosed measles cases. As described by the United States (US) Centers for Disease Control and Prevention (CDC), measles (rubeola) is highly contagious (90% of exposed susceptible persons develop measles) rash illness that is transmitted by direct contact with respiratory droplets or airborne spread between person to person [1]. The MMR vaccine used in the US since the 1980s is the M-M-R® II vaccine (Merck & Co, Inc., Whitehouse Station, NJ), and is a sterile lyophilized preparation of (1) ATTENUVAX® (Measles Virus Vaccine Live), a more attenuated line of measles virus, derived from Enders’ attenuated Edmonston strain and propagated in chick embryo cell culture; (2) MUMPSVAX® (Mumps Virus Vaccine Live), the Jeryl LynnTM (B level) strain of mumps virus propagated in chick embryo cell culture; and (3) MERUVAX® II (Rubella Virus Vaccine Live), the Wistar RA 27/3 strain of live attenuated rubella virus propagated in WI-38 human diploid lung fibroblasts [5]
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