Ideal age for measles vaccination with persisting maternal antibody, human immunodeficiency virus infection and protein-calorie malnutrition.

Abstract

A persisting maternally transmitted measles antibody in late infancy and early into the second year has been associated with a successful take of the measles vaccine. The virus neutralization test is more efficacious at detecting the maternal antibody persistence than the hemagglutination-inhibition test. In infants born to HIV infected mothers immunizations are needed in early infancy to reduce increased measles morbidity. Children with vitamin A deficiency have lower CD4/CD8 ratios a lower proportion of CD4 naive cells and a higher proportion of CD8 and CD45RO cells than those with no vitamin A deficiency. The Edmonston-Zagreb strain of the vaccine during early infancy has promising seroconversion rates. The optimal vaccination age and number of doses of measles vaccine needed for infants of HIV-infected mothers are not known. Thus measles control programs in developed and developing countries need to expand surveillance for measles antibody prevalence in each target population. They should use simplified sensitive and specific antibody estimation procedures that low-skilled personnel can perform. Forceps and a discard pan are all that is needed to perform a dot-immunobinding assay in the office or in the field. Workers can apply serum plasma or whole blood directly to a filter paper strip and transfer it to a nitrocellulose strip. Measles control programs need well-equipped laboratories. In industrialized countries a 2-dose vaccination schedule is recommended; effective vaccines that overcome environmental threats would be good. One must always review the ideal age for measles vaccination and vaccination schedules to prevent measles complications and vaccine failures worldwide.