Measles Vaccines in Iran: A 50-Year Review of Vaccine Development, Production and Effectiveness (1967 - 2017)

Abstract

Context: Information on the measles vaccine is important for future measles control policies. Vaccination history and laboratory confirmation during the development of the AIK measles vaccine in Iran is surveyed in this article. In addition, the production results and effectiveness of the Razi AIK-C/MRC-5 measles strain are compared with other vaccine strains. Evidence Acquisition: The current study was carried out to aim local measles vaccine manufacturing and consequences of that in Iran, using various search engines. Almost complete search carried out in medical databases including PubMed, Scopus, Web of Science, Scientific Information Database, IranMedex, Magiran and Google Scholar. Results: The morbidity rate of measles during the pre-vaccine era of this disease was 10,000 cases/year in 1970 - 1972. In 1997, the rate was 24 in 1000 cases. After using the high quality Razi measles vaccine between 1995 and 2013, the number of measles-positive cases declined to a maximum of 35 cases per year, while the country’s population increased by more than 2.5 times. The median of the Razi measles vaccine efficacy (VE) was > 92.1% compared with that of the pre-vaccine era. For patients who received 2 doses of the measles vaccine at either 6 and 12 months or 9 and 18 months of age, the median VEs were > 90.0% (interquartile range [IQR], 83% - 97%) and 92.0% (IQR, 86% - 98%), respectively. The age at vaccination and strain type used in the vaccines are reviewed in this article. Conclusions: The effectiveness of the local Razi measles vaccine resulted in a significant decline in measles mortality and morbidity in Iran. Two doses of the Razi measles (MR) or measles combination (MMR) vaccine provided excellent protection against measles. The seroprevalance of the measles vaccine in Iran revealed that more than 90% of Iranians are seropositive for the measles virus.