Attenuated Measles Virus Vaccine Research Articles

Avaliação sorológica de imunização contra o sarampo com duas doses administradas aos 6 e 11 meses de idade: estudo prospectivo

A prospective study was designed to evaluate the serologic efficacy of a two dose measles vaccination schedule, at 6 months and 11 months of age. Infants were given a further attenuated measles virus vaccine (BIKEN CAM 70, Fundação Oswaldo Cruz) and serum samples were tested for measles antibodies using the indirect immunofluorescence technique (IFA) and ELISA. Seroconversion rates 6 to 12 months (mean of 8.0 +/- 1.7 months) following the second dose of measles vaccine were 88.5% (85/96) by IFA and 96.8% (93/96) by ELISA. No measles cases were reported during the study period. In regions where a significant proportion of measles cases occurs before nine months of age, vaccination with a two doses schedule, at 6 and 11 months of age, may represent an alternative for measles control.

Epidemiologic Studies of Measles, Measles Vaccine, and Subacute Sclerosing Panencephalitis

Histories obtained in 350 of 375 clinically cofirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles. Forty of the latter patients received live, attenuated measles virus vaccine. In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 7.0 years before onset of SSPE. In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 3.3 years after vaccination. Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (0.5 to 1.1 cases/106) appears to be less than the risk following measles (5.2 to 9.7 cases/106). Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.

Measles Immunization: New Recommendations

Live, attenuated measles virus vaccine was licensed for use in the United States in 1963. During the past 13 years, more than 80 million children have been immunized. During the prevaccine era, major epidemics occurred in most cities at two- or threeyear intervals, and the number of reported cases in the United States was approximately 500,000 each year. The extensive use of measles vaccine during the past decade has had a profound effect on the epidemiology of the disease in this country. The number of reported cases has declined to levels of approximately 35,000 per year, a decrease exceeding 90%. In addition, there has been a corresponding reduction in the number of cases of encephalitis following measles cases, and major nationwide epidemics have not occurred. However, despite this encouraging trend, outbreaks of measles have been observed in adolescents as well as in young children during the past four or five

Clinical and serological studies on a further attenuated live measles virus AIK vaccine

Two lots of AIK vaccines were inoculated subcutaneously on a total of 471 healthy children who was thought to have never experienced measles in the past. This live vaccine was prepared by employing a virus strain attenuated by passage through the primary kidney cell culture of sheep at the kitasato Institute.Of the 471 chidren inoculated, both serological and clinical survey were completed on initially seronegative 321 children (Lot TV-6, 134; Lot TV-7, 187).Reported in the following are the findings thereof.1. Antibody responsesAll the children, who had previously been confirmed negative, were found to have developed antibodies against measles. In the case of Lot TV-6 the mean of the hemagglutination-inhibition antibody titer was 25.7±1.0, and it was 25.6±1.0 with Lot TV-7. Follow up of hemagglutination-inhibition antibody titers feasible on 12 children showed the mean value (G.M.T.) of 25.6 at the end of 6 weeks, 24.4 at I year and 24.3 at 1.6 years after inoculation.2. Clinical reactions(i) Fever: Frequency of the appearance of fever≥37.5°C was 20.9%, and ≥39.0°C was 3.0% with Lot TV-6. In the case of Lot TV-7 the appearance of fever ≥37.5°C was 12.8%, and ≥39.0°C was 1.1%. The mean highest temperatuie of feverish children observed was 38.3°C with Lot TV-6, and 38.1°C with Lot TV-7. Their duration was in an average of 1.6 days in both cases. The mean incubation period before the onset of fever was 8.3 days with Lot TV-6 and 8.8 days with Lot TV-7. There was not a single case of febrile convulsion nor any other toxic reactions.(ii) Rash: Rate of the appearance of rash was 22.4% with Lot TV-6, and 14.4% with Lot TV-7. Period to the appearance of rash after inoculation was in an average of 9.7 days with Lot TV-6, and 9.2 days with Lot TV-7. In more than 70% of the total children inoculated, the number of papel-like rashes was less than 10.Due to the findings described above, the AIK vaccine employed in the present study can be categorized as a further attenuated measles virus vaccine.

Conversion rates and side effects following vaccination with three different batches of the ‘Schwarz’ measles strain

Three different batches of live attenuated measles virus vaccine (Schwarz strain) containing, respectively, 1000, 5000 and 12 500 TCID 50 per dose, were given to groups of 129, 112 and 61 allegedly measles-negative children aged from one to six years. Pre- and postvaccination blood specimens for measles HI-tests were taken from all the vaccinees. High (96–97%) conversion rates were obtained in previously seronegative children immunized with either of the two more potent vaccines, while the vaccine containing 1000 TCID 50, although still acceptable for use according to official U.S.A. requirements, gave conversion only in 86%. There was no significant difference between the three vaccines in geometric mean postvaccination titres of seroconverting vaccinees. A follow-up study, performed two years after vaccination of another group of children with a vaccine containing about 2500 TCID 50 per dose, showed that 130 out of 138 investigated children had demonstrable measles HI-antibodies with titres closely similar to those found in a control group of naturally immune children. The incidence of febrile reactions and rash following vaccination was, respectively, about two and four times higher in seroconverting children vaccinated with the strongest vaccine used (12 500 TCID 50 per dose) than in children given the two other vaccines tested. A vaccine strength of about 5000 TCID 50 per dose, that was found to induce more than 95% conversions while still giving comparatively few side-reactions, would thus appear to be most suitable for routine vaccination of children against measles. However, in view of the relative temperature and storage instability of live attenuated measles virus, even lyophilized, it might be difficult in practice to provide such an exactly defined and reproducible content of viable virus in the vaccine at the time when it is actually being used. The findings stress the importance of adequate calibration of the live virus content in commercially available measles vaccines.

Measles antibody in previously immunized children. The need for revaccination.

Measles antibody was measured in three groups of children: (1) those who had received live measles virus vaccine at less than 1 year of age, (2) previously immunized siblings of children with clinical measles at the time of this study, and (3) previously immunized children who were revaccinated with live further attenuated measles virus vaccine. The results of this study indicated that children who have received live measles virus vaccine at less than 1 year of age, particularly less than 11 months, have very low antibody levels and may need revaccination. This can be accomplished in many children with the live further attenuated measles virus vaccine. However, following exposure to natural measles, many previously immunized children will experience a natural boost in titer.

Combined live measles-rubella vaccine.

To the Editor .—In a previous publication we described the immunological response of 40 seronegative infants following inoculation of combined live measles, mumps, and rubella virus vaccine. 1 A summary of the results is shown in the Table. The antibody responses to the three viruses were excellent and the combined measles, mumps, rubella vaccine was well tolerated. Subsequent to the above publication, an additional 37 seronegative infants were immunized with combined live attenuated measles virus vaccine (Moraten) and HPV-77 duck rubella virus vaccine. The results are shown in the Table. The combined live measles-rubella vaccine was immunogenic, well tolerated, and there was no evidence of interference. These findings confirm similar studies by Villarejos et al. 2

Live, further attenuated rubella vaccine. Serologic responses among term and low birth weight infants.

Responses of infants have been studied following inoculation with live attenuated measles virus vaccine (Schwarz). Maximal responses occurred after 12 months of age regardless of birth weight. However, to achieve measles eradication, it may be desirable to immunize infants as young as 9 months of age. Quantitative differences in levels of antibody are recognized following acquired rubeola infection, and administration of attenuated and further attenuated rubeola virus vaccines. Since the latter, stimulating the lowest antibody levels, are now used almost exclusively, it is conceivable that in the future maternal antibody levels may be lower. Thus, passively acquired antibody levels in infants born of mothers with vaccine-induced immunity can be expected to decline to insignificant levels earlier in infancy. Active immunization may be feasible even earlier in infancy after the next decade.

Measles in Children Previously Vaccinated Against Measles

An outbreak of measles (rubeola) occurred in a city in northeastern Ohio between January and June 1969, involving 14 children previously inoculated with live attenuated measles virus vaccine and 46 unvaccinated children. In a school where the attack rate was 52.4% for unvaccinated children, the attack rate for children vaccinated by one particular physician was 17.9%, compared with 1.2% for children vaccinated by the local health department and other physicians. Vaccine in this physician's office was exposed to temperatures that may have contributed to virus inactivation. This study is an example of vaccine efficacy under conditions of current community use that is less than anticipated by field trial experience. Lack of initial seroconversion is the most likely cause of these vaccine failures and deterioration of vaccine infectivity during storage is proposed as the probable explanation.

MEASLES (RUBEOLA) IN PREVIOUSLY IMMUNIZED CHILDREN

Within a 3-month countywide epidemic of measles in Jacksonville, Florida, 28 cases occurring among a kindergarten enrollment of 145 were carefully studied since 25 of these children had been previously immunized with a live, attenuated measles virus vaccine and immune globulin. Nineteen children had been vaccinated prior to their first birthday. Six children were vaccinated at 13 to 20 months of age. The median measles (rubeola) hemagglutination-inhibition (HI) antibody titer in sera of five convalescent patients immunized before their first birthday was 1:320 and for complement fixation it was 1:128. Sera from nine classmates who did not contract the disease showed a median HI antibody of 1:40 and a median complement fixing antibody (CF) of 1:16. Six had been vaccinated before their first birthday. In a control group of five other children, three had been immunized prior to 12 months of age, one at 13 months, and one at 18 months. Sera from the three earliest contained no antibody; however, sera from the other two had detectable antibody. The analysis of serologic data supported the contention that the outbreak was causally related to defective protection associated with the use of vaccine plus globulin in infants. It also demonstrated persistence of CF antibody many years after immunization and suggested the presence of a booster phenomenon. A review of the clinical illness of the 25 children who had been given the vaccine and 22 who had not revealed little difference in the severity of the disease.

Live Rubella Virus Vaccin n Tuberculous Children

RUBEOLA is known to cause depression of tuberculin skin reactivity and to exert a deleterious effect on the clinical course of untreated, childhood tuberculosis. 1,2 The live, attenuated measles virus vaccine has also been shown to depress skin reactivity and possibly to affect adversely the clinical status of the unrecognized tuberculous child. 1,3,4 Since rubella and rubeola are both exanthematous, viral diseases, it is understandable that the live, attenuated rubella virus vaccine might be suspected of effects similar to those related to the measles vaccine. It is desirable, therefore, that the safety of the rubella product be established for the tuberculous individual before its widespread distribution for clinical use. The present report describes our experience with 18 hospitalized children under treatment for tuberculosis who were inoculated with the Cendehill strain of attenuated rubella virus. Materials and Methods Study Outline. —The study group was composed of 24 tuberculous children ranging in

Clinical, Immunological and Serological Studies on the Combination of Killed and Live Attenuated Measles Virus Vaccines

Pediatrics InternationalVolume 11, Issue 1 p. 57-57 Clinical, Immunological and Serological Studies on the Combination of Killed and Live Attenuated Measles Virus Vaccines Nobuhiro Yamazaki, Department of Pediatrics, Wakayama Medical College (Chief, Prof. Teisukt Kodama)Search for more papers by this author Nobuhiro Yamazaki, Department of Pediatrics, Wakayama Medical College (Chief, Prof. Teisukt Kodama)Search for more papers by this author First published: June 1969 https://doi.org/10.1111/j.1442-200X.1969.tb02721.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume11, Issue1June 1969Pages 57-57 RelatedInformation

Antibody Responses in Serum and Nasal Secretions of Children Immunized with Inactivated and Attenuated Measles-Virus Vaccines

In 24 children immunized with inactivated or attenuated measles-virus vaccines, responses of serum antibody (characterized by density-gradient ultracentrifugation and radioimmunodiffusion studies) were comparable both in peak titers and in immunoglobulin contribution. In eight of nine children immunized with attenuated measles-virus vaccine nasal antibody associated primarily with the γA and less often with γG immunoglobulins developed; nasal antibody was detected in only three of seven immunized with inactivated measles-virus vaccine, and in these both γA and γG activities were observed. Of eight children with pre-existing serum antibody, six had nasal antibody in the preimmunization specimens. The differences in ability of these vaccines to stimulate local respiratory-tract antibody may in part explain the greater clinical effectiveness of the attenuated vaccine as well as the occurrence of altered reactivity of the host who received inactivated vaccine.

Depression of Poison Ivy Skin Tests by Measles Vaccine

The degree of sensitivity to varying dilutions of a poison ivy antigen was established by patch tests in seven individuals. Administration of the live, attenuated measles virus vaccine (Schwarz) to this small group of subjects resulted in a temporary reduction of sensitivity, most marked (33% of control values) between the third and sixth weeks postimmunization. At nine weeks, the sensitivity was returning to preimmunization levels. Five control subjects showed no change in their degree of sensitivity.

Detection of sensitizing tissue culture components in viral vaccines

Adsorbed measles and poliomyelitis vaccines of monkey kidney tissue culture origin sensitize guinea pigs to protein components of the tissue culture, as shown by the passive cutaneous anaphylactic test. Unadsorbed vaccines are not sensitizing, and there is a correlation between the production of anaphylactic antibodies in guinea pigs by different vaccines and their ability to sensitize infants to a subsequent injection of attenuated measles virus vaccine.

Clinical and Immunological Studies on Vaccination with Live Attenuated Measles-Virus Vaccine

Clinical and Immunological Studies on Vaccination with Live Attenuated Measles-Virus Vaccine

Measles immune globulin. Proposed standard dose given with liver attenuated measles virus vaccine.

Serologic responses and reactions to live attenuated measles virus vaccine given with measles immune globulin in two different dosages were compared in children in Catawba County, North Carolina. The two dosages used were (1) approximately 0.01 cc/lb of body weight, and (2) 0.3 cc regardless of the child's weight. Although low-grade fevers were more common in larger children (50 to 70 lb [22.7 to 31.8 kg]) given the proposed standard 0.3 cc dose, both dosages produced similar antibody responses, incidence of high temperature, and school absenteeism.

Measles Immune Globulin

Serologic responses and reactions to live attenuated measles virus vaccine given with measles immune globulin in two different dosages were compared in children in Catawba County, North Carolina. The two dosages used were (1) approximately 0.01 cc/lb of body weight, and (2) 0.3 cc regardless of the child's weight. Although low-grade fevers were more common in larger children (50 to 70 lb [22.7 to 31.8 kg]) given the proposed standard 0.3 cc dose, both dosages produced similar antibody responses, incidence of high temperature, and school absenteeism.

Thrombocytopenic purpura following vaccination with attenuated measles virus.

HEMORRHAGIC PHENOMENA constitute a rare complication of measles infection. Hudson et al 1 in their review of the literature, were able to cite only 22 well-documented cases, all of which were secondary to thrombocytopenia. In 1966, Oski and Naiman 2 reported the thrombocytopenic effect of live attenuated measles virus vaccine. They demonstrated a significant though generally mild depression of platelets in a large proportion of children receiving this vaccine. However, total platelet count never fell below 64,000, and in no instance were purpuric manifestations noted. We believe the patient reported herein to represent the first recognized case of thrombocytopenic purpura secondary to measles vaccination. Report of a Case The patient was a 14-month-old white boy at the onset of thrombocytopenic purpura. He had been delivered by cesarean section at 35 weeks of fetal life, surgery being necessitated by placenta previa. His birth weight was 2,098 gm (4 lb 10 ounces)

MEASLES VACCINES

Live, attenuated measles virus vaccine has been widely used in the United States since licensure in 1963, and approximately 25 million doses have been distributed. Extensive use of the vaccine has confirmed its safety and efficacy and nationwide immunization programs have had a profound effect on the incidence of measles, with the number of reported cases reaching an all-time low this year. Available evidence indicates that a single inoculation of currently licensed live virus preparations probably provides the same lasting immunity as that which follows natural measles infection. Experience with inactivated (killed) measles virus vaccine has been less favorable. Early trials revealed certain disadvantages of inactivated virus as compared with live virus; multiple inoculations were required (three at monthly intervals), and the immunogenic response as well as the protective capacity proved to be less effective. During the past two years various reports have documented the occurrence of unusual and