Live Measles Vaccine Research Articles

Measles immunization in IRAN

Mass immunization with live measles vaccine has been carried out in rural Iran since 1968. Two strains have been used: primary baby calf kidney cell-adapted Sugiyama strain and human diploid cell-adapted AIK strain. More than 94% of the susceptible children experimentally vaccinated with either of the two vaccines have shown seroconversion. Mass immunization in rural regions has covered about 80% of susceptible children. It is now recommended that the live vaccine be administered twice: the first dose at six to nine months and the second at 12-15 months of age. In all of 100 cases of subacute sclerosing panencephalitis (SSPE) observed in the Tehran region between 1977 and 1982, the patient had a history of measles infection in childhood; there was no indication that SSPE developed after vaccination. Most of the patients with SSPE have had a high titer of antibody to measles virus in serum and cerebrospinal fluid, and antibody has commonly been demonstrated in saliva as well.

Acute and delayed neurologic reaction to inoculation with attenuated live measles virus

A Japanese boy developed a high fever and a prolonged convulsion 11 days after inoculation with live measles vaccine. He had 4 more seizures during the next 6 mos. His EEG became transiently abnormal 14 mos later. Antimeasles complement fixation, hemagglutination, and neutralization titers were elevated.

Edmonston-Zagreb Strain of Measles Vaccine: Epidemiologic Evaluation in Yugoslavia

According to epidemiologic data in Yugoslavia, a high level of immunity (95%) must be attained in the susceptible population between eight months and 30 years of age for the eventual eradication of measles (to cut off the seasonal peak and to prevent the epidemiologic wave). Where the vaccination rate produced a lower level of immunity (e.g., 85% and 67%), the cyclic wave did not disappear completely but was greatly reduced. Live measles vaccine prepared from a further-attenuated Edmonston-Zagreb strain was used for vaccination in Yugoslavia.

Canlı Kızamık Aşısı Komplikasyonları ile ilgili Bir Araştırma

Evaluation of the Complications of Live Measles Virus Vaccination Measles is a viral disease which can be prevented. Live measles vaccine is most effective in prevention of measles but even this vaccine has some complications. To evaluate the complications of live measles vaccine, a double blind experiment is planned. Live measles vaccine is injected to a group of children, to another group placebo is used. Both groups are followed up 21 days after injection. In only I child typical measles developed on the eleventh clay of the vaccination (% 1.2). Among many symptoms, only fever is found in higher percentage (% 17.8) in the vaccine group than in the placebo group (% 6.2).

Measles in Tanzania: antibody response in children after vaccination and antibody state of mothers and newborns

The antibody response to attenuated live measles vaccines was studied in two groups of 29 (A) and 53 (B) African children. In group A 22 sera and in group B 34 sera showed no pre-immunization haemagglutination inhibition (HI) titres. Vaccination resulted in seroconversion in 64 and 85% of groups A and B, respectively. The difference in antibody response between the two groups could be traced to children in the age group seven to eight months, where seroconversion was absent in 67% of group A children and in 0% of group B children. Antibody levels were studied in 234 mothers and their newborns. In 131 serum pairs the antibody levels of mother and child were similar. 78 (33%) of mothers showed a higher titre and 25 (11%) a lower titre than their babies. All newborns except one and all mothers except one possessed antibody titres above 10. Children in the age groups seven to eight months and nine to ten months showed antibody in 12 and 7%, respectively. Over 90% of these children had not been infected in the first ten months of life.

Measles virus panniculitis subsequent to vaccine administration

A severe illness developed gradually in a healthy boy following administration of live measles vaccine at age 14 years. Killed measles vaccine had been given at age 2. Panniculitis began near the site of live vaccine injection, extended contiguously to involve the entire upper arm, and then began to appear in distant subcutaneous sites. He was febrile, leukopenic, anemic, and lost weight rapidly. Evidence of a cause-and-effect relationship between the lesions and the measles vaccine included biopsy findings of particles closely resembling measles nucleocapsids and complete virions by electron microscopy, positive fluorescence after staining with two anti-measles nucleocapsid sera, and immunologic aberrations. The lesions regressed after various treatments and completely remitted on two occasions, but recurred. He became severely malnourished and finally died 29 months after the measles vaccination. At autopsy, pannicultitis was found in the subcutis and mesentery, without evidence of involvement of the brain or other vital organs.

Live Measles Vaccine Not a Cause of Atypical Measles Syndrome

In the August issue of PIR (3:55, 1981)1 there is an abstract regarding atypical measles which we believe is misleading and may deter vaccination of a group of adolescents for whom live measles vaccine is indicated. We have received calls from a number of concerned pediatricians and believe the abstract should be corrected. The author states that the atypical measles syndrome is a possible consequence of administering live measles vaccine to former recipients of killed measles vaccine. Although severe local reactions and occasionally systemic reactions do occur following administration of live measles vaccine to former recipients of killed measles vaccine, there is no evidence that the live vaccine causes classic atypical measles syndrome. Three patients, referred to as having severe systemic reactions by Krause et al,2 experienced fever to 103 F (39.4 C), malaise, marked local pain, swelling and erythema seven days following vaccination; these reactions lasted an average of eight days. However, the abstract was incorrect because these patients did not develop the atypical measles syndrome. Although the reactions were more severe than reactions that might be observed in persons who had never received killed measles vaccine, they were substantially less severe than the atypical measles syndrome. Atypical measles is characterized by high fever, pneumonitis (often with pulmonary consolidation and pleural effusion), pedal and hand edema, and an unusual rash which may be maculopapular, petechial, vesicular or urticarial. The rash is often most concentrated on the extremities.3 Revaccination with live measles vaccine is indicated for former recipients of killed measles vaccine to induce permanent immunity to measles, so that the atypical measles syndrome does not develop when the vaccinee is exposed to natural measles. Revaccination will not cause the syndrome. Atypical measles has occasionally been reported in individuals exposed to natural measles who had previously received live measles virus vaccine within a few months of receiving inactivated measles vaccine.4-6 This raises the possibility that the temporary immunity conferred by the killed vaccine precluded an adequate immunologic response to the live measles virus vaccine. Therefore, persons who received live measles vaccine within three months of receiving inactivated measles vaccine should also be revaccinated with live measles vaccine. Killed measles vaccine was used in the United States between 1963 and 1967 when an estimated 1,836,000 doses were distributed. Persons vaccinated with an unknown type of measles vaccine during that period should also be revaccinated with live measles vaccine as the unknown vaccine may have been killed measles vaccine.

Live Measles Vaccine Not a Cause of Atypical Measles Syndrome

In the August issue of PIR (3:55, 1981)1 there is an abstract regarding atypical measles which we believe is misleading and may deter vaccination of a group of adolescents for whom live measles vaccine is indicated. We have received calls from a number of concerned pediatricians and believe the abstract should be corrected. The author states that the atypical measles syndrome is a possible consequence of administering live measles vaccine to former recipients of killed measles vaccine. Although severe local reactions and occasionally systemic reactions do occur following administration of live measles vaccine to former recipients of killed measles vaccine, there is no evidence that the live vaccine causes classic atypical measles syndrome.Three patients, referred to as having severe systemic reactions by Krause et al,2 experienced fever to 103 F (39.4 C), malaise, marked local pain, swelling and erythema seven days following vaccination; these reactions lasted an average of eight days. However, the abstract was incorrect because these patients did not develop the atypical measles syndrome. Although the reactions were more severe than reactions that might be observed in persons who had never received killed measles vaccine, they were substantially less severe than the atypical measles syndrome. Atypical measles is characterized by high fever, pneumonitis (often with pulmonary consolidation and pleural effusion), pedal and hand edema, and an unusual rash which may be maculopapular, petechial, vesicular or urticarial. The rash is often most concentrated on the extremities.3 Revaccination with live measles vaccine is indicated for former recipients of killed measles vaccine to induce permanent immunity to measles, so that the atypical measles syndrome does not develop when the vaccinee is exposed to natural measles. Revaccination will not cause the syndrome. Atypical measles has occasionally been reported in individuals exposed to natural measles who had previously received live measles virus vaccine within a few months of receiving inactivated measles vaccine.4-6 This raises the possibility that the temporary immunity conferred by the killed vaccine precluded an adequate immunologic response to the live measles virus vaccine. Therefore, persons who received live measles vaccine within three months of receiving inactivated measles vaccine should also be revaccinated with live measles vaccine. Killed measles vaccine was used in the United States between 1963 and 1967 when an estimated 1,836,000 doses were distributed. Persons vaccinated with an unknown type of measles vaccine during that period should also be revaccinated with live measles vaccine as the unknown vaccine may have been killed measles vaccine.

Clinical evaluation of a new live measles vaccine derived in chick chorioallantoic membranes

A new measles vaccine (CAM) prepared in chick chorioallantoic membranes was compared with the routinely used measles vaccine (Attenuvax, Merck, Sharpe and Dohme) prepared in chick embryo tissue culture for immunogenicity and adverse reactions in 77 children. Recipients of the CAM vaccine developed significantly ( P = 0·001) higher hemagglutination-inhibition (HI) geometric mean antibody titers (83·3 v. 42·8) than did recipients of Attenuvax. CAM vaccine recipients also experienced significantly ( P

A study of water binding in lyophilized viral vaccine systems

Differential scanning calorimetry (DSC) has been used to estimate the amount of bound water in freeze-dried live measles vaccine in the presence of two cryoprotective mixtures, with and without sucrose. The purpose of the work was to see if a relationship exists between the amount of bound water in viral systems, the nature of the freeze-drying process, and the final stability of the virus preparations. It was shown that although the presence of sucrose in protective agents improves the retention of activity, the limiting amount of bound water (that for which the heat of fusion is zero) in the rehydrated samples was not related to the presence of sucrose, but depended on the method of freeze-drying.

Cell-mediated immune responsiveness to measles. Its occurrence as a result of naturally acquired or vaccine-induced infection and in infants of immune mothers.

Studies of cell-mediated immunity (CMI) to measles were carried out in patients with natural measles infection, in recipients of live measles vaccine, and in umbilical cord blood specimens from infants of mothers who were seropositive for measles. Evidence of CMI to measles was found in 100% of patients with natural infection but in only 62% of vaccine recipients and, interestingly, in 40% of umbilical cord blood specimens. Eight of these infants were subsequently studied at 4 to 5 months of age, at which time evidence of measles CMI was still detectable in three. Sufficient stimulation of cell-mediated immune mechanisms may be a prerequisite for the development of life-long immunity to measles. The effect of congenitally acquired CMI to measles on the outcome of immunization or of exposure to natural measles during the first year of life remains to be determined.

Atypical Measles in Adolescent Siblings 16 Years After Killed Measles Virus Vaccine

The history of killed and live measles vaccine administration and exposure to natural disease is detailed in four adolescent siblings over a 16-year period. In two of these siblings, atypical measles developed 16 years after killed measles virus vaccine was administered, despite intercurrent doses of live measles virus vaccine.

Immune responses to measles and smallpox vaccinations in malnourished children

Children with different levels of nutritional status were studied to determine their immune response to, and complications from, immunization with live measles vaccine and lyophilized smallpox vaccine. Two hundred forty-one children between the ages of 5 months and 9 years were examined to assess their nutritional status at the time of immunization. Sero-conversion was defined as a hemagglutination-inhibition titer to measles virus, of greater than or equal to 1:20 6 to 8 weeks after vaccination in initially sero-negative children. Of 111 initially sero-negative children 94% had an adequate immune response, shown by sero-conversion. Of 193 children without a smallpox vaccinationscar 97% were successfully immunized against smallpox. These rates of immune response were independent of age, sex, and nutritional status of the children. The geometric mean titer rise to measles immunization of groups, whose nutritional status was normal (greater than 90% of median weight for age), mildly (75 to 90%), moderately (60 to 75%), or severely (less than 60%) malnourished were 7.5, 8.8, 7.9, and 7.9, respectively. Malnutrition did not affect the children's ability to develop adequate immune response to measles of smallpox vaccine, and there were no major complications during the 8-week period of follow-up. Since measles is a very severe disease, which in malnourished children can carry a case fatality rate as high as 50%, malnutrition should be a prime indication for measles immunization, and certainly not a contraindication.

Demonstration of HLA restricted killer cells in patients with acute measles.

The relationship between HLA determinants on effector and target cells and cell-mediated cytotoxicity was studied using the release of 51Cr from measles virus-infected PHA-blasts. HLA compatibility between effector and target cells was not required if effector lymphocytes were derived from measles seropositive adults, from a patient with SSPE, and from children after live measles vaccination. Cytotoxicity was always abolished after removal of Fc receptor-bearing lymphoid cells. In these donors, the effect is, therefore, probably due to K cells. In contrast, lymphocytes from children with acute measles preferentially killed those virus-infected target cells with which they shared HLA antigens. Selective lytic activity was still observed after elimination of Fc receptor-bearing lymphoid cells. It is suggested that HLA-dependent killer cells represent specific cytotoxic T lymphocytes. These cells seem to be limited to the acute phase of measles.

Immunization against measles in children at risk for severe disease

Live measles vaccine induced protective levels of antibody in 70% of children with protein-caloriemalnutrition (PCM) within 21 days and possibly in 90% by 42 days. The development of specific antibody was delayed and symptoms due to the vaccine more frequent (64%) in these children than in healthy children. Administration of measles vaccine may have predisposed to an associated fatal pneumonia in one malnourished child. Human measles hyperimmune globulin can maintain adequate antibody levels in most children with PCM (75%) for at least three to four weeks. Vaccination induced protective levels of measles antibody in 83% of healthy children under 10 months of age, which compared well with 86% of successful immunizations done at 10 months or later. There was wastage of vaccine in 40 to 70% of children who, despite a negative history of measles, had protective levels of antibody when admitted to the study. It is suggested that malnourished children in the community or the very young can be safely and effectively vaccinated against measles. But passive immunization is preferred in children with PCM severe enough to be admitted to hospital and thereby at increased risk of exposure to measles and other infections.

Revaccination of previous recipients of killed measles vaccine: Clinical and immunologic studies

Clinical and immunologic studies were performed in association with revaccination with live measles vaccine in 75 adolescents 11 to 14 years after immunization with killed measles vaccine. Ten subjects had local pain with swelling or erythema or both at the injection site; in three, the local reactions were severe and disturbing systemic complaints were also noted. These marked reactions were more common in subjects in whom the interval between the last dose of killed vaccine and the dose of live vaccine of the primary immunization series was less than or equal to 2 months, in subjects with prevaccination serum HAI antibody titers of less than or equal to 5, and in subjects with high measles antigen specific lymphocyte stimulation ratios. Serum complement levels could not be correlated with clinical reactions. Measles specific lymphocyte stimulation ratios were significantly higher in recipients of killed vaccine than in three compara,ive groups, in subjects with a killed-live interval in the initial vaccine series of less than or equal to 2 months as compared with greater than or equal to 3 months, and in subjects with prevaccination HAI antibody titers of less than or equal to 5 as compared with titers greater than or equal to 10. Although both low serum antibody and high measles specific lymphocyte reactivity were associated with marked local reactions, and probably indicative of susceptibility to atypical measles, our findings suggest that exaggerated lymphocyte reactivity is of greater importance in the adverse clinical response.

Localization of specific antigen in organs of animals inoculated with different batches of live measles vaccine

Specific antigen was identified by the immunofluorescent test in the walls of the brain blood vessels, in the neurons, and in the glial cells of albino newborn mice and Syrian hamsters inoculated subcutaneously with 4 different batches of live measles vaccine. The pathomorphological test of the brain tissue revealed mainly vascular disturbances. The data obtained testify to the presence of residual neurotropism in the attenuated measles virus (strain "L-16").

Further attenuated live measles vaccines: The need for revised recommendations

R E C E N T L Y M O D I F I E D R E C O M M E N D A T I O N S 1' ~ f o r the use of live attenuated measles vaccines call for routine immunization of children at 15 months of age or older. During epidemics, infants may be immunized at 6 months of age or older, but must be reimmunized at 15 months. A change in the age recommended for administration, from 12 to 15 months was originally suggested by the retrospective observations of Yeager and associates. 3 This report presents the results of two studies designed to study prospectively the relationship between age at immunization and response to measles vaccine. The first study, done during 1974 and 1975, measured seroconversion rates in 6to 12-month-old children. The second study measured seroconversion following measles vaccine given as measles-mumps-rubella vaccine at 12 months of age simultaneously with trivalent oral polio vaccine.

The measles specificity of the lymphocyte stimulation test with measles complement-fixation antigen

Lymphocytes from normal adult donors were stimulated with measles antigen routinely used in the complement-fixation reaction. The specificity of the reaction was examined by determining the influence of a vaccination of live measles vaccine on this reaction. The results strongly suggest that measles specific immunity can be measured with the lymphocyte stimulation test described in this paper.

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.