Invited commentary: vaccine failure or failure to vaccinate?

Am J Epidemiol. 1999 Feb 15;149(4):302-3. doi: 10.1093/oxfordjournals.aje.a009812.

Abstract

PIP: Despite the availability of safe and effective measles vaccines since 1963, measles still accounts for approximately 10% of global mortality from all causes among children aged less than 5 years, an estimated 36.5 million cases and 1 million deaths in 1996. Worldwide in 1996, routine coverage with 1 dose of measles vaccine was 81%, although the African Region of the World Health Organization reports the lowest coverage, at 56%, and the largest proportion of measles cases and deaths. There is an urgent need to strengthen measles control and explore the best ways to achieve that end, especially in areas such as West Africa. However, the data presented by Cisse et al. do not show that the 1995 outbreak of measles in Niakhar, Senegal, was due mainly to the waning of vaccine-induced immunity among school-aged children. Waning immunity therefore cannot be used to justify the introduction of a multidose vaccination schedule as a key strategy for improving measles control in developing countries. The authors explain the basis for their opinions. The immediate objective of any measles control program should be to provide a first dose of measles vaccine to unvaccinated children.

Publication types

  • Comment

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Developing Countries*
  • Disease Outbreaks / prevention & control*
  • Female
  • Humans
  • Immunization Schedule
  • Infant
  • Male
  • Measles / prevention & control*
  • Measles / transmission
  • Measles Vaccine / administration & dosage*
  • Rural Population*
  • Schools
  • Senegal
  • Treatment Failure

Substances

  • Measles Vaccine