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• W2074330806 endingPage "1815" @default.
• W2074330806 startingPage "1815" @default.
• W2074330806 abstract "<h3>Background:</h3> Measles is the most transmissible disease known to man. During the 1980s, the number of measles cases in the United States rose dramatically. Surprisingly, 20% to 40% of these cases occurred in persons who had been appropriately immunized against measles. In response, the United States adopted a two--dose universal measles immunization program. We critically examine the effect of vaccine failure in measles occurring in immunized persons. <h3>Methods:</h3> We performed a computerized bibliographic literature search (National Library of Medicine) for all English-language articles dealing with measles outbreaks. We limited our search to reports of US and Canadian school-based outbreaks of measles, and we spoke with experts to get estimates of vaccine failure rates. In addition, we devised a hypothetical model of a school where measles immunization rates could be varied, vaccine failure rates could be calculated, and the percentage of measles cases occurring in immunized students could be determined. <h3>Results:</h3> We found 18 reports of measles outbreaks in very highly immunized school populations where 71% to 99.8% of students were immunized against measles. Despite these high rates of immunization, 30% to 100% (mean, 77%) of all measles cases in these outbreaks occurred in previously immunized students. In our hypothetical school model, after more than 95% of schoolchildren are immunized against measles, the majority of measles cases occur in appropriately immunized children. <h3>Conclusions:</h3> The apparent paradox is that as measles immunization rates rise to high levels in a population, measles becomes a disease of immunized persons. Because of the failure rate of the vaccine and the unique transmissibility of the measles virus, the currently available measles vaccine, used in a single-dose strategy, is unlikely to completely eliminate measles. The longterm success of a two-dose strategy to eliminate measles remains to be determined. (Arch Intern Med. 1994;154:1815-1820)" @default.
• W2074330806 created "2016-06-24" @default.
• W2074330806 creator A5044718641 @default.
• W2074330806 creator A5057546038 @default.
• W2074330806 date "1994-08-22" @default.
• W2074330806 modified "2023-09-23" @default.
• W2074330806 title "Failure to Reach the Goal of Measles Elimination" @default.
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• W2074330806 doi "https://doi.org/10.1001/archinte.1994.00420160048006" @default.
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• W2074330806 hasPublicationYear "1994" @default.
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