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Modelling the first dose of measles vaccination: the role of maternal immunity, demographic factors, and delivery systems

Author(s): Metcalf, C. Jessica E.; Klepac, Petra; Ferrari, M.; Grais, R.F.; Djibo, A.; et al

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Abstract: Measles vaccine efficacy is higher at 12 months than 9 months because of maternal immunity, but delaying vaccination exposes the children most vulnerable to measles mortality to infection. We explored how this trade-off changes as a function of regionally varying epidemiological drivers, e.g. demography, transmission seasonality, and vaccination coverage. High birth rates and low coverage both favour early vaccination, and initiating vaccination at 9-11 months, then switching to 12-14 months can reduce case numbers. Overall however, increasing the age-window of vaccination decreases case numbers relative to vaccinating within a narrow age-window (e.g. 9-11 months). The width of the age-window that minimizes mortality varies as a function of birth rate, vaccination coverage and patterns of access to care. Our results suggest that locally age-targeted strategies, at both national and sub-national scales, tuned to local variation in birth rate, seasonality, and access to care may substantially decrease case numbers and fatalities for routine vaccination.
Publication Date: Feb-2011
Electronic Publication Date: 7-Jun-2010
Citation: METCALF, CJE, KLEPAC, P, FERRARI, M, GRAIS, RF, DJIBO, A, GRENFELL, BT. (2011). Modelling the first dose of measles vaccination: the role of maternal immunity, demographic factors, and delivery systems. Epidemiology and Infection, 139 (02), 265 - 274. doi:10.1017/S0950268810001329
DOI: doi:10.1017/S0950268810001329
ISSN: 0950-2688
EISSN: 1469-4409
Pages: 265 - 274
Type of Material: Journal Article
Journal/Proceeding Title: Epidemiology and Infection
Version: Author's manuscript



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