Some developed countries should target adolescents and adults for measles vaccination

August 25, 2017, Bocconi University
Some developed countries should target adolescents and adults for measles vaccination
Measles at a Glance

Even if measles infection incidence has decreased by at least 90 percent all over the world since the introduction of the vaccine, measles is still one of the major causes of death in children among vaccine-preventable diseases. Regular measles epidemics are reported in developing countries and recurrent episodic outbreaks occur in the developed world.

A new study by Bocconi University and Bruno Kessler Foundation analyzing nine countries (Australia, Ethiopia, Kenya, Ireland, Italy, South Korea, Singapore, the UK, the US) and published in The Lancet Infectious Diseases, highlights the role played by demographics in the spread of and concludes that future in high-fertility countries should focus on increasing childhood immunization rates, while immunization campaigns targeting adolescents and young adults are required in low fertility countries.

Using a transmission model calibrated on historical serological data the authors estimate that the susceptible proportion of the population (i.e. unprotected against the infection) varies from ca. 3 percent in the UK to more that 12,5 percent in Ethiopia, with astonishing differences in its age-composition, due to different vaccination strategies and divergent demographic trends. While the percentage of over-15 among susceptible individuals in Ethiopia and Kenya is, respectively, 28 percent and 43 percent, adolescents and young adults represent 74 percent of unprotected individuals in South Korea, 66 percent in Italy and 53 percent in the US, with considerable immunity gaps in individuals aged 30-40 years.

"Every effort to increase the vaccination coverage rate among children is praiseworthy", says Alessia Melegaro, a Bocconi professor and principal investigator of DECIDE, the ERC-funded project which produced the article, "but in some developed countries it's the lack of coverage among adolescents and adults that poses a serious threat to the goal of eliminating measles.".

"Measles incidence could increase, in the next decades, in Italy, Australia and Singapore and Ethiopia is at high risk of future large epidemics", says Stefano Merler from Bruno Kessler Foundation, "and this is particularly worrying considering that individuals get infected later in life when the disease is more severe. The median age at infection for 2015 was estimated to be 5–10 years in the UK, Ireland, and Ethiopia; 10–15 years in the USA, Australia, Singapore, and Kenya; and older than 20 years in Italy and South Korea".

The proposed model shows that the introduction of the , which occurred at different times in the nine countries, has considerably reduced the disease burden in terms of disability-adjusted life-years (DALYs), a measure expressed as the number of years lost because of illness, disability, or early death. Every vaccine dose averts two or three weeks of DALYs in the developed world and around 20 weeks in Kenya and Ethiopia. Which translates into 2-mln years since the vaccine introduction in the UK, 13-mln in the US and 36-mln in Ethiopia.

"Vaccination has undoubtedly achieved incredible results in terms of public health. In particular," continues Prof. Melegaro "our analysis showed that routine first dose vaccine administration has been responsible for more than 90 percent of the overall number of vaccine-immunized individuals in most countries. In Ethiopia and Kenya, catch-up and follow-up campaigns substantially mitigated the effect of suboptimum routine vaccine coverage, generating 25-45 percent of the immunized fraction of the population. Tailoring immunization campaigns to achieve measles eradication goals is essential and currently, for some countries, this means considering also the role of unprotected adolescents and young adults".

Explore further: Despite progress, hundreds of children still die of measles every day

More information: Filippo Trentini et al. Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis, The Lancet Infectious Diseases (2017). DOI: 10.1016/S1473-3099(17)30421-8

Related Stories

Despite progress, hundreds of children still die of measles every day

November 11, 2016
A United Nations-backed report issued today has revealed that despite a 79 per cent worldwide decrease in measles deaths between 2000 and 2015, nearly 400 children still die from the disease every day.

Low vaccination rates in Texas could result in measles epidemics

October 26, 2016
With almost 45,000 children in Texas with nonmedical or "reasons of conscience" exemptions to school immunization laws, an expert at Baylor College of Medicine outlines the possibility of diseases such as measles reappearing ...

Measles deaths fall by over 70% in last decade, WHO reports

January 17, 2013
The global number of measles deaths dropped by 71 percent between 2000 and 2011 largely thanks to a boost in vaccination efforts, the UN World Health Organisation said Thursday.

Few eligible U.S. travelers getting pre-trip measles vaccine

May 17, 2017
(HealthDay)—More than half of eligible Americans traveling abroad don't get a measles vaccine, and a key reason is lack of concern about the disease, according to a study published online May 16 in the Annals of Internal ...

Measles prevention—how to pull the trigger for vaccination campaigns?

October 11, 2016
Measles is an extremely contagious disease that can cause serious health outcomes in children. Routine vaccination has greatly reduced measles deaths in recent years, but very high vaccination coverage is needed in all countries ...

Measles outbreak kills 30 in Romania

June 23, 2017
A measles outbreak affecting several European countries has killed 30 people in Romania, most of them children, health authorities in Bucharest said on Friday.

Recommended for you

Past encounters with the flu shape vaccine response

February 20, 2018
New research on why the influenza vaccine was only modestly effective in recent years shows that immune history with the flu influences a person's response to the vaccine.

Building better tiny kidneys to test drugs and help people avoid dialysis

February 16, 2018
A free online kidney atlas built by USC researchers empowers stem cell scientists everywhere to generate more human-like tiny kidneys for testing new drugs and creating renal replacement therapies.

Expanding Hepatitis C testing to all adults is cost-effective and improves outcomes

February 16, 2018
According to a new study, screening all adults for hepatitis C (HCV) is a cost-effective way to improve clinical outcomes of HCV and identify more infected people compared to current recommendations. Using a simulation model, ...

Study suggests expanded range for emerging tick-borne disease

February 16, 2018
Human cases of Borrelia miyamotoi, a tick-borne infection with some similarities to Lyme disease, were discovered in the eastern United States less than a decade ago. Now new research led by the Yale School of Public Health ...

Flu shot only 36 percent effective, making bad year worse (Update)

February 15, 2018
The flu vaccine is doing a poor job protecting older Americans and others against the bug that's causing most illnesses.

IFN-mediated immunity to influenza A virus infection influenced by RIPK3 protein

February 15, 2018
Each year, influenza kills half a million people globally with the elderly and very young most often the victims. In fact, the Centers for Disease Control and Prevention reported 37 children have died in the United States ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

knowphiself
not rated yet Aug 27, 2017
Some Adult countries could perhaps try and re-consider the concept Immunobiology itself. maybe our immune system is not akin to a computers operating systems that continually need replacing once made redundant by competition. There is always another way. Royal Raymond Rife's life work may be reviewed if understood and applied correctly, as one such alternative. Then this application of medicine by the means radio waves would make apparent the efficacy of using mobile phones themselves as a candidate for the delivery of treatment. All the technology is already built into these devices that billions of humans own and use. Maybe people could crowd source the funding of such an app, with a consequence as wonderful as that of Tim Berners Lee's contribution to Humanity.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.