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Additional, Early Vaccination May Reduce Measles Outbreaks in Developing Countries LONDON -- July 28, 2008 -- Outbreaks of measles in developing countries may be reduced by vaccinating infants at 4.5 months of age as well as at the World Health Organization's recommended routine vaccination at 9 months, according to a study published online in the British Medical Journal. These findings should lead to reconsideration of the policy for vaccination during measles outbreaks and in humanitarian emergencies, said the authors. A measles outbreak in Guinea-Bissau in Africa offered Professor Peter Aaby, Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau, Africa, and colleagues a unique opportunity to assess the protective effect of earlier vaccination at 4.5 months. Infants (N = 1,333) were randomised to receive either measles vaccination at 4.5 months of age (n = 441) or nothing (n = 892). At 9 months of age, all children received a measles vaccination. Blood samples were collected to assess levels of maternal antibodies against measles at 4.5, 9, and 24 months of age in the early vaccination group and at 9, 18, and 24 months of age in the control group. The researchers found that early vaccination at 4.5 months of age offered more than 90% protection against measles infection and 100% protection against measles hospitalisation. Prior to the initial vaccination at 4.5 months of age, only 28% of the children had protective levels of maternal antibodies against measles. After this early vaccination, 92% of the group had measles antibodies at 9 months of age. The researchers found that children vaccinated at 4.5 and 9 months were better protected compared with those vaccinated only at 9 months. The monthly incidence of measles was 0.7% in the children who received 2 doses and 3.1% in the children who received 1 dose at 9 months. "The current goal to achieve high vaccine coverage should not be separated from the need for more timely vaccination, especially in developing countries," the authors noted. But, they continue, "Earlier measles vaccination should not substitute for the dose given to infants at ages 9 to 15 months, which increases overall immunity in the population." SOURCE: British Medical Journal E-mail this page to a friend or colleague! To print, use this version