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Vaccine effectiveness in providing immunity against measles

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Vaccine effectiveness:

  • based on available evidence, vaccination with one dose of MMR vaccine is at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts (1)
  • are 2 main types of vaccine failure:
    • primary failure occurs when an individual fails to make an initial immunological response to the vaccine
      • primary vaccine failure is rare, it can occur (particularly after a single dose)
      • in settings with high levels of close interpersonal contact, such as large households or school settings, controlling measles outbreaks requires a high coverage of 2 doses of MMR
    • secondary failure occurs when an individual responds initially but then protection wanes over time
  • term ‘breakthrough measles’ (previously referred to as ‘reinfection’, or secondary vaccine failure) is used to describe a confirmed case of measles in someone who developed immunity to measles, either from natural measles or from prior receipt of measles containing vaccine, typically between 6 and 30 years after infection or immunisation (1)
    • usually associated with intense and/or prolonged exposure to an infected individual, for example, directly caring for an acutely ill person, and so is generally only seen in healthcare workers or in household settings
    • in breakthrough measles are symptoms are generally mild
      • conjunctivitis is generally absent
      • rash may not follow typical progression
      • duration of measles illness tends to be of shorter duration
      • infectivity of these cases is much lower and transient, unlike primary measles infection
        • although polymerase chain reaction (PCR) positive, the presence of neutralising antibodies in respiratory secretions greatly reduces the infectiveness of the virus

Reference:

  1. UK Health Security Agency (February 2024). National measles guidelines

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