Measles vaccine: effectiveness

Measles vaccinees are capable of infecting others when they are infected themselves, which can be from days after inoculation to many years later [A].

Women “successfully” vaccinated against measles as infants had only one-fifth the antibodies of women who had been exposed to the disease, though the latter were older. L.E. Markowitz, P. Albrecht, P. Rhodes, et al., “Changing levels of measles antibody titers in women and children in the United States: impact on response to vaccination. Kaiser Permanente Measles Vaccine Trial Team”, Pediatrics. 1996 Jan;97(1):53–58, <www.ncbi.nlm.nih.gov/pubmed/8545224>.

Measles occurring shortly after vaccination is not uncommon [B]. In fact, within four years of vaccination, 45% of measles vaccinees undergo measles (more commonly the engineered form) [C]; eventually, most do [D]. Some studies find that the vaccine confers zero immunological benefit [E]. Most commonly the engineered measles infection goes unrecognised at the time. Vaccinees in this way spark outbreaks of the disease, as repeatedly confirmed by laboratory analysis [A].

The confusion that commonly leads researchers to conclude that a measles vaccine effectively prevents infection with measls is a common one in the world of vaccine research: use of often irrelevant surrogate “endpoints”, or outcome measures, in lieu of the only actual measure that is relevant to trials of vaccine effectiveness: protectiveness. The surrogate endpoint most commonly used is blood antibody concentration. It is at best a faulty measure of protectiveness and at times downright misleading (see Surrogate end points and other research deceits).

Women “successfully” vaccinated against measles as infants had only one-fifth the antibodies of women who had been exposed to the disease, though the latter were older [G]. It is increasingly recognised that measles vaccination’s “success” relies heavily upon immune boosts by reexposure to wild virus [H].

The supposed “effectiveness” of measles vaccine is having a devastating effect, however, on population immunity. Widespread measles vaccination of western societies has, through substitution of vaccinal-virus epidemics for exposure to wild virus, had unforeseen effects even upon those women who experienced the disease as children: the lack of recent exposure to circulating wild virus is causing them gradually to lose the maternal immunity they would naturally have passed on to their offspring [I].

References [A]

Tove Rønne, “Measles virus infection without rash in childhood is related to disease in adult life”, The Lancet 1985;325(8419):1–5

Benjamin N. Nkowane, Sandra W. Bart, Walter A. Orenstein, and Michael Baltier, “Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures”, Am J Public Health 1987 April;77(4):434–438, <www.ncbi.nlm.nih.gov/pmc/articles/PMC1646939/pdf>

Richard G. Mathias, William G. Meekison, Teri A. Arcand, and Martin T. Schechter, “The Role of Secondary Vaccine Failures in Measles Outbreaks”, Am J Public Health 1989 Apr;79(4):475–478

N.O. Eghafona, A.A. Ahmad, C.D. Ezeokoli, and S.O. Emejuaiwe, “Haemagglutination inhibition antibody levels one year after natural measles infection and vaccination”, Microbios. 1991;67(274):33–36, <www.ncbi.nlm.nih.gov/pubmed/1758308>

L.V. Bystriakova, R.V. Zaĭtseva, L.V. Kolobova, et al., “[Transplacental measles immunity in infants in the 1st year of life]”, Zh Mikrobiol Epidemiol Immunobiol. 1991 Oct;(10):50–52, <www.ncbi.nlm.nih.gov/pubmed/1839342>

B. Christenson and M. Böttiger, “Measles antibody: comparison of long-term vaccination titres, early vaccination titres and naturally acquired immunity to and booster effects on the measles virus”, Vaccine 1994 Feb;12(2):129–133, <www.ncbi.nlm.nih.gov/pubmed/8147093>

G.A. Jenkin, D. Chibo, H.A. Kelly, P.A. Lynch, and M.G. Catton, “What is the cause of a rash after measles-mumps-rubella vaccination?”, Med J Aust 1999 Aug 16;171(4):194–195, <www.ncbi.nlm.nih.gov/pubmed/10494235>

Florence Morfina, Anne Beguinb, Bruno Linaa, and Danielle Thouvenota, “Detection of measles vaccine in the throat of a vaccinated child”, Vaccine 2002 Feb 22;20(11–12):1541–1543, <www.ncbi.nlm.nih.gov/pubmed/11858860>, <www.sciencedirect.com/science/article/pii/S0264410X01004959>, <dx.doi.org/10.1016/S0264-410X(01)00495-9>

K.L. Berggren, M. Tharp, and K.M. Boyer, “Vaccine-associated “wild-type” measles”, Pediatr Dermatol 2005 Mar–Apr;22(2):130–132, <www.ncbi.nlm.nih.gov/pubmed/15804301>

B. Kaic, I. Gjenero-Margan, B. Aleraj, et al., “Spotlight on measles 2010: Excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010”, Eurosurveillance 2010;15(35):pii=19652, <www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19652>

Lindsay Nestibo, Bonita E. Lee, 2 Kevin Fonseca, et al., “Differentiating the wild from the attenuated during a measles outbreak”, Paediatr Child Health 2012 Apr;17(4): e32–e33, <www.ncbi.nlm.nih.gov/pmc/articles/PMC3381670>

M. Murti, M. Krajden, M. Petric, et al., “Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013”, Eurosurveillance 2013;18(49):pii=20649, <www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20649>

Jennifer B. Rosen, Jennifer S. Rota, Carole J. Hickman, et al., “Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011”, Clin Infect Dis 2014 May 1;58(9):1205–1210, <cid.oxfordjournals.org/content/58/9/1205>, <dx.doi.org/10.1093/cid/ciu105>

References [B]

D.M. Shasby, T.C. Shope, H. Downs, K.L. Herrmann, and J. Polkowski, “Epidemic measles in a highly vaccinated population”, N Engl J Med. 1977 Mar 17;296(11):585–589, <www.ncbi.nlm.nih.gov/pubmed/65732>

Tove Rønne, “Measles virus infection without rash in childhood is related to disease in adult life”, The Lancet 1985;325(8419):1–5

T.L. Gustafson, A.W. Lievens, P.A. Brunell, et al., “Measles outbreak in a fully immunized secondary-school population”, N Engl J Med 1987 Mar 26;316(13):771–774, <www.ncbi.nlm.nih.gov/pubmed/3821823>

N.O. Eghafona, A.A. Ahmad, C.D. Ezeokoli, and S.O. Emejuaiwe, “Haemagglutination inhibition antibody levels one year after natural measles infection and vaccination”, Microbios. 1991;67(274):33–36, <www.ncbi.nlm.nih.gov/pubmed/1758308>

L.V. Bystriakova, R.V. Zaĭtseva, L.V. Kolobova, et al., “[Transplacental measles immunity in infants in the 1st year of life]”, Zh Mikrobiol Epidemiol Immunobiol. 1991 Oct;(10):50–52, <www.ncbi.nlm.nih.gov/pubmed/1839342>

L.E. Markowitz, P. Albrecht, W.A. Orenstein, et al., “Persistence of measles antibody after revaccination”, J Infect Dis. 1992 Jul;166(1):205–208, <www.ncbi.nlm.nih.gov/pubmed/1607699>

B. Christenson and M. Böttiger, “Measles antibody: comparison of long-term vaccination titres, early vaccination titres and naturally acquired immunity to and booster effects on the measles virus”, Vaccine 1994 Feb;12(2):129–133, <www.ncbi.nlm.nih.gov/pubmed/8147093>

G.A. Jenkin, D. Chibo, H.A. Kelly, P.A. Lynch, M.G. Catton, “What is the cause of a rash after measles-mumps-rubella vaccination?”, Med J Aust 1999 Aug 16;171(4):194–195, <www.ncbi.nlm.nih.gov/pubmed/10494235>

Florence Morfina, Anne Beguinb, Bruno Linaa, and Danielle Thouvenota, “Detection of measles vaccine in the throat of a vaccinated child”, Vaccine 2002 Feb 22;20(11–12):1541–1543, <http://www.sciencedirect.com/science/article/pii/S0264410X01004959>, <dx.doi.org/10.1016/S0264-410X(01)00495-9>

M.M. Pütz, F.B. Bouche, R.L. de Swart, and C.P. Muller, “Experimental vaccines against measles in a world of changing epidemiology”, Int J Parasitol. 2003 May;33(5–6):525–545, <www.ncbi.nlm.nih.gov/pubmed/12782053>

Lindsay Nestibo, Bonita E. Lee, 2 Kevin Fonseca, et al., “Differentiating the wild from the attenuated during a measles outbreak”, Paediatr Child Health 2012 Apr;17(4): e32–e33, <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381670>

Z. Wang, R. Yan, H. He, et al., “Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles, mumps, and rubella vaccination”, PLoS One 2014 Feb 20;9(2):e89361, <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930734>, <http://dx.doi.org/10.1371/journal.pone.0089361>

References [C]

S. Isomura, T. Morishima, K. Nishikawa, et al., “A long-term follow-up study on the efficacy of further attenuated live measles vaccine, Biken CAM vaccine”, Biken J. 1986 Mar;29(1):19–26, <www.ncbi.nlm.nih.gov/pubmed/3778422>

I.R. Pedersen, C.H. Mordhorst, G. Glikmann, and H. von Magnus, “Subclinical measles infection in vaccinated seropositive individuals in arctic Greenland”, Vaccine 1989 Aug;7(4):345–348, <www.ncbi.nlm.nih.gov/pubmed/2815970>

Chen RT, Markowitz LE, Albrecht P, et al., “Measles antibody—reevaluation of protective titers”, J Infect Dis 1990;162:1036–42

M.M. Fathy, T.H. el-Khashaab, and M.A. Darwish, “Antibody level after measles vaccination”, J Egypt Public Health Assoc. 1992;67(3–4):369–78, <www.ncbi.nlm.nih.gov/pubmed/1296968>

U. Hess, “[Mumps vaccines: vaccination failures from an immunological viewpoint]”, Soz Praventivmed.1995;40(2):110–15

T. Wu, S.L. Wang, and Y.Z. Xiang, “[Study on the subclinical infection of the recipients of measles vaccine]”, Zhonghua Liu Xing Bing Xue Za Zhi 1996 Apr;17(2):70–72, <www.ncbi.nlm.nih.gov/pubmed/8758397>

S. Huiss, B. Damien, F. Schneider, et al., “Characteristics of asymptomatic secondary immune responses to measles virus in late convalescent donors”, Clin Exp Immunol 1997;109:416–20

R.F. Helfand, D.K. Kim, H.E. Gary, et al., “Nonclassic measles infections in an immune population exposed to measles during a college bus trip”, J Med Virol 1998;56:337–41

I. Lisse, B. Samb, H. Whittle, et al., “Acute and long-term changes in T-lymphocyte subsets in response to clinical and subclinical measles: A community study from rural Senegal”, Scand J Infect Dis 1998;30(1):17–21, <http://www.ncbi.nlm.nih.gov/pubmed/9670353?dopt=Abstract>

Hilton C. Whittle, Peter Aaby, Badara Samb, et al., “Effect of subclinical infection on maintaining immunity against measles in vaccinated children in West Africa”, The Lancet 1999 Jan 9;353(9147):98–102, <http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)02364-2/abstract>, <http://dx.doi.org/10.1016/S0140-6736(98)02364-2>

References [D]

M. Paunio, K. Heman, I, Davidkin, et al., “Secondary measles vaccine failures identified by measurement of IgG avidity: high occurrence among teenagers vaccinated at a young age”, Epidemiol Infect 2000;124:263–271, <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810910>

A.V. Atrasheuskayaa, M.V. Kulaka, A.A. Neverova, S. Rubinb, and G.M. Ignatyeva, “Measles cases in highly vaccinated population of Novosibirsk, Russia, 2000–2005”, Vaccine 2008 Apr 16;26(17):2111–2118, <http://www.sciencedirect.com/science/article/pii/S0264410X08001692>, <http://dx.doi.org/10.1016/j.vaccine.2008.02.028>

Concerns over the increasing ineffectiveness of measles vaccine can’t be separated entirely from concerns over its conflict with natural measles immunity and the tendency of researchers to seek ways to subvert natural immunity in order to use a vaccine to induce antibody production.

References [E]

W.E. Rawls, M.L. Rawls, and M.A. Chernesky, “Analysis of a measles epidemic; possible role of vaccine failures”, Can Med Assoc J. 1975 Nov 22;113(10):941–944, <www.ncbi.nlm.nih.gov/pmc/articles/PMC1956577>

T.M. Bell, P.M. Tukei, G.R. Ademba, et al., “Investigation of the effectiveness of measles vaccination in children in Kenya”, J Hyg (Lond). 1985 Dec;95(3):695–702, <www.ncbi.nlm.nih.gov/pmc/articles/PMC2129565>

Masae Itoh, Yoshinobu Okuno, and Hak Hotta, “Comparative Analysis of Titers of Antibody against Measles Virus in Sera of Vaccinated and Naturally Infected Japanese Individuals of Different Age Groups”, J Clin Microbiol. 2002 May;40(5):1733–1738, <www.ncbi.nlm.nih.gov/pmc/articles/PMC130661>.

Reference [G]

L.E. Markowitz, P. Albrecht, P. Rhodes, et al., “Changing levels of measles antibody titers in women and children in the United States: impact on response to vaccination. Kaiser Permanente Measles Vaccine Trial Team”, Pediatrics 1996 Jan;97(1):53–58, <www.ncbi.nlm.nih.gov/pubmed/8545224>

Reference [H]

Joel Mossong, David James Nokes, William John Edmunds, et al., “Modeling the Impact of Subclinical Measles Transmission in Vaccinated Populations with Waning Immunity”, Am J Epidemiol 1999;150:1238–1249, <aje.oxfordjournals.org/content/150/11/1238.long>

References [I]

M. Ohsaki, H. Tsutsumi, R. Takeuchi, et al., “Reduced passive measles immunity in infants of mothers who have not been exposed to measles outbreaks”, Scand J Infect Dis. 1999;31(1):17–19, <www.ncbi.nlm.nih.gov/pubmed/10381212>

Corina Nicoara, Kristina Zäch, Daniel Trachsel, Daniel Germann, and Lukas Matter, “Decay of passively acquired maternal antibodies against measles, mumps, and rubella viruses”, Clin Vaccine Immunol 1999 Nov;6(6):868–71, <http://cvi.asm.org/content/6/6/868.full>

“Children of mothers vaccinated against measles and, possibly, rubella have lower concentrations of maternal antibodies and lose protection by maternal antibodies at an earlier age than children of mothers in communities that oppose vaccination. This increases the risk of disease transmission in highly vaccinated populations.” Sandra Waaijenborg, Susan J. M. Hahné, Liesbeth Mollema, et al., “Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage”, J Infect Dis 2013;208(1):10–16, <http://jid.oxfordjournals.org/content/208/1/10>, <http://dx.doi.org/10.1093/infdis/jit143>

See also the references quoted in healthimpactnews.com/2013/outbreaks-of-measles-in-vaccinated-children-intensifying.