PEDIATRICS Vol. 97 No. 5 May 1996, pp. 613-618
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An Evaluation of Measles Revaccination Among School-entry-aged Children

John C. Watson MD, MPH1, John A. Pearson MD2, Lauri E. Markowitz MD3, Andrew L. Baughman MPH3, Dean D. Erdman DrPH4, William J. Bellini PhD4, Roy C. Baron MD, MPH1, and David W. Fleming MD5

1 Epidemic Intelligence Service and Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta
2 Northwest Kaiser Permanente and the Kaiser Permanente Center for Health Research, Portland, Oregon
3 National Immunization Program, Centers for Disease Control and Prevention, Atlanta
4 Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
5 Office of Epidemiology and Health Statistics, Oregon Health Division, Portland, Oregon

Background. A two dose measles vaccination schedule is recommended routinely for all schoolentry-aged children. We evaluated this recommendation by determining both measles antibody seroprevalence and the response to revaccination in seronegative children in this age group.

Methods. Children 4 to 6 years of age who had received a single dose of measles vaccine between the ages of 15 to 17 months were tested for measles antibody by using an enzyme-linked immunosorbent assay (ELISA) microneutralization technique. Seronegative children were revaccinated and again tested for measles antibody (immunoglobulin M [IgM] and neutralizing).

Results. Of 679 children tested, 37 (5.4%) were seronegative. Seronegativity was not significantly associated with age, sex, race, age at initial vaccination, time since vaccinalion, or maternal year of birth. However, children of mothers with a college degree were 12 times more likely to be seronegative than children of mothers who never attended college (P< .01). Of the 37 seronegative children, 36 seroconverted after revaccination—33 producing IgM measles antibody, suggestive of a primary immune response. The cost per seroconversion would have been an estimated $415 if all 679 children had been revaccinated.

Conclusions. Revaccination reduces the pool of children who are susceptible to measles. Although the cost per seroconversion is high, a two-dose schedule should reduce the substantial costs of controlling measles outbreaks by reducing the number of outbreaks.

Submitted on February 23, 1995
Accepted on June 19, 1995




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