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Epidemiol Infect. Apr 1995; 114(2): 319–344.
PMCID: PMC2271287

Predicting the impact of measles vaccination in England and Wales: model validation and analysis of policy options.

Abstract

Measles incidence in England and Wales has fallen to an all-time low. Attention is now focused on preventing local outbreaks, and, in the long run, on the elimination of indigenous measles. A realistic age-structured (RAS) mathematical model of measles transmission is used to reconstruct the impact of measles vaccination in England and Wales from 1968 to the present and to evaluate the merits of future policy options. In general, the predictions of the model show good agreement with long-term age stratified case reports and seroprevalence surveys. The model underestimates the proportion of cases that are notified in 0-2-year-old children. However, recent work suggests a high degree of misdiagnosis in this age group. Projections on the basis of the existing vaccination strategy in the UK suggest that the present level of measles vaccine coverage will be insufficient to eliminate small seasonal outbreaks of measles. This result is, however, sensitive to the assumed level of vaccine efficacy. Explorations of a variety of changes to current vaccination strategy favour a 2-dose schedule with the second dose administered at age 4 years irrespective of vaccination history. A vaccination campaign in school-age children, to reduce deficits in herd immunity, would accelerate progress towards measles elimination.

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Selected References

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  • Miller E, Nokes DJ, Anderson RM. Measles, mumps, and rubella vaccination. BMJ. 1992 May 30;304(6839):1440–1441. [PMC free article] [PubMed]
  • Nokes DJ, Anderson RM. The use of mathematical models in the epidemiological study of infectious diseases and in the design of mass immunization programmes. Epidemiol Infect. 1988 Aug;101(1):1–20. [PMC free article] [PubMed]
  • Fine PE, Clarkson JA. Measles in England and Wales--I: An analysis of factors underlying seasonal patterns. Int J Epidemiol. 1982 Mar;11(1):5–14. [PubMed]
  • Schenzle D. An age-structured model of pre- and post-vaccination measles transmission. IMA J Math Appl Med Biol. 1984;1(2):169–191. [PubMed]
  • Anderson RM, May RM. Age-related changes in the rate of disease transmission: implications for the design of vaccination programmes. J Hyg (Lond) 1985 Jun;94(3):365–436. [PMC free article] [PubMed]
  • Bolker BM, Grenfell BT. Chaos and biological complexity in measles dynamics. Proc Biol Sci. 1993 Jan 22;251(1330):75–81. [PubMed]
  • Ukkonen P, von Bonsdorff CH. Rubella immunity and morbidity: effects of vaccination in Finland. Scand J Infect Dis. 1988;20(3):255–259. [PubMed]
  • Grenfell BT, Anderson RM. The estimation of age-related rates of infection from case notifications and serological data. J Hyg (Lond) 1985 Oct;95(2):419–436. [PMC free article] [PubMed]
  • Brown DW, Ramsay ME, Richards AF, Miller E. Salivary diagnosis of measles: a study of notified cases in the United Kingdom, 1991-3. BMJ. 1994 Apr 16;308(6935):1015–1017. [PMC free article] [PubMed]
  • Morgan-Capner P, Wright J, Miller CL, Miller E. Surveillance of antibody to measles, mumps, and rubella by age. BMJ. 1988 Sep 24;297(6651):770–772. [PMC free article] [PubMed]
  • Farrington CP. Modelling forces of infection for measles, mumps and rubella. Stat Med. 1990 Aug;9(8):953–967. [PubMed]
  • Anderson RM, Grenfell BT. Quantitative investigations of different vaccination policies for the control of congenital rubella syndrome (CRS) in the United Kingdom. J Hyg (Lond) 1986 Apr;96(2):305–333. [PMC free article] [PubMed]
  • Anderson RM, May RM. Vaccination against rubella and measles: quantitative investigations of different policies. J Hyg (Lond) 1983 Apr;90(2):259–325. [PMC free article] [PubMed]
  • Fine PE, Zell ER. Outbreaks in highly vaccinated populations: implications for studies of vaccine performance. Am J Epidemiol. 1994 Jan 1;139(1):77–90. [PubMed]
  • Morse D, O'Shea M, Hamilton G, Soltanpoor N, Leece G, Miller E, Brown D. Outbreak of measles in a teenage school population: the need to immunize susceptible adolescents. Epidemiol Infect. 1994 Oct;113(2):355–365. [PMC free article] [PubMed]
  • Walker J, Nokes DJ, Jennings R. Longitudinal study of Toxoplasma seroprevalence in South Yorkshire. Epidemiol Infect. 1992 Feb;108(1):99–106. [PMC free article] [PubMed]
  • Agur Z, Cojocaru L, Mazor G, Anderson RM, Danon YL. Pulse mass measles vaccination across age cohorts. Proc Natl Acad Sci U S A. 1993 Dec 15;90(24):11698–11702. [PMC free article] [PubMed]
  • Nokes DJ, Wright J, Morgan-Capner P, Anderson RM. Serological study of the epidemiology of mumps virus infection in north-west England. Epidemiol Infect. 1990 Aug;105(1):175–195. [PMC free article] [PubMed]

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