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Measles Vaccine Effectiveness

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Last Updated: 02 July 2021

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General | Latest Info

Measles is a very contagious disease caused by a virus. It spreads through the air when an infected person coughs or sneezes. Measles starts with a cough, runny nose, red eyes, and fever. Then a rash of tiny, red spots breaks out. It starts in the head and spreads to the rest of the body. Measles can be prevented with MMR Vaccine. Vaccines protect against three diseases: Measles, Mumps, and Rubella. Cdc recommends children get two doses of MMR Vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination. MMR Vaccine is very safe and effective. Two doses of MMR Vaccine are about 97% effective at preventing Measles; one dose is about 93% effective. Children may also get MMRV Vaccine, which protects against Measles, Mumps, Rubella, and Varicella. This vaccine is only licensed for use in children who are 12 months through 12 years of age. Before the Measles vaccination program started in 1963, estimated 3 to 4 million people get Measles each year in the United States. Of these, approximately 500 000 cases were reported each year to CDC; of these, 400 to 500 died, 48 000 were hospitalize, and 1 000 developed encephalitis from Measles. Since then, widespread use of Measles Virus - containing Vaccine has led to a greater than 99% reduction in Measles cases compared with the pre - Vaccine era. However, Measles is still common in other countries. Unvaccinated people continue to get Measles while abroad and bring the disease into the United States and spread it to others.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

MATERIALS AND METHODS

All Measles cases notified to the National Notifiable Diseases Surveillance System with onset between 1 January 2006 and 31 December 2012. Who were born after 1996 were include. Data was restricted to 2006 through 2012 because NNDSS data for all States and territories were more complete from 2006 onwards. Those aged less than 1 year old were excluded as they were not eligible for Measles Vaccination. Controls were selected from the Australian Childhood Immunization Register database. Acir is a population - base Register which includes all children of citizens and permanent residents enrol in the National publicly funded Health - care System regardless of Vaccination status. 7 For each case, controls were randomly sampled from ACIR and matched to cases by date of birth and state or territory of residence. Twenty Age - match controls were sampled for each case to maximize precision based on previously used methods. 8 Only cases aged less than 17 years were included in the analysis because ACIR began in 1996. Vaccination status for cases was obtained from NNDSS and was summarized as zero, one, two doses or unknown. Where NNDSS had only classified cases as partially or fully vaccinate, vaccination status was interpreted according to case age and vaccination schedule in place at time of illness for analysis. Fully vaccinated was interpreted as one dose for anyone aged less than 4 years at the time of disease onset and two doses for anyone aged 4 years or older. Partially vaccinated, therefore was interpreted as one dose for anyone aged 4 years or older. Any doses recorded within two weeks before disease onset were excluded from analysis. Vaccination status For controls, as well as gender and Indigenous status was obtained from ACIR. Controls WHO had received dose within two weeks of onset of disease in their matched case were considered to have had invalid dose but were still included in analysis.


1. Introduction

Measles is a highly contagious viral disease with a high burden of morbidity and mortality, particularly in children in low - income countries. 1 2 Between 2000 and 2017, improvements in measles control reduced the estimated global number of measles - related deaths by 80%, from 545 174 to 109 638. 3 However, increases in coverage of measles vaccination have slowed over the past 5 - 6 years. As a result, measles outbreaks still occur, predominantly in areas where weak immunisation systems have led to suboptimal immunity. 2 4 WHO recommends that children receive two doses of measles - containing vaccine as part of routine immunisation. In countries where measles - related mortality is high in the first year of life, first MCV dose is recommended at 9 months of age, whereas in countries with low measles transmission, MCV1 is recommended at 12 months of age. 1 second dose of MCV is offered in 171 WHO member States. 5 measles incidence has increased in several WHO regions in infants younger than 9 months, adolescents, and adults. The increase in young infants has been particularly apparent in Europe, 6, Asia, 7 8 and Africa, 9 and this trend might worsen because of declining immunity and increased transmission in adolescents and adults. Another explanation for the increase of measles in young infants is that mothers WHO have vaccine - induced antibodies lose passive immunity approximately 3 months earlier than infants with mothers WHO have naturally acquired immunity. 10 11 12 Since measles in young infants is more severe than in older children, 13 they disproportionally contribute to the burden of measles - related morbidity and mortality. In response to these observations, suggestions have been made to offer MCV1 to infants younger than 9 months in areas with high measles virus transmission. 14 optimal timing for first MCV depends on the age at which infant is at greatest risk of infection, age when their immune system is sufficiently mature to respond to vaccine, and age when maternal antibodies, which interfere with vaccine response, are no longer present. 13 15 Additionally, uptake of first MCV at different ages is of relevance. Before initiating our review, WHO guidelines for measles vaccination and public assessment reports by the European Medicines Agency did not provide recommendations for MCV use in infants younger than 9 months. 1 16 17 we, therefore, review and analyse evidence on immunogenicity, efficacy, effectiveness, duration of immunity, and safety of MCV1 vaccination to infants younger than 9 months.


Who Should Get MMR Vaccine?

You do not need measles, Mumps, and Rubella vaccine if you meet any of these criteria for presumptive evidence of immunity: You have written documentation of adequate vaccination: at least one dose of measles, Mumps, and Rubella virus - containing vaccine administered on or after first birthday for preschool - age children and adults not at high risk for exposure and transmission two doses of measles and Mumps virus - containing vaccine for school - age children and adults at high risk for exposure and transmission, including college students, healthcare personnel, international travelers, and groups at increase risk during outbreaks You have laboratory confirmation of past infection or had blood tests that show You are immune to measles, Mumps, and Rubella. You were born before 1957. * If you do not have presumptive evidence of immunity against measles, Mumps, and Rubella, talk with your doctor about getting vaccinate. If youre unsure whether youve been vaccinate, you should first try to find your vaccination records. If you do not have written documentation of MMR vaccine, you should get vaccinate. The MMR vaccine is safe, and there is no harm in getting another dose if you may already be immune to measles, Mumps, or Rubella. If you received measles vaccine in the 1960s, you may not need to be revaccinated. People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with either inactivated measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of LIVE attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963 - 1967 and was not effective.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

DISCUSSION

There are two options for protecting children WHO are 12 months - 12 years old against Measles, Mumps, Rubella, and varicella: using varicella vaccine and trivalent Measles, Mumps, and Rubella vaccine or using quadrivalent Measles, Mumps, Rubella, and varicella vaccine. This means that parents and caregivers have a decision to make, and they will rely on you as their children's healthcare provider for help in making that decision. Using MMRV vaccine does result in one fewer injection, which may appeal to many parents. However, when used as first dose at ages 12 - 23 months, studies have shown that this benefit comes with a tradeoff: at this age, MMRV vaccine is associated with higher risks of fever within 42 days after vaccination and febrile seizures during 5 - 12 days after vaccination when compared with administration of first dose MMR and varicella vaccines at same visit. Data are limited to this age group, but experts agree that this increased risk of fever and febrile seizures during 5 - 12 days after first dose of MMRV vaccination likely also occurs in children aged 24 - 47 months. As you know, questions or concerns about vaccines can be a source of stress for some parents during well - child visit. As their children's healthcare provider, you remain the parents ' most trusted source of information about vaccines. For first dose of Measles, Mumps, Rubella, and varicella vaccines given at ages 12 - 47 months, either MMR and varicella vaccines or MMRV vaccine can be used. However, if you are considering using the MMRV vaccine for children in this age group, it is important to take time to talk with parents or caregivers about the benefits and risks of both vaccination options. Unless a parent or caregiver expresses preference for MMRV vaccine, CDC recommends that MMR vaccine and varicella vaccine should be administered as separate injections for first dose in children 12 - 47 months of age. Discussing whether to use MMRV vaccine or MMR and varicella vaccines for 12 - 47 - month - olds first vaccination centers on helping parents understand the risk / benefit tradeoff. About 2 - 5 percent of young children will have at least one febrile seizure. Febrile seizures usually occur in children aged 6 - 60 months. The peak age for febrile seizures is 14 - 18 months, which overlaps with ages when first doses of Measles, Mumps, Rubella and varicella vaccines are recommend. Although febrile seizures generally have excellent prognosis, witnessing this type of event can be very distressing for parents and caregivers and often results in trip to the emergency room for child. With this in mind, it is especially important to discuss febrile seizure risk with parents when considering using MMRV vaccine for first dose in children aged 12 - 47 months. A personal history of febrile seizures or family history of either febrile seizures or epilepsy increases children's risk of having febrile seizure. Children WHO have a personal or family history of seizures should generally be vaccinated with MMR and varicella vaccines instead of MMRV vaccine.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Background

As described by the United States centers for Disease Control and Prevention, Measles is a highly contagious rash illness that is transmitted by direct contact with respiratory droplets or airborne spread between person to person. Measles was observed to occur in epidemic cycles and virtually all people acquired Measles before adulthood in the US prior to implementation of the National Measles Vaccine program in 1963. It was described prior to the National Measles Vaccine program in the US, annually about 500 000 cases of Measles were report, of whom 500 people die, 48 000 were hospitalize, and about 1000 cases of encephalitis with permanent brain damage were observe. In the US, Measles Vaccination was initially recommended for Administration at 9 months in 1963, 12 months in 1965, and 15 months in 1967. During the 1970s, combined Measles - Mumps - Rubella Vaccine was introduced in the US. MMR Vaccine used in the US since 1980s is M - MR II Vaccine, and is sterile lyophilized preparation of ATTENUVAX, more attenuated line of Measles Virus, derived from Enders attenuate Edmonston strain and propagated in chick embryo cell culture; MUMPSVAX, Jeryl Lynn strain of Mumps Virus propagated in chick embryo cell culture; and MERUVAX II, Wistar RA 27 / 3 strain of Live attenuate Rubella Virus propagate in WI - 38 human diploid lung fibroblasts. Since, late 1980s / early 1990s, Advisory Committee on Immunization Practices, American Academy of Pediatrics, and American Academy of Family Practitioners have recommended that first dose of MMR Vaccine should be given to children aged 12 through 15 months. The Measles Vaccine program in the US was so successful against Measles infections that it is the largest country in the world to have ended endemic Measles transmission. Therefore, it would be ethically unacceptable to conduct placebo - Control trials to assess Measles Vaccine effectiveness in the US, and as a result, current epidemiological research on the effectiveness of MMR Vaccine needs to focus on retrospective studies of populations to optimize protection by modifying Immunization schedules. The purpose of the present retrospective longitudinal cohort study was to examine vaccine effectiveness of childhood MMR Vaccination to reduce the incidence rate of childhood Measles infections in the US during the 1990s / 2000s. In addition, this study examine relationship between age of childhood MMR Vaccination and its impact on effectiveness of vaccine.


Results

We include 41 and 67 studies in measles protection and immunogenicity analyses. Older age at MCV1, from 6 to 15 months, improves antibody response and measles protection among one - dose recipients. Pool measles RR ranges from 3. 56 for MCV1 at < 9 months to 0. 48 for MCV1 at 15 months, both compared to 12 - 14 months. Pool seroconversion RR range from 0. 93 for MCV1 at 9 - 11 months to 1. 03 for MCV1 at 15 months, both compared to 12 months. After second dose, serological studies report high seropositivity regardless of age at administration of MCV1 while epidemiological data based on a few studies suggest lower protection with earlier age at MCV1.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Six common misconceptions about immunization

This is another argument frequently found in anti - Vaccine literature, implication being that this proves that vaccines are not effective. In fact, it is true that in outbreaks, those WHO have been vaccinated often outnumber those WHO have not even with vaccines such as measles, which we know to be about 98% effective when used as recommended. This apparent paradox is explained by two factors. First, no vaccine is 100% effective. To make vaccines safer than disease, bacteria or viruses are killed or weaken. For reasons relate to individual, not all vaccinated people develop immunity. Most routine childhood vaccines are effective for 85% to 95% of recipients. Second, in countries such as the United States, people WHO have been vaccinated vastly outnumber those WHO have not. How these two factors work together to result in outbreaks in which the majority of cases have been vaccinated can be more easily understood by looking at a hypothetical example: in a high school of 1 000 students, none has ever had measles. All but five of the students have had two doses of measles Vaccine, and so are fully immunize. The entire student body is exposed to measles, and every susceptible student becomes infect. Five unvaccinated students will be infect, of course. But of 995 WHO have been vaccinate, we would expect several not to respond to the vaccine. The Efficacy rate for two doses of measles Vaccine can be as high as > 99%. In this class, seven students do not respond, and they, too, become infected. Therefore, seven out of 12, or about 58%, of cases occur in students WHO have been fully vaccinate. As you can see, this doesn't prove the vaccine didn't work, only that most of children in the class had been vaccinate, so those WHO were vaccinated and did not respond outnumbered those WHO had not been vaccinate. Looking at it another way, 100% of children WHO had not been vaccinated get measles, compared with less than 1% of those WHO had been vaccinate. The Measles Vaccine protects most of the class; if nobody in the class had been vaccinate, there would probably have been 1 000 cases of measles. Who gratefully acknowledges permission of CDC Atlanta, to present an edited version of six common misconceptions about immunization.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Vaccine efficacy and effectiveness

We conducted a systematic Review of PubMed / MEDLINE, Embase, Web of Science and Cochrane databases to identify observational studies estimating Vaccine effectiveness and / or Measles attack rates by Age at first Vaccination as well as experimental studies comparing Seroconversion by Age at first Vaccination. Random effect models were used to pool Measles risk ratios, Measles odds ratios and Seroconversion RR of MCV1 administered at < 9 9 - 11 or 15 months compared with 12 or 12 - 14 months of age. Eligibility requires evaluation of vaccination with one or two doses of further attenuated live MCV. In each study, first dose had to be administered at different ages, but all before the age of two years. Cohort and case - control studies that report VE and Measles AR by Age at MCV1 were eligible for Review of Measles protection. Studies or participants vaccinated during the outbreak were exclude. Randomize controlled trials and quasi - experimental studies were included in Review of Immunogenicity if Seroconversion after MCV1 and / or seropositivity after MCV2 were reported by Age at first Vaccination. As both age and antibody detection were objective measures, quasi - experimental designs were thought to give valuable data on immunogenicity response to Measles Vaccine. Studies of kill and high titer vaccines were exclude, as well as those examining aerosol or intradermal administration or targeting populations with special characteristics such as immunosuppressed or malnourished children. When different vaccine strains were administered in one study, results were extracted according to strains to compare children receiving the same strain at different ages. Studies were identified by systematic search of PubMed / MEDLINE, Embase, Web of Science and Cochrane databases from 1964, when the first Measles Vaccine was license, to May 2017. Reference lists of select articles and key published reviews were also hand - search. The following search terms include: Measles Vaccine, Measles - Mumps - Rubella Vaccine, Measles / prevention and control, Vaccination, Measles Mumps Rubella Varicella Vaccine, MMR, MMRV, Vaccine effectiveness, Efficacy, Epidemic, Outbreak, Treatment failure, Vaccine failure, Antibody, Serologic Tests, Seroconversion, Immunogenicity, Age, Age at Vaccination, Age at immunization and Age factor. A Search strategy, validated by a professional librarian, was adapted to each database. Search results were limited to human studies. Studies published in English, French, Spanish or Portuguese were include. Data extraction forms were developed and tested for each sub - analysis. A single author abstract data from studies, which were checked by a second reviewer. Authors of original articles were contacted in event of missing or inaccurate information. When VE or Seroconversion risk was not reported but there was enough data to estimate it by Age at Vaccination, calculation was done by reviewers. We extract information on study characteristics, population, intervention and outcome. VE was calculated by comparing Measles AR among vaccinated and Non - vaccinated or comparing vaccination status of cases and Non - cases during Measles epidemics. Measles cases were defined by clinical, epidemiological and / or serological criteria. Attenuate or Non - classical Measles cases were included only if confirmed by laboratory.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Who Should Get MMR Vaccine?

MMR Vaccine is very effective at protecting people against Measles, Mumps, and Rubella, and preventing complications caused by these diseases. People WHO receive two doses of MMR Vaccine as children according to the US vaccination schedule are usually considered protected for life and do need a booster dose. Additional doses may be needed if you are at risk because of a Mumps outbreak. One dose of MMR Vaccine is 93% effective against Measles, 78% effective against Mumps, and 97% effective against Rubella. Two doses of MMR Vaccine are 97% effective against Measles and 88% effective against Mumps. Mmr is an attenuated live virus vaccine. This means that after injection, viruses cause harmless infection in vaccinated person with very few, if any, symptoms before they are eliminated from the body. A person's immune system fights infection caused by these weakened viruses, and immunity develops. Some people WHO get two doses of MMR Vaccine may still get Measles, Mumps, or Rubella if they are exposed to viruses that cause these diseases. Experts are not sure why; it could be that their immune systems didnt respond as well as they should have to vaccine or their immune systems ' ability to fight infection decreased over time. However, disease symptoms are generally milder in vaccinated people. About 3 out of 100 people WHO get two doses of MMR Vaccine will get Measles if exposed to the virus. However, they are more likely to have milder illness, and are also less likely to spread disease to other people. Two doses of MMR Vaccine are 88% effective at preventing Mumps. Mumps outbreaks can still occur in highly vaccinated US communities, particularly in settings where people have close, prolonged contact, such as universities and close - knit communities. During an outbreak, public health authorities may recommend additional doses of MMR for people WHO belong to groups at increased risk for Mumps. Additional doses can help improve protection against Mumps disease and related complications. While there are not many studies available, most people WHO do not respond to the Rubella component of the first MMR dose would be expected to respond to the second dose.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

What is MMRV Vaccine?

We conducted a systematic Review of PubMed / MEDLINE, Embase, Web of Science and Cochrane databases to identify observational studies estimating Vaccine effectiveness and / or Measles attack rates by Age at first Vaccination as well as experimental studies comparing Seroconversion by Age at first Vaccination. Random effect models were used to pool Measles risk ratios, Measles odds ratios and Seroconversion RR of MCV1 administered at < 9 9 - 11 or 15 months compared with 12 or 12 - 14 months of age. The population eligible for enrollment in this retrospective cohort study is represented by children resident in ASL Rome1, WHO were present in vaccination registers and had been vaccinated in the period between 2009 - 2011 for MMR. Follow - up starts as follow: for vaccinated children at time of vaccination and ending after 24 months; B for unvaccinated children, start of follow - up was considered as median month when children should have received vaccine for their birth cohort and ending after 24 months fig. 1. In this sample, T0 and T1 represent starting and ending points of study. For each component of cohort status of MMR Vaccination was ascertained in the register of ASL, database that includes names of children vaccinated both at immunization clinics of ASL and with family pediatricians. Descriptive analysis was conducted to represent main characteristics of the sample. Univariate analysis, to evaluate possible associations between the number of doses of vaccination and 3 different outcomes considered was also perform. Finally, Cox regression models were constructed to assess the association between Vaccination status and outcomes. Results are present as Hazard ratios HR and 95% confidence intervals 95% CI. Models were adjusted considering age and gender as possible confounders. Statistical analysis was performed using SPSS version 23 for Windows, with level of significance set at p < 0. 05. Eligibility requires evaluation of vaccination with one or two doses of further attenuated live MCV. In each study, first dose had to be administered at different ages, but all before the age of two years. Cohort and case - Control studies that report VE and Measles AR by Age at MCV1 were eligible for Review of Measles protection. Studies or participants vaccinated during the outbreak were exclude. Randomize controlled trials RCT and quasi - experimental studies included in Review of Immunogenicity if Seroconversion after MCV1 and / or seropositivity after MCV2 were reported by Age at first Vaccination. As both age and antibody detection were objective measures, quasi - experimental designs were thought to give valuable data on immunogenicity response to Measles Vaccine. Studies of kill and high titer vaccines were exclude, as well as those examining aerosol or intradermal administration or targeting populations with special characteristics such as immunosuppressed or malnourished children. When different vaccine strains were administered in one study, results were extracted according to strains to compare children receiving the same strain at different ages.


Results

The study involved analysis of 11 004 children of mainly Italian nationality, resident in the territory of ASL Rome 1. 2302 of these children did not receive the MMR vaccination, 5392 received one dose and 3310 received 2 doses of this vaccine. With regard to target diseases of vaccination, over period study, no hospitalizations occurred for Rubella, 2 hospitalizations were seen for Mumps and 12 occurred for Measles, of which 9 among not vaccinated group, 3 among those vaccinated with one dose, and none among those who received 2 doses of vaccine. Overall, vaccine was highly protective against Measles or Measles and Mumps hospitalizations. As for all infectious diseases, target and Non - target of vaccination, 414 hospitalizations were note, of which 262 among those Non - vaccinate, 82 among those who had received one dose of vaccine and 70 among those who had received 2 doses. Overall, vaccine was highly protective against hospitalizations for all infectious diseases. With regard to respiratory disease, there were 809 admissions, of which 424 among those who had not been vaccinate, 202 among children vaccinated having received just the first dose and 183 among children vaccinated with 2 doses. Overall, vaccine was highly protective against hospitalizations for respiratory diseases, with a HR of 0.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Educational Materials

Panel is a screen shot of a web page discussion MMR Vaccine safety viewed by parents in the intervention group, while Panel B is a web pate discussing MMR Vaccine safety shown to all parents in the control group. The menu on left in Panel is tailored to highlight the most important concerns identified by that parent, while all parents in the control group receive the standard menu shown in Panel B. Both parents from examples were Asian - American mothers between 25 - 34 y old with male child aged 11 - 15 mo. All parents first read the introductory page about study and proceed to the survey, then view either tailored or untailored Vaccine information before completing post - survey questions. Different levels of tailored use in intervention are shown on panel. Green, name tailoring; blue, content tailoring; red, image tailoring; purple, experiential tailoring.


Results

Our search retrieved 1156 records, of which 85 were duplicates and were exclude. Titles and abstracts of the remaining 1071 published articles were screened and 241 articles were found to meet inclusion criteria and were assessed for eligibility via full - text evaluation. 110 additional publications were found through screening bibliographies of assessed full - text articles. 295 records in total do not meet inclusion criteria after this second full - text review. Data from the remaining 56 studies were included in the primary analysis. 35 articles report relevant information on immunogenicity, three on duration of immunity, two on vaccine efficacy, nine on vaccine effectiveness, and 15 on safety information. The estimated proportion of infants who seroconverted was based on 20 studies 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 that present data by age at MCV1 vaccination, ranging from 4 to 8 months. Pooled estimate of the proportion of infants who seroconverted increased from 50% at age 4 months, to 67% at 5 months, 76% at 6 months, 72% at 7 months, and 85% at 8 months. Heterogeneity in the proportion of infants who seroconverted was moderate to high. Forest plots by age at MCV1 and vaccine strain and titre are shown in the appendix. Many studies in our search present results for MCV1 vaccination in range of ages, rather than by month of vaccination and were therefore not included in our meta - analyses. However, we do additional sensitivity analyses by pooling and comparing seroconversion data from 24 studies presenting data on MCV1 by month of vaccination and age ranges. 25 26 28 29 31 36 37 38 39 40 45 46 47 48 49 data presented as age ranges were in accordance with our estimates per month of vaccination. Multivariable meta - regression analysis shows age, vaccine strain Edmonston - Zagreb - Mexico, and vaccine titre as independent determinants of seroconversion, increasing proportion of infants who seroconverted when vaccinated with MCV1 before 9 months of age. Type of test, continent of study, and decade of data collection were not found to be independent determinants. Data from four studies 25 28 36 45 allow us to pool in meta - analysis head - to - head comparisons of infants vaccinated with Schwarz MCV strain with those vaccinated with Edmonston - Zagreb MCV strain at 6 months of age. 18% more infants seroconverted when vaccinated with Edmonston - Zagreb strain at 6 months than when vaccinated with Schwarz strain. There was insufficient data for head - to - head comparisons of other strains of measles vaccine or to compare other ages of MCV1 vaccination. Results from meta - regression of studies reporting on seroconversion by age of MCV1 administration stratified by presence or absence of maternal antibodies show that seroconversion was significantly reduced when maternal antibodies were present, with a mean difference in the proportion of infants who seroconverted of 33%.


Who Should Get MMR Vaccine?

Cdc recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive second dose earlier as long as it is at least 28 days after the first dose. The MMR vaccine is given later than some other childhood vaccines because antibodies transferred from mother to baby can provide some protection from disease and make the MMR vaccine less effective until about 1 year of age. Learn about the MMRV vaccine, which protects against measles, Mumps, Rubella, and varicella. This vaccine is only licensed for use in children who are 12 months through 12 years of age.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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