Measles vaccine

Detection of patients should be done as early as possible and isolated (4 days before and 6 days after the rash appears). Avoid direct contact of the receiver with the sick. Sections of measles in hospitals will be more strictly separated (Air-borne contamination).

The measles vaccine is one of the most common and safe vaccines on the market. It is widely used and administered, either by injection or by nasal airways (this last one is still in test used primarily in the parts of the world with high temperature and humidity).

The protection for the receivers can be achieved by specific preventive measures (passive or active).

A. Protection by passive immunization is done with standard gamma globulin specific protective effect, if given within the first 5 days of contact and effective mitigation, you are given these days of incubation. Duration of protection is 3 weeks.

B. Protection with active immunization. Currently, prevention of measles is successful, provided by mass immunization with live attenuated measles vaccine. Introduced in 1963, the measles vaccine showed high efficacy, inducing a protective immunity in about 95% of cases, substantially reducing morbidity from measles (in the U.S. of 400,000 cases per year, less than 3,000 cases in 1984).

Age of recommended vaccination. Usually the administration of measles vaccine begins with the age of twelve months (even 15 months according to authors) and later at any age. Experience has shown that performing the measles vaccine under the age of 12 months can reduce the chance and degree serum conversion because of more prolonged persistence of antibodies passed from mother. All authors are in agree that in cases of high risk of infectious contact for infants (epidemics in nursery, lower morbidity than age) is appropriate to make the measles vaccine earlier than six months.

In these cases, the measles vaccine needs to be repeated at the age of 15 months, for complete protection (under 12 months the protection is only 67%). Older children and teenagers are given the measles vaccine if they are receptive. Exposure to measles (contact infection) is not a contraindication to vaccination. If the measles vaccine is made in the first 3 days of contact, the vaccine induces protection that prevents the development of measles.

Precautions and counter indications. Anti measles vaccine is postponed for 2-3 months, if the child received gamma globulin, blood or plasma (interference vaccination).

Excluded from vaccination: pregnant women (risk of malformation of the fetus), children with severe febrile illness, active tuberculosis, and those with impaired immunity (leucosis and other blood diseases, people treated with corticosteroids, chemotherapy, irradiation) because danger of developing serious reactions. Children with these contraindications are protected (in this case of contact infection) with standard or specific immunoglobulin.

Adverse effects. Experience of over 15 years with measles vaccine showed a very good security and an acceptable tolerance. Between 5-15% of vaccine, developed fever up to 39 degrees Celsius, starting from the 6th day after the inoculation and lasted several days, eruptions occur more rarely easy. EEG changes, transient and reversible, are possible, like seizures, but neurological manifestations have been reported only in the proportion of 1-1,2% / 1000.000 vaccination

Other authors give higher proportions (1: 25.000) of neurological complications. Exceptional cases were cited by Guillain-Barre syndrome and paresis. The risk of sub acute sclerosing pan encephalitis is considered quite exceptional.

Duration of immunization. The experience so far shows that immunity from vaccination lasts between 10 and 12 years (continuous observations), suggesting an immunity for all his life (although it appears less strong than that after natural infection ).

Anti measles vaccine failures are rare (1-5%) and explained either by the presence of antibodies in vaccinated child (infant or recently receiving immunoglobulin) or mainly by failure to conserve vaccine cold ( “cold chain” necessary from producer to the application) due to lack of technology, because measles vaccine is very labile at high temperature and light (a big impediment to tropical areas).

To avoid failures by residual humoral immunity in infants, attempts were made on these infants to administer measles vaccine given by nose, by aerosol, with good results. Measles eradication is possible only on a program vaccination with live vaccine anti measles, widespread and sustained annual children each generation.