| Epidemiology and Vaccine Efficacy of Measles During the 1993 measles Epidemic |
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Soon Ki Kim1, Jong Woon Choi1, Byong Kwan Son1, Seung Nam Park2, Churl Young Chung2, Young Min Ahn3, Chong Young Park4, Ki Yang Ryoo4, Woo Kap Chung4, Hoan Jong Lee5 |
1Department of Pediatrics, College of Medicine, Inha University, Inha Hospital, Seongnam, Korea
2Department of Pediatrics, College of Medicine, Injae University, Sanggyue Paik Hospital, Seoul, Korea
3Department of Pediatrics, Kangnam Hospital Public Corporation, Seoul, Korea
4Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
5Division of Infectious Disease, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea |
| 1993년 유행한 홍역의 역학 및 MMR백신 효능 |
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김순기1, 최종운1, 손병관1, 박승남2, 정철영2, 안영민3, 박종영4, 유기영4, 정우갑4, 이환종5 |
1인하대학교 의과대학 소아과학교실
2인제대학교 의과대학 소아과학교실
3지방공사 강남병원 소아과
4한림대학교 의과대학 소아과학교실
5서울대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Because of increased measles incidence in Korea during 1993 and the recent finding of genomic differences between vaccine virus and contemporary wild measles viruses, we conducted a measles vaccine efficacy study involving children ages 1 to 5 yeark, with the demographic analysis of patients brought to the hospitals during measles outbreak that had occurred 1993 in Seoul and Seong-nam city.
Methods
: Reported cases of measles, which were brought to 6 General Hospitals(Inha, Sanggyue Paik, 3 Saint Heart Hospitals, and Kangnam General Hospital Public Corporation) were investigated. We compared the measles attack rates for vaccinated and unvaccinated children to obtain the relative risk(RR) for measles infection of those vaccinated.
Results
: 1) A total of 380 patients(M:F=216:164) participated in this study. Two hundred and nine cases(55.0%) occurred in less than 5 years of age, and 167(43.9%) were under 16 months of age. The highest recorded age-specific incidence rates showed two major outbreak, : those in which of the cases occurred blow 16 months of age and those in which most of cases occurred among school-age persons.
2) Only 9.6%(16/167) in those less than 16 months of age were vaccinated, 59.5%(2.42) in children 16 months to 4 years of age have been vaccinated, and 91.8%(157/171) of the cases in school-aged children have been vaccinated.
3) Attack rated among the 122 vaccinated and 12 unvaccinated children were 5.7% and 75%, respectively. Vaccine efficacy was 92.4%(95% confidence interval : 83.6%, 96.4%).
4) The causes of MMR unvaccination above 15 months of age were mild acute illness not contraindicated to vaccine use in 77.4%(24/31). Neglect or oblivion in 6.4%(2/31).
Conclusion
: The high vaccine efficacy in household exposures suggests that measles outbreaks in Korea are not due to reduced vaccine efficacy. A booster dose of measles vaccine at the time of school entry may be necessary, with the reinforcement of age-appropriate immunization in Korea. |
| Key Words:
Measles, Measles vaccination, Vaccine failure, vaccine efficacy |
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