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. 2016 Mar 24;3(2):ofw064.
doi: 10.1093/ofid/ofw064. eCollection 2016 Mar.

Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014

Craig M Hales  1 , Eliaser Johnson  2 , Louisa Helgenberger  3 , Mark J Papania  1 , Maribeth Larzelere  1 , Sameer V Gopalani  3 , Emmaculate Lebo  4 , Greg Wallace  1 , Edna Moturi  4 , Carole J Hickman  1 , Paul A Rota  1 , Hinden S Alexander  2 , Mona Marin  1
Affiliations

Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014

Craig M Hales et al. Open Forum Infect Dis. .

Abstract

Background. A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods. We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results. Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], -425 to 87.3) for 1 dose, 63.4% (95% CI, -103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, -52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions. Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.

Keywords: Federated States of Micronesia; MMR; measles; measles vaccine; vaccine effectiveness.

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Figures

Figure 1.
Figure 1.
Number of precampaign measles-containing vaccine doses in secondary cases (A) and well household contacts (B), by age group—Pohnpei State, Federated States of Micronesia, 2014. All vaccine doses were received at age 6 months or older with at least 28 days between doses if more than 1 dose was received. Abbreviations: M, month; Y, year.
See this image and copyright information in PMC

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