The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness – A systematic review

Stephanie L. Hughes, Shelly Bolotin, Sumaiya Khan, Ye Li, Caitlin Johnson, Lindsay Friedman, Andrea C. Tricco, Susan J.M. Hahné, Jane M. Heffernan, Alya Dabbagh, David N. Durrheim, Walter A. Orenstein, William J. Moss, Mark Jit, Natasha S. Crowcroft

Research output: Contribution to journalReview article

Abstract

Background: In settings where measles has been eliminated, vaccine-derived immunity may in theory wane more rapidly due to a lack of immune boosting by circulating measles virus. We aimed to assess whether measles vaccine effectiveness (VE) waned over time, and if so, whether differentially in measles-eliminated and measles-endemic settings. Methods: We performed a systematic literature review of studies that reported VE and time since vaccination with measles-containing vaccine (MCV). We extracted information on case definition (clinical symptoms and/or laboratory diagnosis), method of vaccination status ascertainment (medical record or vaccine registry), as well as any biases which may have arisen from cold chain issues and a lack of an age at first dose of MCV. We then used linear regression to evaluate VE as a function of age at first dose of MCV and time since MCV. Results: After screening 14,782 citations, we identified three full-text articles from measles-eliminated settings and 33 articles from measles-endemic settings. In elimination settings, two-dose VE estimates increased as age at first dose of MCV increased and decreased as time since MCV increased; however, the small number of studies available limited interpretation. In measles-endemic settings, one-dose VE increased by 1.5% (95% CI 0.5, 2.5) for every month increase in age at first dose of MCV. We found no evidence of waning VE in endemic settings. Conclusions: The paucity of data from measles-eliminated settings indicates that additional studies and approaches (such as studies using proxies including laboratory correlates of protection) are needed to answer the question of whether VE in measles-eliminated settings wanes. Age at first dose of MCV was the most important factor in determining VE. More VE studies need to be conducted in elimination settings, and standards should be developed for information collected and reported in such studies.

Original languageEnglish (US)
JournalVaccine
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Measles Vaccine
Measles
systematic review
Vaccination
Vaccines
vaccination
vaccines
dosage
Refrigeration
Measles virus
Clinical Laboratory Techniques
Proxy
Medical Records
Registries
Immunity
Linear Models

Keywords

  • Eliminated
  • Endemic
  • Immunisation
  • Measles
  • Vaccine effectiveness
  • Waning immunity

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Hughes, S. L., Bolotin, S., Khan, S., Li, Y., Johnson, C., Friedman, L., ... Crowcroft, N. S. (Accepted/In press). The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness – A systematic review. Vaccine. https://doi.org/10.1016/j.vaccine.2019.10.090

The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness – A systematic review. / Hughes, Stephanie L.; Bolotin, Shelly; Khan, Sumaiya; Li, Ye; Johnson, Caitlin; Friedman, Lindsay; Tricco, Andrea C.; Hahné, Susan J.M.; Heffernan, Jane M.; Dabbagh, Alya; Durrheim, David N.; Orenstein, Walter A.; Moss, William J.; Jit, Mark; Crowcroft, Natasha S.

In: Vaccine, 01.01.2019.

Research output: Contribution to journalReview article

Hughes, SL, Bolotin, S, Khan, S, Li, Y, Johnson, C, Friedman, L, Tricco, AC, Hahné, SJM, Heffernan, JM, Dabbagh, A, Durrheim, DN, Orenstein, WA, Moss, WJ, Jit, M & Crowcroft, NS 2019, 'The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness – A systematic review', Vaccine. https://doi.org/10.1016/j.vaccine.2019.10.090
Hughes, Stephanie L. ; Bolotin, Shelly ; Khan, Sumaiya ; Li, Ye ; Johnson, Caitlin ; Friedman, Lindsay ; Tricco, Andrea C. ; Hahné, Susan J.M. ; Heffernan, Jane M. ; Dabbagh, Alya ; Durrheim, David N. ; Orenstein, Walter A. ; Moss, William J. ; Jit, Mark ; Crowcroft, Natasha S. / The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness – A systematic review. In: Vaccine. 2019.
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abstract = "Background: In settings where measles has been eliminated, vaccine-derived immunity may in theory wane more rapidly due to a lack of immune boosting by circulating measles virus. We aimed to assess whether measles vaccine effectiveness (VE) waned over time, and if so, whether differentially in measles-eliminated and measles-endemic settings. Methods: We performed a systematic literature review of studies that reported VE and time since vaccination with measles-containing vaccine (MCV). We extracted information on case definition (clinical symptoms and/or laboratory diagnosis), method of vaccination status ascertainment (medical record or vaccine registry), as well as any biases which may have arisen from cold chain issues and a lack of an age at first dose of MCV. We then used linear regression to evaluate VE as a function of age at first dose of MCV and time since MCV. Results: After screening 14,782 citations, we identified three full-text articles from measles-eliminated settings and 33 articles from measles-endemic settings. In elimination settings, two-dose VE estimates increased as age at first dose of MCV increased and decreased as time since MCV increased; however, the small number of studies available limited interpretation. In measles-endemic settings, one-dose VE increased by 1.5{\%} (95{\%} CI 0.5, 2.5) for every month increase in age at first dose of MCV. We found no evidence of waning VE in endemic settings. Conclusions: The paucity of data from measles-eliminated settings indicates that additional studies and approaches (such as studies using proxies including laboratory correlates of protection) are needed to answer the question of whether VE in measles-eliminated settings wanes. Age at first dose of MCV was the most important factor in determining VE. More VE studies need to be conducted in elimination settings, and standards should be developed for information collected and reported in such studies.",
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AU - Hughes, Stephanie L.

AU - Bolotin, Shelly

AU - Khan, Sumaiya

AU - Li, Ye

AU - Johnson, Caitlin

AU - Friedman, Lindsay

AU - Tricco, Andrea C.

AU - Hahné, Susan J.M.

AU - Heffernan, Jane M.

AU - Dabbagh, Alya

AU - Durrheim, David N.

AU - Orenstein, Walter A.

AU - Moss, William J.

AU - Jit, Mark

AU - Crowcroft, Natasha S.

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N2 - Background: In settings where measles has been eliminated, vaccine-derived immunity may in theory wane more rapidly due to a lack of immune boosting by circulating measles virus. We aimed to assess whether measles vaccine effectiveness (VE) waned over time, and if so, whether differentially in measles-eliminated and measles-endemic settings. Methods: We performed a systematic literature review of studies that reported VE and time since vaccination with measles-containing vaccine (MCV). We extracted information on case definition (clinical symptoms and/or laboratory diagnosis), method of vaccination status ascertainment (medical record or vaccine registry), as well as any biases which may have arisen from cold chain issues and a lack of an age at first dose of MCV. We then used linear regression to evaluate VE as a function of age at first dose of MCV and time since MCV. Results: After screening 14,782 citations, we identified three full-text articles from measles-eliminated settings and 33 articles from measles-endemic settings. In elimination settings, two-dose VE estimates increased as age at first dose of MCV increased and decreased as time since MCV increased; however, the small number of studies available limited interpretation. In measles-endemic settings, one-dose VE increased by 1.5% (95% CI 0.5, 2.5) for every month increase in age at first dose of MCV. We found no evidence of waning VE in endemic settings. Conclusions: The paucity of data from measles-eliminated settings indicates that additional studies and approaches (such as studies using proxies including laboratory correlates of protection) are needed to answer the question of whether VE in measles-eliminated settings wanes. Age at first dose of MCV was the most important factor in determining VE. More VE studies need to be conducted in elimination settings, and standards should be developed for information collected and reported in such studies.

AB - Background: In settings where measles has been eliminated, vaccine-derived immunity may in theory wane more rapidly due to a lack of immune boosting by circulating measles virus. We aimed to assess whether measles vaccine effectiveness (VE) waned over time, and if so, whether differentially in measles-eliminated and measles-endemic settings. Methods: We performed a systematic literature review of studies that reported VE and time since vaccination with measles-containing vaccine (MCV). We extracted information on case definition (clinical symptoms and/or laboratory diagnosis), method of vaccination status ascertainment (medical record or vaccine registry), as well as any biases which may have arisen from cold chain issues and a lack of an age at first dose of MCV. We then used linear regression to evaluate VE as a function of age at first dose of MCV and time since MCV. Results: After screening 14,782 citations, we identified three full-text articles from measles-eliminated settings and 33 articles from measles-endemic settings. In elimination settings, two-dose VE estimates increased as age at first dose of MCV increased and decreased as time since MCV increased; however, the small number of studies available limited interpretation. In measles-endemic settings, one-dose VE increased by 1.5% (95% CI 0.5, 2.5) for every month increase in age at first dose of MCV. We found no evidence of waning VE in endemic settings. Conclusions: The paucity of data from measles-eliminated settings indicates that additional studies and approaches (such as studies using proxies including laboratory correlates of protection) are needed to answer the question of whether VE in measles-eliminated settings wanes. Age at first dose of MCV was the most important factor in determining VE. More VE studies need to be conducted in elimination settings, and standards should be developed for information collected and reported in such studies.

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KW - Endemic

KW - Immunisation

KW - Measles

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KW - Waning immunity

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