Skip main navigationJournal menuClose Drawer MenuOpen Drawer Menu
Skip main navigationJournal menuClose Drawer MenuOpen Drawer Menu
Journal of The Royal Society Interface
Restricted access Research articles

Estimation of measles vaccine efficacy and critical vaccination coverage in a highly vaccinated population

Michiel van Boven

Michiel van Boven

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 Bilthoven, The Netherlands

[email protected]

Google Scholar

Find this author on PubMed

Search for more papers by this author

,
Mirjam Kretzschmar

Mirjam Kretzschmar

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 Bilthoven, The Netherlands

Julius Center for Health Research & Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 Utrecht, The Netherlands

Google Scholar

Find this author on PubMed

Search for more papers by this author

,
Jacco Wallinga

Jacco Wallinga

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 Bilthoven, The Netherlands

Julius Center for Health Research & Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 Utrecht, The Netherlands

Google Scholar

Find this author on PubMed

Search for more papers by this author

,
Philip D O'Neill

Philip D O'Neill

School of Mathematical Sciences, University of Nottingham, Nottingham NG7 2RD, UK

Google Scholar

Find this author on PubMed

Search for more papers by this author

,
Ole Wichmann

Ole Wichmann

Department for Infectious Disease Epidemiology, Robert Koch-Institute, DGZ-Ring 1, 13086 Berlin, Germany

Google Scholar

Find this author on PubMed

Search for more papers by this author

and
Susan Hahné

Susan Hahné

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 Bilthoven, The Netherlands

Google Scholar

Find this author on PubMed

Search for more papers by this author

Published:14 April 2010https://doi.org/10.1098/rsif.2010.0086

    Abstract

    Measles is a highly infectious disease that has been targeted for elimination from four WHO regions. Whether and under which conditions this goal is feasible is, however, uncertain since outbreaks have been documented in populations with high vaccination coverage (more than 90%). Here, we use the example of a large outbreak in a German public school to show how estimates of key epidemiological parameters such as the basic reproduction number (R0), vaccine efficacy (VES) and critical vaccination coverage (pc) can be obtained from partially observed outbreaks in highly vaccinated populations. Our analyses rely on Bayesian methods of inference based on the final size distribution of outbreak size, and use data which are easily collected. For the German public school the analyses indicate that the basic reproduction number of measles is higher than previously thought (Inline Formula, 95% credible interval: 23.6–40.4), that the vaccine is highly effective in preventing infection (Inline Formula, 95% credible interval: 0.993–0.999), and that a vaccination coverage in excess of 95 per cent may be necessary to achieve herd immunity (Inline Formula, 95% credible interval: 0.961–0.978). We discuss the implications for measles elimination from highly vaccinated populations.

    References

    • Anderson R. M.& May R. M. . 1991 Infectious diseases of humans. Dynamics and control. Oxford, UK: Oxford University Press. Google Scholar
    • Ball F.& O'Neill P. D. . 1999 The distribution of general final state random variables for stochastic epidemic models. J. Appl. Probab. 36, 473–491. (doi:10.1239/jap/1032374466). Crossref, ISI, Google Scholar
    • Basta N. E., Halloran M. E., Matrajt L.& Longini I. M. . 2008 Estimating influenza vaccine efficacy from challenge and community-based study data. Am. J. Epidemiol. 168, 1343–1352. (doi:10.1093/aje/kwn259). Crossref, PubMed, ISI, Google Scholar
    • Becker N. G.& Britton T. . 2004 Estimating vaccine efficacy from small outbreaks. Biometrika 91, 363–382. (doi:10.1093/biomet/91.2.363). Crossref, ISI, Google Scholar
    • Becker N. G., Britton T.& O'Neill P. D. . 2003 Estimating vaccine effects on transmission of infection from household outbreak data. Biometrics 59, 467–475. (doi:10.1111/1541-0420.00056). Crossref, PubMed, ISI, Google Scholar
    • Demiris N.& O'Neill P. D. . 2005 Bayesian inference for stochastic multitype epidemics in structured populations via random graphs. J. R. Statist. Soc. B 67, 731–745. (doi:10.1111/j.1467-9868.2005.00524.x). Crossref, Google Scholar
    • Demiris N.& O'Neill P. D. . 2006 Computation of final outcome probabilities for the generalized stochastic epidemics. Statist. Comput. 16, 309–317. (doi:10.1007/s11222-006-8320-4). Crossref, ISI, Google Scholar
    • Diekmann O.& Heesterbeek J. A. P. . 2000 Mathematical epidemiology of infectious diseases. model building, analysis and interpretation. New York, NY: Wiley. Google Scholar
    • Finkenstadt B. F.& Grenfell B. T. . 2000 Time series modelling of childhood diseases: a dynamical systems approach. J. R. Statist. Soc. 49, 187–205. Crossref, Google Scholar
    • Halloran M. E., Longini I. M.& Struchiner C. J. . 2010 Design and analysis of vaccine studies. New York, NY: Springer. Crossref, Google Scholar
    • He D., Ionides E. L.& King A. A. . 2010 Plug-and-play inference for disease dynamics: measles in large and small populations as a case study. J. R. Soc. Interface 7, 271–283. (doi:10.1098/rsif.2009.0151). Link, ISI, Google Scholar
    • Lynn T. V., Beller M., Funk E. A., Middaugh J. P., Ritter D., Rota P. A., Bellini W. J.& Torok T. J. . 2004 Incremental effectiveness of 2 doses of measles-containing vaccine compared with 1 dose among high school students during an outbreak. J. Infect. Dis. 189, S86–S90. (doi:10.1086/377699). Crossref, PubMed, ISI, Google Scholar
    • Muscat M., Bang H., Wohlfart J., Glismann S.& Mølbak K. . 2009 Measles in Europe: an epidemiological assessment. Lancet 373, 383–389. (doi:10.1016/S0140-6736(08)61849-8). Crossref, PubMed, ISI, Google Scholar
    • Ong G., Rasidah N., Wan S.& Cutter J. . 2007 Outbreak of measles in primary school students with high first dose MMR vaccination coverage. Singapore Med. J. 48, 656–661. PubMed, Google Scholar
    • Orenstein W. A., Bernier R. H.& Dondero T. J. . 1985 Field evaluation of vaccine efficacy. Bull. World Health Organ. 63, 1055–1068. PubMed, ISI, Google Scholar
    • Paunio M., Peltola H., Valle M., Davidkin I., Virtanen M.& Heinonen O. P. . 1998 Explosive school-based measles outbreak: intense exposure may have resulted in high risk, even among revaccinees. Am. J. Epidemiol. 148, 1103–1110. Crossref, PubMed, ISI, Google Scholar
    • Pawitan Y. . 2001 In all likelihood: statistical modelling and inference using likelihood. Oxford, UK: Oxford University Press. Google Scholar
    • Sutcliffe P. A.& Rea E. . 1996 Outbreak of measles in a highly vaccinated secondary school population. Can. Med. Assoc. J. 155, 1407–1413. ISI, Google Scholar
    • van Boven M., Koopmans M., Du Ry van Beest Holle M., Meijer A., Klinkenberg D., Donnelly C. A.& Heesterbeek J. A. P. . 2007 Detecting emerging transmissibility of avian influenza virus in human households. PLoS Comput. Biol. 3, e145. (doi:10.1371/journal.pcbi.0030145). Crossref, PubMed, ISI, Google Scholar
    • Wallinga J., Teunis P.& Kretzschmar M. . 2003 Reconstruction of measles dynamics in vaccinated populations. Vaccine 21, 2643–2650. (doi:10.1016/S0264-410X(03)00051-3). Crossref, PubMed, ISI, Google Scholar
    • Wallinga J., Heijne J. C.& Kretzschmar M. . 2005 A measles epidemic threshold in a highly vaccinated population. PLoS Med. 2, e316. (doi:10.1371/journal.pmed.0020316). Crossref, PubMed, ISI, Google Scholar
    • WHO. 2003 Strategic plan for measles and congenital rubella infection in the European Region of WHO. www.euro.who.int/document/e81567.pdf. Google Scholar
    • Wichmann O., Hellenbrand W., Sagebiel D., Santibanez S., Ahlemeyer G., Vogt G., Siedler A.& Van Treech V. . 2007 Large measles outbreak at a German public school, 2006. Pediatr. Infect. Dis. J. 26, 782–786. (doi:10.1097/INF.0b013e318060aca1). Crossref, PubMed, ISI, Google Scholar
    • Wichmann O., Siedler A., Hellenbrand W., Sagebiel D., Santibanez S., Mankertz A., Vogt G., van Treeck U.& Krause G. . 2009 Further efforts needed to achieve measles elimination in Germany—results of an outbreak investigation. Bull. World Health Organ. 87, 108–115. (doi:10.2471/BLT.07.050187). Crossref, PubMed, ISI, Google Scholar
    • Yeung L. F., Lurie P., Dayan G., Eduardo E., Britz P. H., Redd S. B., Papania M. J.& Seward J. F. . 2005 A limited measles outbreak in a highly vaccinated US boarding school. Pediatrics 116, 1287–1291. (doi:10.1542/peds.2004-2718). Crossref, PubMed, ISI, Google Scholar
    Previous Article
    Next Article
    VIEW FULL TEXT DOWNLOAD PDF