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词条 Measles vaccine
释义

  1. Medical uses

     Schedule 

  2. Adverse effects

     Contraindications 

  3. History

  4. Types

  5. References

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}}Measles vaccine is a vaccine that prevents measles.[1] Nearly all of those who do not develop immunity after a single dose develop it after a second dose.[1] When rates of vaccination within a population are greater than 92% outbreaks of measles typically no longer occur; however, they may occur again if rates of vaccination decrease.[1] The vaccine's effectiveness lasts many years.[1] It is unclear if it becomes less effective over time.[1] The vaccine may also protect against measles if given within a couple of days after exposure to measles.[1]

The vaccine is generally safe, even for those with HIV infections.[1] Side effects are usually mild and short lived.[1] These may include pain at the site of injection or mild fever.[1] Anaphylaxis has been documented in about 3.5–10 cases per million doses.[1] Rates of Guillain–Barré syndrome, autism and inflammatory bowel disease do not appear to be increased by measles vaccination.[1]

The vaccine is available both by itself and in combinations such as the MMR vaccine (a combination with the rubella vaccine and mumps vaccine)[1] or the MMRV vaccine (a combination of MMR with the chickenpox vaccine).[2] The measles vaccine is equally effective for preventing measles in all formulations, but side effects vary depending with the combination.[1][3] The World Health Organization recommends measles vaccine be given at nine months of age in areas of the world where the disease is common, or at twelve months where the disease is not common.[1] Measles vaccine is based on a live but weakened strain of measles.[1] It comes as a dried powder which is mixed with a specific liquid before being injected either just under the skin or into a muscle.[1] Verification that the vaccine was effective can be determined by blood tests.[1]

About 85% of children globally have received this vaccine as of 2013.[4] In 2015, at least 160 countries provided two doses in their routine immunization.[5] It was first introduced in 1963.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about 0.70 USD per dose as of 2014.[8] As outbreaks easily occur in under-vaccination populations, the disease is seen as a tests of sufficient vaccination within a population.[9]

Medical uses

Before the widespread use of the vaccine, measles was so common that infection was considered "as inevitable as death and taxes."[10] In the United States, reported cases of measles fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963 (see chart at right). Increasing uptake of the vaccine following outbreaks in 1971 and 1977 brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. No more than 220 cases were reported in any year from 1997 to 2013, and the disease was believed no longer endemic in the United States.[11][12][13] In 2014, 667 cases were reported.[14]

The benefit of measles vaccination in preventing illness, disability, and death have been well documented. Within the first 20 years of being licensed in the U.S., measles vaccination prevented an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths.[15] During 1999–2004, a strategy led by the World Health Organization and UNICEF led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide.[16] The vaccine for measles has led to the near-complete elimination of the disease in the United States and other developed countries.[33] While the vaccine is made with a live virus which can cause side effects, these are far fewer and less serious than the sickness and death caused by measles itself, side effects ranging from rashes to, rarely, convulsions, occur in a small percentage of recipients.[17]

Measles is common worldwide. Although it was declared eliminated from the U.S. in 2000, high rates of vaccination and excellent communication with those who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles in the U.S.[35] Of the 66 cases of measles reported in the U.S. in 2005, slightly over half were attributable to one unvaccinated individual who acquired measles during a visit to Romania.[18] This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; 9% were hospitalized, and the cost of containing the outbreak was estimated at $167,685. A major epidemic was averted due to high rates of vaccination in the surrounding communities.[19]

The vaccine has non specific effects such as preventing respiratory infections, that may be greater than those of measles prevention alone. These benefits are greater when the vaccine is given before one year of age. A high titre vaccine resulted in worse outcomes in girls and thus is no longer recommended by the World Health Organization.[20]

Schedule

The World Health Organization recommends two doses of vaccine for all children.[1] In countries with high risk of disease the first dose should be given around nine months of age.[1] Otherwise it can be given at twelve months of age.[1] The second dose should be given at least one month after the first dose.[1] This is often done at age 15 to 18 months.[1] After one dose at the age of nine months 85% are immune, while a dose at twelve months results in 95% immunity.[6]

In the US, the CDC recommends that children aged 6 to 12 months traveling outside the United States receive their first dose of MMR vaccine.[21] Otherwise the first dose is typically given between 12–18 months. A second dose is given by 7 years (on or before last day of year 6) or by kindergarten entry.[22]

In the UK, the NHS recommendation is for a first dose at around 13 months of age and the second at 3 years and 4 months old.[23]

In Canada, Health Canada recommends that children travelling outside North America should receive an MMR vaccine if they are aged 6 to 12 months. However, after the child is 12 months old they should receive 2 additional doses to ensure long-lasting protection.[24]

Adverse effects

Adverse effects associated with the MMR vaccine include fever, rash, injection site pain and, in rare cases, red or purple discolorations on the skin known as thrombocytopenic purpura, or seizures related to fever (febrile seizure).[25][26]

Numerous studies have found no relationship between MMR vaccine and autism.[27][28][29][30]

Contraindications

  • Pregnancy: MMR vaccine and its components should not be administered to pregnant women.[31]
  • HIV-infected children may receive measles vaccines if their CD4+ lymphocyte count is greater than 15%.[32]

History

As a fellow at Children's Hospital Boston, Thomas C. Peebles worked with John Franklin Enders. Enders became known as "The Father of Modern vaccines", and Enders shared the Nobel Prize in 1954 for his research on cultivating the polio virus that led to the development of a vaccination for the disease. Switching to study measles, Enders sent Peebles to Fay School in Massachusetts, where an outbreak of the disease was under way, and there Peebles was able to isolate the virus from some of the blood samples and throat swabs he had taken from the students. Even after Enders had taken him off the study team, Peebles was able to cultivate the virus and show that the disease could be passed on to monkeys inoculated with the material he had collected.[33] Enders was able to use the cultivated virus to develop a measles vaccine in 1963 based on the material isolated by Peebles.[34] In the late 1950s and early 1960s, nearly twice as many children died from measles as from polio.[35] The vaccine Enders developed was based on the Edmonston strain of attenuated live measles virus, which was named for the Fay student from whom Peebles had taken the culture that led to the virus's cultivation.[36]

In the mid-20th century, measles was particularly devastating in West Africa, where child mortality rates were 50 percent before age 5, and the children were struck with the type of rash and other symptoms common prior to 1900 in England and other countries. The first trial of a live attenuated measles vaccine was undertaken in 1960 by David Morley in a village near Ilesha, Nigeria; in case he could be accused of exploiting the Nigerian population, Morley included his own four children in the study. The encouraging results led to a second study of about 450 children in the village and at the Wesley Guild Hospital in Ilesha. Following another epidemic, a larger trial was undertaken in September and October 1962 in New York City with the assistance of the World Health Organization: 131 children received the live Enders attenuated Edmonston B strain plus gamma globulin, 130 children received a "further attenuated" vaccine without gamma globulin, and 173 children acted as control subjects for both groups. As also shown in the Nigerian trial, the trial confirmed that the "further attenuated" vaccine was superior to the Edmonston B vaccine, and caused significantly fewer instances of fever and diarrhea. The successful results led to 2,000 children in the area being vaccinated.[37][38]

Maurice Hilleman at Merck & Co., a pioneer in the development of vaccinations, developed the MMR vaccine in 1971, which treats measles, mumps and rubella in a single shot followed by a booster.[17][39] One form is called "Attenuvax".[40] The measles component of the MMR vaccine uses Attenuvax,{{cn|date=April 2018|reason=A reference is needed showing that the MMR vaccine used Attenuvax at some past point.}}{{update inline|date=April 2018|reason=This needs updating in light of the subsequent sentence stating that Attenuvax was discontinued in 2009. (Unless the discontinuation was itself reconsidered, in which case the subsequent sentence should be updated.)}} which is grown in a chick embryo cell culture using the Enders' attenuated Edmonston strain.{{cn|date=April 2018}} Merck decided not to resume production of Attenuvax on October 21, 2009.[41]

Types

Measles is seldom given as an individual vaccine and is often given in combination with rubella, mumps, or varicella.

  • Measles vaccine (standalone vaccine)
  • Measles rubella vaccine (MR vaccine)
  • Mumps measles rubella vaccine, live (MMR vaccine)
  • Mumps measles rubella and varicella virus vaccine (MMRV vaccine)
{{-}}

References

1. ^1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 {{cite journal |last1=World Health Organization |title=Measles vaccines: WHO position paper – April 2017 |journal=Weekly Epidemiological Record |date=28 April 2017 |volume=No 17, 2017, 92 |pages=205–22 8|url=http://apps.who.int/iris/bitstream/10665/255149/1/WER9217.pdf?ua=1 |language=English, French |deadurl=no |archiveurl=https://web.archive.org/web/20170908135232/http://apps.who.int/iris/bitstream/10665/255149/1/WER9217.pdf?ua=1 |archivedate=8 September 2017}}
2. ^{{cite book |last1=Mitchell |first1=Deborah |title=The essential guide to children's vaccines |date=2013 |publisher=St. Martin's Press |location=New York |isbn=9781466827509 |page=127 |url=https://books.google.com/books?id=w0C7L9o3m-MC&pg=PA127 |deadurl=no |archiveurl=https://web.archive.org/web/20170908135232/https://books.google.com/books?id=w0C7L9o3m-MC&pg=PA127 |archivedate=9 September 2017}}
3. ^{{cite web |title=Information Sheet Observed Rate of Vaccine Reactions |url=http://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf?ua=1 |website=WHO |accessdate=1 December 2018}}
4. ^{{cite web|title=Measles Fact sheet N°286|url=http://www.who.int/mediacentre/factsheets/fs286/en/|website=who.int|accessdate=4 February 2015|date=November 2014|deadurl=no|archiveurl=https://web.archive.org/web/20150203144905/http://www.who.int/mediacentre/factsheets/fs286/en/|archivedate=3 February 2015|df=}}
5. ^{{Cite web |url=http://www.who.int/mediacentre/factsheets/fs378/en/ |title=Immunization coverage |website=World Health Organization |access-date=12 July 2017 |deadurl=no |archiveurl=https://web.archive.org/web/20170713161900/http://www.who.int/mediacentre/factsheets/fs378/en/ |archivedate=13 July 2017}}
6. ^1 {{cite book |author=Centers for Disease Control and Prevention |title=CDC health information for international travel 2014 the yellow book |date=2014 |isbn=9780199948505 |page=250 |url=https://books.google.com/books?id=nVppAgAAQBAJ&pg=PA250 |deadurl=no |archiveurl=https://web.archive.org/web/20170908135232/https://books.google.com/books?id=nVppAgAAQBAJ&pg=PA250 |archivedate=9 September 2017}}
7. ^{{cite web|title=WHO Model List of Essential Medicines (19th List)|url=http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|work=World Health Organization|accessdate=8 December 2016|date=April 2015|deadurl=no|archiveurl=https://web.archive.org/web/20161213052708/http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|archivedate=13 December 2016|df=}}
8. ^{{cite web|title=Vaccine, Measles|url=http://mshpriceguide.org/en/single-drug-information/?DMFId=793&searchYear=2014|website=International Drug Price Indicator Guide|accessdate=6 December 2015}}
9. ^{{cite book |last1=Abramson |first1=Brian |title=Vaccine, vaccination, and immunization law |date=2018 |publisher=Bloomberg Law |isbn=9781682675830 |pages=10–30}}
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11. ^Centers for Disease Control and Prevention [https://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm Summary of notifable diseases—United States, 1993] {{webarchive |url=https://web.archive.org/web/20100309075517/http://www.cdc.gov/mmwr/preview/mmwrhtml/00035381.htm |date=9 March 2010}} Published October 21, 1994 for Morbidity and Mortality Weekly Report 1993; 42 (No. 53)
12. ^Centers for Disease Control and Prevention [https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5653a1.htm Summary of notifable diseases—United States, 2007] {{webarchive |url=https://web.archive.org/web/20100309080727/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5653a1.htm |date=9 March 2010}} Published July 9, 2009 for Morbidity and Mortality Weekly Report 2007; 56 (No. 53)
13. ^Centers for Disease Control and Prevention. [https://www.cdc.gov/vaccines/pubs/pinkbook/default.htm Epidemiology and Prevention of Vaccine-Preventable Diseases] {{webarchive |url=https://web.archive.org/web/20110410074626/http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm |date=10 April 2011}}. Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. 11th ed. Washington DC: Public Health Foundation, 2009
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15. ^{{cite journal |vauthors=Bloch AB, Orenstein WA, Stetler HC, etal |title=Health impact of measles vaccination in the United States |journal=Pediatrics |volume=76 |issue=4 |pages=524–32 |year=1985 |pmid=3931045}}
16. ^{{cite journal |journal=MMWR Morb Mortal Wkly Rep |year=2006 |volume=55 |issue=9 |pages=247–9 |title=Progress in reducing global measles deaths, 1999–2004 |author=Centers for Disease Control and Prevention (CDC) |pmid=16528234 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5509a8.htm |deadurl=no |archiveurl=https://web.archive.org/web/20071016143014/http://cdc.gov/mmwr/preview/mmwrhtml/mm5509a8.htm |archivedate=16 October 2007}}
17. ^1 Collins, Huntly. "The Man Who Saved Your Life - Maurice R. Hilleman - Developer of Vaccines for Mumps and Pandemic Flu: Maurice Hilleman's Vaccines Prevent Millions of Deaths Every Year" {{webarchive |url=https://web.archive.org/web/20090306224906/http://www.njabr.org/njsor/science_superstars/maurice_hilleman/ |date=6 March 2009}}{{dead link|date=November 2017}}, copy of article from The Philadelphia Inquirer, August 30, 1999. Accessed August 4, 2010.
18. ^{{cite journal |journal=MMWR Morb Mortal Wkly Rep |year=2006 |volume=55 |issue=50 |pages=1348–51 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm |title=Measles—United States, 2005 |author=Centers for Disease Control and Prevention (CDC) |pmid=17183226 |deadurl=no |archiveurl=https://web.archive.org/web/20150313120119/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm |archivedate=13 March 2015}}
19. ^1 {{cite journal |vauthors=Parker AA, Staggs W, Dayan GH, etal |title=Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States |journal=N Engl J Med |volume=355 |issue=5 |pages=447–55 |year=2006 |pmid=16885548 |doi=10.1056/NEJMoa060775}}
20. ^1 2 {{cite journal |vauthors=Sankoh O, Welaga P, Debpuur C, Zandoh C, Gyaase S, Poma MA, Mutua MK, Hanifi SM, Martins C, Nebie E, Kagoné M, Emina JB, Aaby P |title=The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems |journal=Int J Epidemiol |volume=43 |issue=3 |pages=645–53 |year=2014 |pmid=24920644 |pmc=4052142 |doi=10.1093/ije/dyu101 |url=}}
21. ^{{cite web|title=Measles and the Vaccine (Shot) to Prevent It|url=https://www.cdc.gov/vaccines/vpd-vac/measles/fs-parents.html|publisher=Centers for Disease Control|accessdate=24 January 2015|deadurl=no|archiveurl=https://web.archive.org/web/20150120072249/http://www.cdc.gov/vaccines/vpd-vac/measles/fs-parents.html|archivedate=20 January 2015|df=}}
22. ^Washington Stat Dept of Health
23. ^{{cite web |title=Measles |url=https://www.nhs.uk/conditions/measles/ |website=National Health Service UK |accessdate=11 March 2019 |date=20 October 2017}}
24. ^{{Cite web |url=https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html |title=Measles vaccine: Canadian immunization guide |date=18 July 2007 |website=Public Health Agency of Canada |access-date=13 March 2019}}
25. ^https://www.who.int/vaccine_safety/initiative/tools/MMR_vaccine_rates_information_sheet.pdf
26. ^{{cite journal |vauthors=Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C |title=Vaccines for measles, mumps and rubella in children |journal=Cochrane Database Syst Rev |volume=2 |issue= 2|pages=CD004407 |year=2012 |pmid=22336803 |doi=10.1002/14651858.CD004407.pub3 |url=}}
27. ^https://www.nap.edu/read/13164/chapter/6#152
28. ^{{cite web |url=http://cdc.gov/vaccinesafety/concerns/mmr_autism_factsheet.htm |title= Measles, mumps, and rubella (MMR) vaccine |date=22 August 2008 |accessdate=21 December 2008 |publisher= Centers for Disease Control and Prevention |archiveurl= https://web.archive.org/web/20081008040738/http://www.cdc.gov/vaccinesafety/concerns/mmr_autism_factsheet.htm |archivedate=9 October 2008}}
29. ^Immunization Safety Review: Vaccines and Autism {{webarchive |url=https://web.archive.org/web/20070623134938/http://www.iom.edu/CMS/3793/4705/20155.aspx |date=23 June 2007}}. From the Institute of Medicine of the National Academy of Sciences. Report dated 17 May 2004; accessed 13 June 2007.
30. ^{{cite journal |vauthors=Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C |title=Vaccines for measles, mumps and rubella in children |journal=Cochrane Database Syst Rev |volume=2 |page=CD004407 |year=2012 |pmid=22336803 |doi=10.1002/14651858.CD004407.pub3}}
31. ^[https://www.cdc.gov/vaccines/pubs/preg-guide.htm Guidelines for Vaccinating Pregnant Women] {{webarchive |url=https://web.archive.org/web/20141028092143/http://www.cdc.gov/vaccines/pubs/preg-guide.htm |date=28 October 2014}}
32. ^[https://www.cdc.gov/vaccines/recs/vac-admin/contraindications-vacc.htm Chart of Contraindications and Precautions to Commonly Used Vaccines] {{webarchive |url=https://web.archive.org/web/20141204085601/http://www.cdc.gov/vaccines/recs/vac-admin/contraindications-vacc.htm |date=4 December 2014}}
33. ^1 Martin, Douglas. [https://www.nytimes.com/2010/08/05/health/05peebles.html "Dr. Thomas C. Peebles, Who Identified Measles Virus, Dies at 89"] {{webarchive |url=https://web.archive.org/web/20170213090951/http://www.nytimes.com/2010/08/05/health/05peebles.html |date=13 February 2017}}, The New York Times, 4 August 2010. Accessed 3 August 2010.
34. ^Staff. [https://pqasb.pqarchiver.com/courant/access/917283942.html?dids=917283942:917283942&FMT=ABS&FMTS=ABS:AI&type=historic&date=Mar+22%2C+1963&author=&pub=Hartford+Courant&desc=Work+by+Enders+Brings+Measles+Vaccine+License&pqatl=google "Work by Enders Brings Measles Vaccine License"] {{webarchive |url=https://web.archive.org/web/20121103111429/http://pqasb.pqarchiver.com/courant/access/917283942.html?dids=917283942%3A917283942&FMT=ABS&FMTS=ABS%3AAI&type=historic&date=Mar+22%2C+1963&author=&pub=Hartford+Courant&desc=Work+by+Enders+Brings+Measles+Vaccine+License&pqatl=google |date=3 November 2012}}, The Hartford Courant, 22 March 1963. Accessed 4 August 2010. "A strain of measles virus isolated in 1954 by Dr. Thomas C. Peebles, instructor in pediatrics at Harvard, and Enders, formed the basis for the development of the present vaccine".
35. ^Staff. [https://select.nytimes.com/gst/abstract.html?res=FB0F16FB3F581A7B93CAAB1788D85F478685F9 "The Measles Vaccine"] {{webarchive|url=https://web.archive.org/web/20140219101310/http://select.nytimes.com/gst/abstract.html?res=FB0F16FB3F581A7B93CAAB1788D85F478685F9 |date=19 February 2014}}, The New York Times, 26 March 1963. Accessed 4 August 2010.
36. ^Hilleman, Maurice R. "Past, Present, and Future of Measles, Mumps, and Rubella Virus Vaccines", Pediatrics (journal), Vol. 90 No. 1. July 1992, pp. 149–153. Accessed 4 August 2010.
37. ^{{cite journal|last1=Morley|first1=David. C.|title=Measles and Measles Vaccination in an African Village|journal=Bulletin of the World Health Organization|date=1964|volume=30|pages=733–739|pmc=2554995|pmid=14196817}}
38. ^{{cite news|last=Pritchard|first=John|title=Obituary: Dr C. A. Pearson|url=https://www.independent.co.uk/news/obituaries/obituary-dr-c-a-pearson-1293756.html|accessdate=29 January 2014|newspaper=The Independent|date=13 November 1997|deadurl=no|archiveurl=https://web.archive.org/web/20140224220736/http://www.independent.co.uk/news/obituaries/obituary-dr-c-a-pearson-1293756.html|archivedate=24 February 2014|df=}}
39. ^{{cite news |url=https://www.washingtonpost.com/wp-dyn/articles/A48244-2005Apr12.html |title=Maurice R. Hilleman Dies; Created Vaccines (washingtonpost.com) |work=The Washington Post |accessdate=21 July 2009 |first=Patricia |last=Sullivan |date=13 April 2005 |deadurl=no |archiveurl=https://web.archive.org/web/20121020102622/http://www.washingtonpost.com/wp-dyn/articles/A48244-2005Apr12.html |archivedate=20 October 2012}}
40. ^{{cite journal |vauthors=Ovsyannikova IG, Johnson KL, Naylor S, Poland GA |title=Identification of HLA-DRB1-bound self-peptides following measles virus infection |journal=J. Immunol. Methods |volume=297 |issue=1–2 |pages=153–67 |date=February 2005 |pmid=15777939 |doi=10.1016/j.jim.2004.12.020 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-1759(05)00014-1}}
41. ^[https://www.cdc.gov/vaccines/vac-gen/shortages/mmr-faq-12-17-08.htm Q & As about Monovalent M-M-R Vaccines] {{webarchive |url=https://web.archive.org/web/20120515090920/http://www.cdc.gov/vaccines/vac-gen/shortages/mmr-faq-12-17-08.htm |date=15 May 2012}}
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