Wednesday, 7th of September 2011 |
Pierre Loulergue,1 Jean-Paul Guthmann,1 Laure Fonteneau, Jean-Baptiste Armengaud, Daniel Levy-Brühl, and Odile Launay
Author affiliations: Assistance Publique Hôpitaux de Paris, Paris, France (P. Loulergue, J.-B. Armengaud, O. Launay); and Institut de Veille Sanitaire, Saint-Maurice, France (J.-P. Guthmann, L. Fonteneau, D. Levy-Brühl)
Suggested citation for this article
To the Editor: A measles epidemic is currently occurring in several countries in Europe (1,2). Although most cases concern unvaccinated children and young adults, health care professionals (HCPs) are also affected. Cases occur mostly in unvaccinated persons, but also in those who have received a single dose of vaccine.
In France, the measles vaccine was introduced in the childhood-immunization schedule in 1983. Current guidelines recommend 2 doses: one at 12 months of age and the second between 13 and 24 months of age. For persons born after 1992, one catch-up dose is recommended (3). Coverage by >1 dose, by the age of 2 years, remained at 83%–87% during 1997–2005. The latest figures show a slight increase to 90% in 2007 (4).
The risk for measles in HCPs has been estimated as 13× higher than that for the general population (5) and is also higher among students (6). Vaccination against measles is recommended, not mandatory, for HCPs and health care students (HCSs) (medicine, nursing, and midwifery) who have no history of measles. The objective is to prevent transmission to a nonimmunized patient or another HCP, and from patients to susceptible HCPs. HCSs are in close and repeated contact with patients and therefore targeted by the recommendations. We conducted a cross-sectional survey in the university hospitals in Paris, France, to assess measles vaccination coverage in HCSs.
The sampling frame included 15 hospitals with an obstetrics department. All midwifery students were selected. Other students were selected through a multistage random sampling. Sampling units were selected at each stage by simple random sampling. We selected 10 hospitals at the first stage, 10 clinical wards by hospital at the second stage, and all nursing students and half the medical students by ward at the third stage. A total of 116 students were required from each profession to estimate 50% coverage with 10% precision.
Students gave oral informed consent. Information was collected by face-to-face interview. Vaccination-status was assessed from a document when available. Measles vaccination coverage was defined as the number of students with no history of measles who had received >1 dose of vaccine divided by the total number of students with no history of measles. The study was approved by the French Ethics Board and conducted from March 2009 through July 2009.
Of the 106 selected wards, 10 could not be included (clearance from the head of department was not given). Of the 488 selected students, 432 were enrolled in the study (participation rate 88.5%); 178 (41%) were medical students, 147 (34%) nursing students, and 107 (25%) midwifery students. A document confirming the student's vaccination status was available for 376 (87%) students; 38 (10.1%) had a history of measles (removed from analysis). Median age was 22 years (interquartile range 21–24 years); 74% were female. Measles vaccination was cited by 61.5% (95% confidence interval [CI] 50.0%–71.9%) as a recommended vaccination. Measles vaccination coverage was 79.3% (95% CI 71.0%–75.8%) for >1 dose and 49.6% (95% CI 40.3%–59.1%) for 2 doses (Table). When considering only the students’ accounts (without written confirmation), 1- and 2-dose vaccination coverage was 93.3% (95% CI 88.0%–96.3%) and 83.6% (95% CI 68.0%–92.4%), respectively. In multivariate analysis, younger students (<22 years of age) were more likely to have had 1 dose than older students (p<0.001).
In the context of measles epidemics affecting France, and considering that the World Health Organization recommends 95% coverage of the population with 2 doses of a measles vaccine, our study shows insufficient coverage among students currently being trained as HCPs in university hospitals within the Paris area. Thus, all unvaccinated students (20.7%) and ≈5% of the 50% who have received 1 dose could be susceptible to measles. Moreover, a rather low proportion of students knew that measles vaccination was recommended, as described for HCPs (7), which may explain the insufficient coverage.
In France, this situation has resulted in several measles outbreaks within hospitals in recent years (8). Particular efforts should be made in certain units, such as pediatrics, because an early waning of maternal antibodies has been demonstrated (9). Measures should be taken to reinforce the vaccination policy in this well-defined group; information can be obtained and follow-up vaccinations can be provided easily during their training period. A mandatory health check could contribute to increasing the vaccination coverage (10).
Our study provides original data for measles vaccination coverage in HCSs in France. A similar conclusion applies to HCS-recommended vaccines for which we found insufficient coverage (<50% had received a pertussis booster in the past 15 years and only 6/27 without a history of varicella have been vaccinated against varicella). Such evaluations should be performed regularly. Although our data were collected from a representative sample of students in Paris, it is likely that the situation is qualitatively similar in other regions and therefore could contribute to future nosocomial epidemics. Mandatory vaccination of HCPs against vaccine-preventable diseases protects not only the HCP and his/her family, but also protects the patient. Increased vaccination of this group should contribute to a better control of measles outbreaks in France.
Loulergue P, Guthmann J-P, Fonteneau L, Armengaud J-B, Levy-Brühl D, Launay O. Susceptibility of health care students to measles, Paris, France [letter]. Emerg Infect Dis [serial on the Internet]. 2011 Sep [date cited]. http://www.cdc.gov/EID/content/17/9/110141.htm
Assessment of Immune Status Against Measles, Mum ...
Assessment of Immune Status Against Measles, Mumps, and Rubella in Young Kuwaitis: MMR Vaccine Efficacy. Madi N, Altawalah H, Alfouzan W ...2017 M&RI Partners Meeting Presentations
The global Measles and Rubella Initiative meeting was held in Washington DC on 7th and 8th Sept. 2017. The meeting which was hosted by American Red Cr ...STORIES OF LIFE IN A CHANGING WORLD Scientists Cr ...
STORIES OF LIFE IN A CHANGING WORLD Scientists Crack a 50-Year-Old Mystery about the Measles Vaccine Worth a little pain? Back in 1990 a school bo ...20 most consulted measles and rubella articles in ...
Dear AllToday we share a review of the year 2016 regarding measles and rubella items posted on our web page. We shared articles on topics ranging from ...Region of the Americas is declared free of measles ...
More information on this great milestone can be found on url link belowhttp://www.paho.org/hq/index.php?option=com_content&view=article&id=125 ...Progress Toward Regional Measles Elimination — W ...
Progress Toward Regional Measles Elimination — Worldwide, 2000–2014 Morbidity and Mortality Weekly Report Best read, with ta ...Health Equity Initiative, New York, NY, 25-26 Febr ...
Health Equity Initiative, Summit, NYC, 25-26 February 2016 For details, consult http://www.healthequityinitiative.org/hei/programs/summit/REQUEST FOR PROPOSAL: MEASLES VACCINATION UNDER 9 ...
1 REQUEST FOR PROPOSAL: Measles Vaccination Under 9 Months of Age APPLICATION SUBMISSION DATE: January 26, 2015 1. In ...CARTOON CHARACTERS JOIN THE FIGHT AGAINST MEASLES
[source] Measles and Rubella Initiative[|source]Thanks to reader Jane Wachira for pointing out the following weblink. Measles eradication consists not ...I LOVE/HATE THIS GLOBAL VACCINATION COVERAGE GRAPH ...
[source]Rosling s FactPod[|source]This video from Hans Rosling explaining what he loves with global measles vaccination coverage trends namely rapid i ...POWER POINT PRESENTATIONS FROM THE 13TH ANNUAL ADV ...
[source]Measles and Rubella Initiative[|source]The Measles and Rubella Initiative has spent much effort fighting for its cause by means of widespread ...CALLING THE SHOTS
[source]PBS Network[|source]"VACCINES -- CALLING THE SHOTS" This TV program, broadcast on the PBS network, looks at the commonest arguments by anti-v ...COMBATING HEALTHCARE CORRUPTION AND FRAUD WITH IMP ...
[source]BMC International Health and Human Rights[|source]Corruption is a serious threat to global health outcomes, leading to financial waste and adv ...CORRUPTION KILLS: ESTIMATING THE GLOBAL IMPACT OF ...
[source]PLoS One[|source]Many countries still have high levels of child mortality, particularly in sub-Saharan Africa and South Asia, and in recent ye ...READY OR NOT: RESPONDING TO MEASLES IN THE POSTELI ...
[source]Annals of Internal Medicine[|source]Opnion Paper Although endemic measles was eliminated in the United States in 2000, two concurrent measle ...RUBELLA AND CONGENITAL RUBELLA SYNDROME CONTROL AN ...
[source]Morbidity and Mortality Weekly Report (MMWR)[|source]In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy f ...PROGRESS TOWARDS MEASLES ELIMINATION – EASTERN M ...
[source]Weekly Epidemiological Record (WER)[|source]During the period 2008–2012, regional progress towards measles elimination stagnated, and th ...THE IMMUNIZATION PROGRAMME THAT SAVED MILLIONS OF ...
[source]Bulletin of the WHO[|source]In the world vaccination week, the Bulletin of the World Health Organization outlines the history, status and impa ...HEALTH SYSTEM COST OF DELIVERING ROUTINE VACCINATI ...
[source]Bulletin of the WHO[|source]On the eve of the 40th anniversary of launching of the Expanded Programme on Immunization (EPI) in 1974, during th ...World Immunization Week
[source]WHO/IVB Publication[|source]Never miss another jab, The slogan for World Immunization Week 2014 is “Immunize for a healthy future: Know ...Measles: know the risks, check your status, protec ...
[source]WHO/IVB Publication[|source]Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles ...THE RIGHTS OF THE UNVACCINATED CHILD: THE LEGAL FR ...
[source]Los Angeles Times[|source]In light of what s starting to look like a surge of measles cases spread by unvaccinated carriers, Hasting ...Consultants: Measles and rubella control/eliminati ...
[source]Technical Network for Strengthening EPI[|source]Announcement solicits interest from potential candidates to act as consultants for WHO through ...PUBLIC HEALTH OFFICIALS MARK 50TH YEAR OF MEASLES ...
[source]Journal of American Medical Association[|source]Until the 1960s, measles was a rite of passage for US children; nearly all had the disease bef ...THE TOLL OF THE ANTI-VACCINATION MOVEMENT, IN ONE ...
[source]Los Angelos Times[|source]Aaron Carroll today offers a graphic depiction of the toll of the anti-vaccination movement. It comes from a Council ...“Can we use $30 of the taxes you’re already pa ...
[source]Annual Letter of BMGF[|source]If you were asked this question today, what answer would you give? Bill and Melinda Gates ask, "Would you check ...REACHING HARD-TO-REACH INDIVIDUALS: NONSELECTIVE V ...
[source]American Journal of Epidemiology[|source]Source: American Journal of Epidemiology The World Health Organization guidelines for response to me ...Rubella and Congenital rubella syndrome control an ...
[source]Weekly Epidemiological Record (WER)[|source]Full text record of Rubella and CRS control/elimination are available at http://www.who.int/wer/20 ...Measles Press Conference at CDC: 50th Anniversary ...
[source]CDC Media Release, 5th Dec[|source]Full text, video and question and answer session for journalists all avalable at http://www.cdc.gov/media/r ...A bibliometric analysis of childhood immunization ...
[source]BMC Medicine[|source]During the past four decades national EPI programs have developed or adapted and implemented a broad range of strategies ...Lessons from the tragic measles outbreak in Samoa
Monday, 9th of March 2020 |
Characterisation of diversity of measles viruses in India: genomic sequencing and comparative genomics studies.
Monday, 9th of March 2020 |
The elimination of measles in Iran
Monday, 9th of March 2020 |
Measles-containing vaccines in Brazil: Coverage,
Monday, 9th of March 2020 |
Measles-containing vaccines in Brazil: Coverage, homogeneity of coverage and associations with contextual factors at municipal level.
Monday, 9th of March 2020 |
Website Views |
47313738 |