Administration Route and WHO Perspective on Measles Vaccine

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Immunization and Vaccination

Measles Vaccine

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MEASLES - VACCINE - LATEST UPDATES

Measles Vaccine & Vitamin A: Few studies have demonstrated immune enhancing effects of Vitamin A supplementation along with measles vaccine. But to the contrary a randomized control trial from Vellore failed to demonstrate the immune augmenting effect of Vitamin A supplementation.

Edible measles vaccine! Vaccine induced immunity against measles is less robust than natural immunity. Waning of immunity by time may eventually require a revaccination of adults. Recently measles antigens expressing plants have been developed which were found to be antigenic and immunogenic both after invasive and oral vaccination. Maybe some day we may find measles vaccine on breakfast table!

Advances in route of administration: Recently intranasal administration of measles vaccine was found to be no less effective than subcutaneous route. It induces generalized immune response and formation of anti-measles IgA in nasopharyngeal mucosa, and safer than inhalation method which involves exposure of the bronchial mucosa to the live measles virus. It was proposed that adding appropriate adjuvant could increase efficiency of mucosal measles vaccination.

Development of DNA vaccine against measles is underway with advantage of giving them to newborn infants also

WHO perspective on measles vaccination:
1. A dose of measles vaccine should be given to a very high proportion of infants at 9 months of age or shortly thereafter through routine immunization services.
2. All children should have a second opportunity to receive measles vaccine in order to increase the measles vaccinees that receive at least one dose and also in helping to assure measles immunity in previously vaccinated children who failed to develop such immunity.

Vitamin A and malnutrition: To improve overall health of the child, measles vaccination should be used as an opportunity to provide supplementary doses of vitamin A in areas where deficiency of vitamin A in prevalent. It can be supplemented during routine measles vaccination (at 9 months of age), national immunization days or during supplementary measles campaigns. It is vital that measles case, whether isolated or in outbreaks receive vitamin A supplementation as part of the measles treatment.

References :-

Cherian T, Varkki S, Raghupathy P et al. Effect of Vitamin A supplementation on the immune response to measles vaccination. Vaccine 2003;21(19-20):2418-20.
Muller CP, Fack F, Damien B et al. Immunogenic measles antigens expressed in plants: role as an edible vaccine for adults. Vaccine 2003;21(7-8):816-9.
Liashchenko VA, Iuminova NV. Intranasal vaccination with live measles vaccines within the framework of measles eradication strategy. Vopr Virusol 2002;47(3):7-10.
Premenko-Lanier M, Rota P et al. Prior DNA vaccination does not interfere with the live-attenuated measles vaccine. Vaccine 2004;22(5-6):762-5.
Core information for the development of Immunization Policy. WHO- Vaccines and Biologicals. 2002 Update

Last Updated on 05-11-2004 Courtesy Pediatric Oncall

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