Measles immunization

Measles Immune globulin (IM) Normal hosts 0.25 mL/kg IM. Postexposure prophylaxis (within 6 days after exposure) in nonimmune contacts of acute cases. 

Measles giant-cell pneumonia after measles immunization has been described in a 21-year-old man with AIDS (13). 

Taking into consideration the long interval between measles immunization and pneumonia, the causal relation in this case was doubtful. 

Claims that cases of encephalopathy followed by permanent brain injury or death were due to measles immunization, submitted to the US National Vaccine Injury Compensation Program, have been reviewed (SED-13, 920) (18). A total of 403 claims of encephalopathy and/or seizure disorders after measles, measles-rubella, measles-mumps-rubella, mumps, or rubella immunization were identified during the period 1970-93. The medical records of these cases were reviewed by physicians in the compensation program to determine, if possible, the cause of injury and the classification of the findings. The inclusion criteria established by the compensation program were met by... 

The 1994 report of the Institute of Medicine concluded that the evidence was inadequate to accept or reject a causal relation between MMR and encephalopathy, and it is known that the incidence of encephalitis after measles immunization of healthy children tends to be lower than the observed incidence of encephalitis of unknown cause. Two large studies have been negative. In a study analogous to the British Childhood Encephalopathy Study there were no increased risks of either encephalopathy or neurological sequelae after measles immunization (19). A retrospective case-control study through the CDC Vaccine Safety DataUnk assessing the risk for 300 000 doses of MMR found not a single case of encephalitis/ encephalopathy within 30 days of the administration of MMR (20). In contrast, the review mentioned above (18) reported an association between measles vaccine and encephalopathy. However, the conclusion of the report of the Institute of Medicine is still valid, namely that evidence is stiU inadequate to accept or reject a causal relation between measles vaccine and these diseases. 

After the publication of the Institute of Medicine report, a literature search for adverse events after measles immunization, limited to publications published in 1994— 98, unearthed a considerable amount of data that strengthened the rare association of measles-containing vaccines with postinfectious encephalomyelitis (6). The report has also been criticized as an attempt to establish an adverse event of a vaccine, without a specific laboratory... 

Anemia has been reported after measles immunization... 

In an international case-control study of 499 patients with chronic inflammatory bowel disease and 998 control patients from nine countries, there was no difference in the risk of inflammatory bowel disease in association with either natural measles or measles immunization (112). 

An 11-month-old boy developed hypertrichosis at the injection site (2.5 x 3 cm) 1 month after measles immunization (115). The hypertrichosis and induration persisted during the follow-up period of 3 months. 

It has been suggested that hydrolysed gelatin, rather than egg protein, is responsible for most episodes of anaphylaxis after measles immunization (6). Egg allergy should no longer be a contraindication to measles immunization. However, a previous anaphylactic reaction to measles or MMR vaccine remains a contraindication. 

Originally, the Committee on Infectious Diseases of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices (ACIP) recommended that severely immunocompromised patients with HIV infection should not receive measles vaccine (139). However, in 1988, recognizing the severity of measles in immunodeficient individuals, it revised its measles immunization guidelines and recommended that... 

Knudsen KM, Aaby P, Whittle H, Rowe M, Samb B, Simondon F, Sterne J, Fine P. Child mortality following standard, medium or high titre measles immunization in West Africa. Int J Epidemiol 1996 25(3) 665-73. 

American Academy of Pediatrics Committee on Infectious Diseases. Personal and family history of seizures and measles immunization. Pediatrics 1987 80(5) 741-2. 

Ozkan H, Dundar NO, Ozkan S, Kumral A, Duman N, Gulcan H. Hypertrichosis following measles immunization. Pediatr Dermatol 2001 18(5) 457-8. 

Giampietro PG, Bruno G, Grandolfo M, Businco L. Adverse reaction to measles immunization. Eur J Pediatr 1993 152(1) 80. 

The risks of adverse effects after immnnization against diphtheria, pertussis, tetanus, pohomyehtis, measles, and tuberculosis have been discussed in the framework of the WHO Expanded Program on Immunization and compared with the complication rate following natural disease (40). Table 8 presents a comparison of the estimated risks of adverse reactions after DTP immunization with the complication rates of natural whooping cough, while Table 9 shows a similar comparison for measles immunization and natural measles. The authors concluded that no vaccine is without adverse effects, but that the risks of serious complications from vaccines used in WHO s Expanded Program on Immunization are much lower than the risks from the natural disease. 

Table 9 A comparison of the estimated risks of adverse reactions after measles immunization with the complication rates of natural measles...

Webster DE, Cooney ML, Huang Z, et al. Successful boosting of a DNA measles immunization with an oral plant-derived measles virus vaccine. ). Virol., 2002 76(15) 7910-7912. 

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