Vaccinated Children Get Milder Measles Infection: A Community Study from Guinea-Bissau

Abstract

We studied the occurrence of measles in vaccinated children from an urban area of GuineaBissau where measles causes high mortality. Vaccinated children who developed measles required more-intense exposure to become infected (they had a higher ratio of secondary cases [infected in the house] to index cases [infected outside the house]), had a lower mortality among secondary cases, and were less infectious (they generated fewer secondary cases than did unvaccinated children with measles). The attack rate among vaccinated children was significantly higher in households in which someone died of measles. Both severity of infection and development of measles in vaccinated children were related to intensity of exposure. Vaccine efficacy was 72%, and 33% of cases occurred among vaccinated children; however, most mothers remained confident that vaccinated children get milder measles. Moreover, there was significantly greater vaccination coverage among younger siblings of vaccinated children who had contracted measles than among other children in the community.