Effectiveness assessment of vaccination policy against measles epidemic in Japan using an age―time two-dimensional mathematical model

In 2007, measles prevailed among the youth and young adult population in Japan, creating in a serious social problem. Among the developed countries, Japan has a relatively high incidence of measles. The objective of this study was to assess the effect of improvements in the vaccination policy agains...

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Bibliographic Details
Published in:Environmental health and preventive medicine 2012-01, Vol.17 (1), p.34-43
Main Authors: MAITANI, Yusuke, ISHIKAWA, Hirofumi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Age composition
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Child
Child, Preschool
Computer Simulation
developed countries
Disease Outbreaks - prevention & control
Disease transmission
Effectiveness studies
Environmental health
Epidemics
Health care policy
Health Policy
Human viral diseases
Humans
Immunity
immunization
Infant
Infants
Infection
Infectious diseases
Japan - epidemiology
Maintenance
Mathematical models
Measles
Measles - prevention & control
Measles - transmission
Measles-Mumps-Rubella Vaccine - administration & dosage
Measles-Mumps-Rubella Vaccine - immunology
Medical sciences
Middle Aged
Models, Biological
outbreaks
Regular
Risk factors
Simulation
social conditions
Time Factors
Vaccination
Vaccines
Viral diseases
Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
Young Adult
young adults
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Summary:In 2007, measles prevailed among the youth and young adult population in Japan, creating in a serious social problem. Among the developed countries, Japan has a relatively high incidence of measles. The objective of this study was to assess the effect of improvements in the vaccination policy against measles through simulations. We developed an age-time two-dimensional model for the transmission of measles to reflect an age structure, enabling contact rate to be selected by age. Introduction of the maternal immunity class into the model allowed natural infection and vaccination to be discriminated along the course of an infant's mother acquiring the immunity, thereby resulting in an improved accuracy of the simulations in infants. Several vaccination scenarios were attempted in order to assess the influence of various vaccination policies on the prevention of a measles epidemic. The results of this quantitative study indicated that suppression of a measles outbreak requires the maintenance of high vaccine coverage and that a decline in vaccine coverage may result in a measles epidemic. The present standard immunization program for measles will maintain an acceptable level of immunity and is therefore associated with a low risk of an epidemic after discontinuation of the third and fourth stages as scheduled--as long as at least 90% vaccine coverage of the first and second is maintained. The simulation results show that discontinuation of the third and fourth stages of vaccination as scheduled should be accompanied by endeavors to maintain appropriate high vaccine coverage of the first and second stages.
ISSN:1342-078X
1347-4715
DOI:10.1007/s12199-011-0217-y