Assessing age-dependent susceptibility to measles in Japan

Ryo Kinoshita; Hiroshi Nishiura

doi:10.1016/j.vaccine.2017.05.011

Assessing age-dependent susceptibility to measles in Japan

Vaccine. 2017 Jun 5;35(25):3309-3317. doi: 10.1016/j.vaccine.2017.05.011. Epub 2017 May 10.

Authors

Ryo Kinoshita¹, Hiroshi Nishiura²

Affiliations

¹ Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-9638, Japan; CREST, Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan.
² Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-9638, Japan; CREST, Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan. Electronic address: nishiurah@med.hokudai.ac.jp.

PMID: 28501456
DOI: 10.1016/j.vaccine.2017.05.011

Abstract

Background: Routine vaccination against measles in Japan started in 1978. Whereas measles elimination was verified in 2015, multiple chains of measles transmission were observed in 2016. We aimed to reconstruct the age-dependent susceptibility to measles in Japan so that future vaccination strategies can be elucidated.

Methods: An epidemiological model was used to quantify the age-dependent immune fraction using datasets of vaccination coverage and seroepidemiological survey. The second dose was interpreted in two different scenarios, i.e., booster and random shots. The effective reproduction number, the average number of secondary cases generated by a single infected individual, and the age at infection were explored using the age-dependent transmission model and the next generation matrix.

Results: While the herd immunity threshold of measles likely ranges from 90% to 95%, assuming that the basic reproductive number ranges from 10 to 20, the estimated immune fraction in Japan was below those thresholds in 2016, despite the fact that the estimates were above 80% for all ages. If the second dose completely acted as the booster shot, a proportion immune above 90% was achieved only among those aged 5years or below in 2016. Alternatively, if the second dose was randomly distributed regardless of primary vaccination status, a proportion immune over 90% was achieved among those aged below 25years. The effective reproduction number was estimated to range from 1.50 to 3.01 and from 1.50 to 3.00, respectively, for scenarios 1 and 2 in 2016; if the current vaccination schedule were continued, the reproduction number is projected to range from 1.50 to 3.01 and 1.39 to 2.78, respectively, in 2025.

Conclusion: Japan continues to be prone to imported cases of measles. Supplementary vaccination among adults aged 20-49years would be effective if the chains of transmission continue to be observed in that age group.

Keywords: Herd immunity; Mathematical model; Measles; Seroepidemiology; Vaccination coverage.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Age Factors
Child
Child, Preschool
Disease Outbreaks / prevention & control
Disease Susceptibility*
Female
Humans
Immunity, Herd
Immunization Schedule
Infant
Japan / epidemiology
Male
Measles / epidemiology*
Measles / immunology*
Measles / prevention & control*
Measles / transmission
Measles Vaccine / administration & dosage
Middle Aged
Models, Theoretical
Seroepidemiologic Studies
Vaccination
Vaccination Coverage
Young Adult

Substances

Measles Vaccine