Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, New York, USA.
New York University Grossman School of Medicine, New York, New York, USA.
J Pediatric Infect Dis Soc. 2022 Jul 21;11(7):322-328. doi: 10.1093/jpids/piac026.
In 2018-2019, large outbreaks of measles occurred in Israel and in New York City, driven in part by travel of unimmunized children between the 2 communities.
A retrospective chart review was conducted for children tested for measles (March 2018-September 2019) at NYU Langone Health in New York, NY, and in Ramla subdistrict, Israel. Vaccination records were reviewed to determine vaccination status for measles, mumps, and rubella (MMR) at the time of measles testing and 1-year post-testing.
A total of 264 children were tested for measles, and 102 (38.6%) had confirmed measles. Only 20 (19.6%) of measles-positive cases received a full 2-dose course of vitamin A. 82.4% of children with measles were ≥1 year at the time of diagnosis and fully eligible for MMR vaccine. Of the 100 measles-positive cases with available vaccine records, 63 were unvaccinated at testing, and 27 remained unimmunized against MMR 1 year later. At testing, measles-negative children were significantly more likely to have received MMR than measles-positive children (65.4% vs 37%, P < .01). One year later, 70.4% of measles-negative cases and only 57.1% of measles-positive cases had received MMR vaccine (P = .18).
The majority of measles cases occurred in unimmunized children eligible for vaccination, and >25% of children in both measles-positive and -negative groups remained unimmunized for MMR 1-year post-outbreak. Our results suggest the need for novel, longitudinal vaccination strategies and increased awareness of the role of vitamin A.
2018-2019 年，麻疹在以色列和纽约市大规模爆发，部分原因是这两个地区未接种疫苗的儿童之间的旅行。
对 2018 年 3 月至 2019 年 9 月在纽约市 NYU Langone 健康中心和以色列 Ramla 分区接受麻疹检测的儿童进行回顾性图表审查。审查接种记录，以确定麻疹、腮腺炎和风疹（MMR）疫苗在麻疹检测时和检测后 1 年的接种状态。
共有 264 名儿童接受了麻疹检测，其中 102 名（38.6%）麻疹检测呈阳性。仅有 20 例（19.6%）麻疹阳性病例接受了完整的 2 剂维生素 A 治疗。82.4%的麻疹患儿在诊断时已年满 1 岁，完全有资格接种 MMR 疫苗。在 100 例有麻疹检测记录的麻疹阳性病例中，63 例在检测时未接种疫苗，27 例在 1 年后仍未接种 MMR 疫苗。在检测时，麻疹阴性儿童接种 MMR 的比例明显高于麻疹阳性儿童（65.4%对 37%，P<0.01）。1 年后，70.4%的麻疹阴性病例和仅 57.1%的麻疹阳性病例接种了 MMR 疫苗（P=0.18）。
大多数麻疹病例发生在有资格接种疫苗的未接种疫苗儿童中，且麻疹阳性和阴性组各有超过 25%的儿童在疫情爆发后 1 年仍未接种 MMR 疫苗。我们的研究结果表明，需要制定新的、纵向的疫苗接种策略，并提高对维生素 A 作用的认识。
