Nkowane B M, Bart S W, Orenstein W A, Baltier M
Am J Public Health. 1987 Apr;77(4):434-8. doi: 10.2105/ajph.77.4.434.
An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures. Persons who were unimmunized or immunized at less than 12 months of age had substantially higher attack rates compared to those immunized on or after 12 months of age. Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak. There was no evidence to suggest that waning immunity was a contributing factor among the vaccine failures. Close contact with cases of measles in the high school, source or provider of vaccine, sharing common activities or classes with cases, and verification of the vaccination history were not significant risk factors in the outbreak. The outbreak subsided spontaneously after four generations of illness in the school and demonstrates that when measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but that such transmission is not usually sustained.
一所高中爆发了麻疹疫情，该校有记录的疫苗接种率为98%。其中19例（70%）病例是在12月龄及以上有麻疹疫苗接种史的学生，因此被视为疫苗接种失败。与12月龄及以后接种疫苗的人相比，未接种疫苗或在12月龄之前接种疫苗的人发病率要高得多。在此次疫情中，明显接种了足够剂量疫苗的个体中出现的疫苗接种失败病例至少占48%的感染源。没有证据表明免疫力下降是导致疫苗接种失败的一个因素。在高中与麻疹病例密切接触、疫苗来源或提供者、与病例共同参加活动或课程以及核实疫苗接种史，都不是此次疫情中的显著危险因素。在学校出现四代病例后，疫情自行平息，这表明当麻疹传入高疫苗接种率人群时，疫苗接种失败可能在传播中起一定作用，但这种传播通常不会持续下去。
