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December 12, 1977

Failure of Attenuated Viral Vaccine in Prevention of Atypical Measles

JAMA. 1977;238(24):2635. doi:10.1001/jama.1977.03280250061027

ATYPICAL illness on exposure to wild measles virus has been described in children previously immunized with inactivated measles vaccine1 as well as in children who received one dose of live vaccine shortly after receiving killed vaccines (KKL group). The American Academy of Pediatrics, however, recommends administration of live attenuated measles vaccine in children immunized previously with killed vaccine to prevent atypical illness on exposure to wild virus.1 We report the case of a child in whom atypical measles developed despite the fact that she had received live vaccine several years after receiving killed vaccine.

Report of a Case  A 12-year-old girl was in excellent health until May 20, 1975, when she complained of headache and myalgia. Three days later a severe headache and high fever developed. A maculopapular rash was observed on both knees two days after the onset of fever. In the next 48 hours, the rash