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February 26, 1982

Assessment of Susceptibility to Measles and Rubella

Author Affiliations

From the Immunization Division, Center for Prevention Services (Drs Preblud, Halsey, and Hinman), the Perinatal Virology Branch, Virology Division, Center for Infectious Diseases (Dr Herrmann), and the Office of Program Planning and Evaluation (Dr Koplan), Centers for Disease Control, Atlanta, and the US Merchant Marine Academy, Kings Point, Long Island, NY (Dr Gross). Dr Preblud is now with the Infectious Diseases Division, Children's Hospital of Philadelphia. Dr Halsey is with the Department of Tropical Medicine, Tulane University School of Medicine, New Orleans.

JAMA. 1982;247(8):1134-1137. doi:10.1001/jama.1982.03320330030021

We conducted a serological and questionnaire study of 755 US Merchant Marine Academy cadets (aged 16 to 29 years) and their parents to determine the cadets' susceptibility rate to measles and rubella and to see if there was any difference in the accuracy of cadet and parental histories of previous infection and vaccination. Approximately 4% of the cadets were susceptible to measles and 17% were susceptible to rubella. Undocumented histories, regardless of the source, were of little value in predicting susceptibility. We also determined the costs and the effectiveness of three alternative strategies for vaccinating susceptible adolescents and young adults: (1) vaccinating all persons regardless of past history; (2) serologically screening all persons and vaccinating only those who were susceptible; and (3) vaccinating all individuals who do not have physician-documented proof of proper vaccination, past infection (measles only), or serological immunity. The cost savings among the three alternatives are dependent on the proportion of potential vaccinees with records available for review and must be balanced against the proportion of susceptible persons protected by each alternative. We also found that a combined vaccination program for both measles and rubella is less costly than a program aimed at providing immunity to only one of the two diseases.

(JAMA 1982;247:1134-1137)