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April 1984

Measles Vaccine and Age at Immunization-Reply

Author Affiliations

Health Care of the Bluegrass 212 N Upper St Lexington, KY 40502

Am J Dis Child. 1984;138(4):412. doi:10.1001/archpedi.1984.02140420078030

In Reply.—Dr Cunningham suggests that children who are vaccinated at or after 11 months of age are sufficiently protected against developing measles during a short-term outbreak. He incorrectly states that our vaccine efficacy rates were similar to those of Marks et al.1 In fact, we did not study vaccine efficacy because of the limitations of the method stated in the article.

As a former public health officer, I consider the relative risk of five or greater a clinically and epidemiologically significant unsafe level of measles protection. On a practical level, because of the data that were obtained from the outbreak in Livingston County, Michigan, in 1978, we required vaccination in all children who were vaccinated before 13 months of age. Since that outbreak, to my knowledge, there has not been a single reported case of measles in the county.

While our data do not show the effect of

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