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Measles Vaccination

Jane Polkowski, MD, MPH; Norman S. Hayner, MD, MPH
JAMA. 1990;264(17):2211. doi:10.1001/jama.1990.03450170059014.
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To the Editor.—  Analysis of a 1982 outbreak of measles in a Dearborn, Mich, high school supports several recent observations on 1986 Dane County, Wisconsin, measles by Edmonson et al1 and raises an important question about who benefits from repeated vaccination.As in Dane County, the Dearborn high school outbreak showed both typical (13) and vaccine-modified mild (15 confirmed and suspected) cases. Modified cases showed a generalized scattering of papules without confluence with or without moderate fever, cough, conjunctivitis or coryza. Eight typical and seven modified cases were verified by demonstration of fourfold changes in measles immunoadherence of neutralizing antibody titers, or by positive measles IgM using sucrose gradient centrifugation. As in Dane County, all five modified cases tested negative for measles IgM 13 to 15 days after onset.The clinical similarity of these two outbreaks contrasts with their epidemiologic dissimilarity. The Dearborn high school outbreak required only


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