Objectives
In 2007, measles prevailed among the youth and young adult population in Japan, creating in a serious social problem. Among
the developed countries, Japan has a relatively high incidence of measles. The objective of this study was to assess the effect
of improvements in the vaccination policy against measles through simulations.
Methods
We developed an age–time two-dimensional model for the transmission of measles to reflect an age structure, enabling contact
rate to be selected by age. Introduction of the maternal immunity class into the model allowed natural infection and vaccination
to be discriminated along the course of an infant’s mother acquiring the immunity, thereby resulting in an improved accuracy
of the simulations in infants. Several vaccination scenarios were attempted in order to assess the influence of various vaccination
policies on the prevention of a measles epidemic.
Results
The results of this quantitative study indicated that suppression of a measles outbreak requires the maintenance of high vaccine
coverage and that a decline in vaccine coverage may result in a measles epidemic.
Conclusions
The present standard immunization program for measles will maintain an acceptable level of immunity and is therefore associated
with a low risk of an epidemic after discontinuation of the third and fourth stages as scheduled—as long as at least 90% vaccine
coverage of the first and second is maintained. The simulation results show that discontinuation of the third and fourth stages
of vaccination as scheduled should be accompanied by endeavors to maintain appropriate high vaccine coverage of the first
and second stages.
Keywords Measles – Vaccination coverage – Routine immunization program – Age–time model – Maternal immunity