Impact of Measles in the United States
Level 4 - case-series / case-control
Historically controlled ecological population surveillance study.
OpenAlex W2093375385 · doi:10.1093/clinids/5.3.439
What was done
Analysis of United States historical epidemiological surveillance data comparing the pre-vaccine era (1950s) to post-licensure surveillance (up to 1981) following the introduction of the measles vaccine in 1963.
What was found
During the 1950s, an annual average of >500,000 cases and nearly 500 deaths were reported (incidence of 336.3 cases per 100,000 population), with 95% of the population infected by age 15. Following the 1963 vaccine rollout, measles incidence dropped to <1% of pre-vaccine levels, reaching 1.3 cases per 100,000 population in 1981, with only 10% of US counties reporting cases. Severe complications (encephalitis and subacute sclerosing panencephalitis, which lagged by ~7 years) also declined markedly.
Why it matters
This paper documents the dramatic population-level reduction in measles morbidity, mortality, and long-term neurologic sequelae following the establishment of widespread childhood vaccination in the United States.
Limits
The abstract reports aggregate national surveillance data without reporting individual patient numbers, statistical confidence intervals, or adjusting for changes in reporting practices and supportive care over time.
Cited by
- context Measles mortality or incidence had already decreased by over 90% before the introduction of the measles vaccine in the 1960s.