During the early 20^th century, ten thousand children died every year from measles in the UK. Since then, the disease has become far less dangerous; the number of children dying every year fell to less than a hundred before the introduction of immunisation.

The Disease

Measles is a highly infectious disease. The incubation period (the time from contact with someone with the illness to the first signs of developing the disease) is usually 10 -11 days, though may be as long as three weeks.

The first signs of measles are a fever, cough, runny nose and conjunctivitis (red sticky eyes). After about 4 days a rash appears, initially on the neck and spreading over the next 2-3 days to the rest of the body including the face, arms and legs. Over the next few days, the rash fades, the temperature returns to normal and the child returns to health.

The large majority of children with measles are unwell for a week or so, following which they make a swift and full recovery. However, complications, occasionally severe, can occur.¹

Pneumonia, or other chest infection, occurs in 1 in 26 children.
1 in 40 children will suffer an ear infection (otitis media).
Both these can usually be successfully treated with antibiotics.
A febrile convulsion (fit as a result of a fever) affects 1 in 500 children.
The measles virus infects the brain (encephalitis) in 1 in 1,000 cases; of these 1 in 7 will die.

SSPE (Subacute sclerosing panencephalitis) is, thankfully, very rare as it is a terrible disease in which the measles virus infects the brain. Instead of causing normal encephalitis, a slow insidious disease develops, resulting in inevitable death some years later. This probably occurs in 1 in every 200,000 cases. Children do die from measles but this is rare in the UK, especially in healthy, well-nourished children. In the UK in 1963, the death rate was around 1 in 5,000 cases, though this was less than 1 in 10,000 in healthy children.²

The Vaccine

The single measles vaccine was introduced into the UK in 1968, and was replaced by the MMR vaccine in 1988. The vaccine is ‘live’, containing live measles virus that has been altered (attenuated) to become relatively harmless.

Effectiveness

The vaccine works in around 9 out of 10 children; the single measles vaccine is at least as effective as the measles component of the MMR. A single dose, provided it works (which can be checked by a blood test) provides long lasting protection into adulthood.

When is the vaccine given?

The vaccination can be given at any time from 12 months. However, maximum effectiveness may not be reached before 15 months of age. It is strongly recommended that the measles vaccine be given first.

Side effects

The vaccine causes symptoms of mild measles (rash, fever, sticky eyes and runny nose) in around 1 in 10 of children about one week after receiving the vaccine. Typical symptoms include a high temperature, runny nose, sticky eyes and possibly a rash and/or vomiting, usually lasting 2-3 days. Treat this as you would any 'flu like illness.

1 in 2,000 children suffer a febrile convulsion (fit as a result of a fever) after the vaccine. A febrile convulsion is more than twice as likely to occur after the MMR than after the single measles vaccine.^{3 4 5}

ITP (Idiopathic Thrombocytopenic Purpura) is a rare autoimmune bleeding disorder that occurs after 1 in every half a million vaccinations. It can be serious, even fatal, though most children make a full recovery within six months. ITP occurs more commonly after the MMR than after the single measles vaccine.⁶ Though this is not proven, there may be around 1 in a million chance of your child developing encephalitis. This is a serious condition with a 15% chance of death. However, it should be noted that the risk of developing encephalitis after measles is around 1 in 5,000. This means that encephalitis is around 200 times more likely with measles that following measles immunisation. There is a theoretical possibility that the single measles vaccine could trigger autism and bowel disease in extremely susceptible children.

All side effects of the single measles vaccine occur at least as commonly with the MMR vaccine.

The choices

Rouvax
Type of vaccine:	Single live measles vaccine
Manufacturer:	Sanofi Pasteur (France)
Protects against:	Measles
Active ingredients:	Schwarz strain of measles virus
Mercury content:	Nil
Aluminium content:	Nil
Other ingredients:	Human albumin
Primary course:	Single dose from the age of 12 months
Boosters:	A second dose is only necessary if he first dose did not work. This can be checked with a blood test

Measles vaccine (SII)
Type of vaccine:	Single live egg-free measles vaccine
Manufacturer:	Serum Institute of India (SII)
Protects against:	Measles
Active ingredients:	Edmonston-Zagreb strain of measles virus
Mercury content:	Nil
Aluminium content:	Nil
Other ingredients:	None
Primary course:	Single dose from the age of 12 months
Boosters:	A second dose is only necessary if he first dose did not work. This can be checked with a blood test

The supply of single and small combination vaccines may change over time. At BabyJabs we are on the constant lookout for safe and effective vaccines to offer your child. We may obtain different vaccines to those listed above. We will only offer you alternative vaccines if we are completely confident of their safety and efficacy.


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¹ Miller DL. Frequency of Complications of Measles, 1963. Report On A National Inquiry By The Public Health Laboratory Service In Collaboration With The Society Of Medical Officers Of Health. British Medical Journal 1964; 5401: 75-8.

² Freis Ed. Deaths from Measles in England and Wales in 1961. A Report from The Epidemiological Research Laboratory, Colindale, London, N.W.9. Monthly Bulletin of the Ministry of Health & the PHLS 1963; 22: 167-75.

³ Allerdist H. Neurological complications following measles vaccination. Developments in Biological Standardization 1979; 43: 259-64.

⁴ Miller C et al. Surveillance of symptoms following MMR vaccine in children. Practitioner 1989; 233: 69-74.

⁵ Vestergaard M et al. MMR Vaccination and Febrile Seizures. Evaluation of Susceptible Subgroups and Long-term Prognosis. Journal of the American Medical Association 2004; 292: 351-357.

⁶ Jonville-Bera AP. Autret E. Galy-Eyraud C. Hessel L. Thrombocytopenic purpura after measles, mumps and rubella vaccination: a retrospective survey by the French regional pharmacovigilance centres and pasteur-merieux serums et vaccins. Pediatric Infectious Disease Journal 1996; 15(1): 44-8.