Evidence map›Paper›PMID 40373694›Full record

ArticleVaccine2025

What is the current evidence base for measles vaccination earlier than 9 months of age?: Report from an informal technical consultation of the World Health Organization.

Anshu Varma, Shelly Bolotin, Gaston De Serres, Arnaud M Didierlaurent, Kristen Earle, Kurt Frey, Susan Hahné, Daniel Kapelus, L Kendall Krause, Kevin McCarthy and 14 more

Abstract read
In one paragraph

Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Anshu VarmaDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Shelly BolotinCentre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
Gaston De SerresFaculty of Medicine, Laval University, Quebec, Canada.
Arnaud M DidierlaurentCenter of vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
Kristen EarleVaccine Development, Bill & Melinda Gates Foundation, Washington, United States.
Kurt FreyInstitute for Disease Modelling, Bill & Melinda Gates Foundation, Washington, United States.
Susan HahnéCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Daniel KapelusWits Vaccines and Infectious Diseases Analytics Research Unit, University of Witwatersrand, Johannesburg, South Africa.
L Kendall KrauseImmunization, Bill & Melinda Gates Foundation, Washington, United States.
Kevin McCarthyInstitute for Disease Modelling, Bill & Melinda Gates Foundation, Washington, United States.
William J MossInternational Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Walter A OrensteinEmory Vaccine Center, Emory University, Atlanta, United States.
Rob van BinnendijkCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Dorthe Maria VittrupChild and adolescent Department, Rigshospitalet, Copenhagen, Denmark.
Merryn VoyseyOxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, United Kingdom.
Tom WoudenbergCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Naor Bar-ZeevDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Anindya S BoseDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Joachim HombachDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Mick N MuldersDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Laura Nic LochlainnDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Kezia SuwintonoDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Daniel R FeikinDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland.
Natasha S CrowcroftDepartment of Immunization, Vaccines, and Biologicals World Health Organization, Geneva, Switzerland. Electronic address: natasha.crowcroft@utoronto.ca.

Funding

World Health Organization 001
6 · The paper itself

Abstract

Measles is one of the most contagious vaccine preventable diseases, causing severe complications and deaths globally. While vaccination with a measles-containing vaccine (MCV) has prevented millions of measles deaths, recent trends, especially from low- and middle-income countries, are discouraging. Measles cases have increased since 2021 as MCV coverage has decreased; and an estimated 107,500 measles deaths, mostly in children under-five years, occurred in 2023. Thus, a renewed focus on proven and innovative strategies to control measles is needed. The World Health Organization (WHO) recommends a first MCV dose administered at 9-15 months of age (routine MCV1), however MCV1 below 9 months of age (early MCV1) may increase vaccination coverage because uptake of all vaccines tends to be higher the younger the child, and this might protect vulnerable infants earlier in life. However, due to concerns about possible reduced vaccine performance, early MCV1 is not routinely recommended by WHO. WHO hosted an informal technical consultation on December 6-7, 2023, in Geneva, Switzerland to evaluate recent evidence on early MCV1 and identify evidence gaps for policy making. The recent evidence suggests a robust humoral immune response shortly after early MCV1 at 5-8 months of age. Immune blunting of a routine second MCV dose (e.g., MCV2) after early MCV1 was not demonstrated in the presented data. However, 3-7 years after MCV1, children receiving early MCV1 had lower measles antibodies than children receiving routine MCV1, suggesting faster waning of immunity. The totality of evidence on immune blunting remains inconsistent. Meeting participants thought more data are needed before revisiting WHO's current recommendation for a potential revision. Evidence gaps include: understanding measles disease burden and severity in infants; early MCV1 effectiveness and duration; vaccine-induced cellular immunogenicity; whether measles in infants is acquired from other infants or older children or adults; and blunting of routine MCV2. Addressing evidence gaps through targeted studies and measles outbreak investigations, as well as evaluations of country-level introductions of early MCV1 are warranted. Ensuring high MCV1 and MCV2 coverage remains the priority in measles control.

Indexed as

Immunization ScheduleMeaslesMeasles VaccineVaccinationHumansInfantVaccination CoverageWorld Health OrganizationMeasles VaccineEarly measles vaccinationImmune bluntingImmunogenicityVaccine effectiveness

Identifiers

PMID40373694
PMCPMC12176663

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.