Epidemiology and Infection

Table of Contents - 2001 - Volume 127, Issue 02  


Estimation of measles reproduction ratios and prospects for elimination of measles by vaccination in some Western European countries

J.  WALLINGA  a1 c1, D.  LÉVY-BRUHL  a2, N. J.  GAY  a3 and C. H.  WACHMANN  a4
a1 Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
a2 Unite Maladies infectieuses, Institut de Veille Sanitaire, 12 rue du val d'Osne, 94415 Saint-Maurice Cedex, France
a3 Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
a4 Biostatistik, Statens Serum Institut, Artillerivej 5, 2300 København S., Denmark

Abstract

The objective of this study is to estimate the measles reproduction ratio for eight Western European vaccination programmes. Because many plausible age-structured transmission patterns result in a similar description of the observations, it is not possible to estimate a unique value of the reproduction ratio. A method is developed to estimate bounds and confidence intervals for plausible values of the reproduction ratios using maximum likelihood methods. Lower and upper bounds for plausible values of the basic reproduction ratio are estimated to be 7·17 (95% CI 7·14–7·20) and 45·41 (95% CI 9·77–49·57), corresponding to lower and upper bounds on critical vaccine coverage of 86·6% and 98·1%. Of the eight evaluated vaccination programmes, four have vaccine coverage below the lower bound and allow measles to persist, and four have vaccine coverage at the upper bound and may eventually eliminate measles.

(Accepted June 15 2001)


Correspondence:
c1 Author for correspondence.

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