2023-11-26 20:53:00
In France, the November 16, 2023the General Directorate of Health has distributed to doctors, nurses, midwives and pharmacists vaccination recommendations against measles concerning the departments of the Drome and theArdeche. These recommendations are part of the fight against the measles epidemic which broke out since September 19 in and around a college in the town of Guilherand-Granges in Ardèche (see the news of October 22). Their aim is to avoid an epidemic resumption and to limit the spread of the epidemic.
Reminder of the situation
The index case is a teenager from Drôme returning from a trip to Indonesia. The viral strain identified in this patient is circulating in Indonesia, a country which is currently experiencing active viral circulation. The strain is covered by vaccines marketed in France.
As of November 8, 2023, 64 cases of measles have been identified, including 40% were not or incompletely vaccinated and 60% were vaccinated with 2 doses of MMR, but 73% of adolescents vaccinated 2 doses had received their first dose before the age of 12 months (the majority of cases were born between 2009 and 2011, years during which it was recommended to vaccinate children entering the community before the age of 12 months, but also years of major measles epidemic in Rhône-Alpes, particularly in Ardèche but also in Drôme, having been able to reinforce early vaccination, before the age of 12 months).
The attack rate among college students vaccinated after 12 months was 3%, compared to respectively 10% among those vaccinated with the first dose before 12 months and 100% among those not vaccinated. Although 9 out of 10 cases were linked to college, the epidemic nevertheless affected those close to them (siblings, parents, friends) for the vast majority not up to date with their measles vaccination.
The situation now seems to be stabilizing with a number of cases much lower than previous weeks and in the week 2023-40 when the epidemic peak was reached.
Early vaccination before 12 months can lead to less long-term immunity and explain the significant proportion of vaccinated middle school students who contracted measles.
Recommendations addressed to health professionals in Drôme and Ardèche
Check the vaccination status of all people born after 1980 by ensuring that each person has received 2 doses of measles vaccine and that these 2 doses were administered after the age of 12 months, with a minimum delay of 1 month between the 2 doses; Complete, if necessary, the vaccination schedule by administering: a 3rd dose of MMR vaccine if the person has already received two doses but the 1st dose was administered before the age of 12 months, a 2nd dose if a single dose was administered after the age of 12 months (general recommendation for people born since 1980), two doses with a minimum delay of 1 month between doses if the patient has never been vaccinated, never contracted measles, or received only one dose before the age of 12 months.
These recommendations are in line with the usual contraindications of MMR vaccines marketed in France (PRIORIX and MM-RVAXPRO) and in theinstruction relating to what to do around one or more cases of measles from September 28, 2018.
Source: Directorate General of Health.
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