Modelling measles re-emergence as a result of waning of immunity in vaccinated populations

Joël Mossong*, Claude P. Muller

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

82 Citations (Scopus)


An age-structured mathematical model of measles transmission in a vaccinated population is used to simulate the shift from a population whose immunity is derived from natural infection to a population whose immunity is vaccine-induced. The model incorporates waning of immunity in a population of vaccinees that eventually will become susceptible to a milder form of vaccine-modified measles with a lower transmission potential than unvaccinated classical measles. Using current estimates of duration of vaccine-derived protection, measles would not be expected to re-emerge quickly in countries with sustained high routine vaccine coverage. However, re-emergence is possible to occur several decades after introduction of high levels of vaccination. Time until re-emergence depends primarily on the contagiousness of vaccine-modified measles cases in comparison to classical measles. Interestingly, in a population with a high proportion of vaccinees, vaccine-modified measles and classical measles would occur essentially in the same age groups. Although waning of humoral immunity in vaccinees is widely observed, re-emergence of measles in highly vaccinated populations depends on parameters for which better estimates are needed.

Original languageEnglish
Pages (from-to)4597-4603
Number of pages7
Issue number31
Publication statusPublished - 7 Nov 2003
Externally publishedYes


  • Mathematical model
  • Measles
  • Vaccination
  • Waning immunity


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