Measles vaccination by the intradermal route.

Introduction Live further-attenuated measles vaccines were made generally available in the United Kingdom early in 1966 following the Measles Vaccine Committee's Report to the Medical Research Council (1966). Two years later the Ministry of Health (1968, Circular CM 05/68) through its Joint Committee on Vaccination and Immunization recommended that measles vaccination should be offered to all children aged between 12 months and 15 years not previously protected by either vaccination or an attack of the disease. Mass vaccination campaigns employing the standard technique of individual subcutaneous injections are time-consuming and unpopular with children. A safe and successful method allowing rapid, relatively painless vaccination would be welcome. Symptoms induced by the vaccine in the postvaccination period and referred to as 'reactions', though generally mild with further-attenuated vaccines have, nevertheless, led to some reluctance on the part of physicians to use them. Any new technique introduced for vaccination against measles should not increase reactions and preferably help to reduce them. Live measles vaccines have been successfully administered to African children by the intradermal route using a spring-loaded needleless injector, the Dermojet (Cooper et al., 1966). In an initial investigation in 1966, involving a small number of children in the United Kingdom (Sutcliffe et al., 1967) five vaccines of different titres were prepared from the Schwarz strain of further-attenuated measles virus and injected intradermally in children aged between 9 months and 2 years. The results suggested that successful antibody response could be expected in substantially all children following intradermal vaccination, using the accepted standard immunizing dose of virus, approximately 1000 Tissue Culture Doses (TCDi) contained in 01 ml. These preliminary studies also suggested that post-vaccination reactions might be reduced using the intradermal route. In a period of 16 months following successful vaccination children exposed to measles have remained fully protected (Sutcliffe, Burland & Hitchens, 1968).