Expert committee suggests new methodology in combating measles

The first dose of the MMR vaccine is normally administered to children around the age of one and the second dose between the ages of four and six.

By ZACHARY KEYSER
A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. Picture taken March 20, 2019 (photo credit: REUTERS/LINDSEY WASSON)
A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. Picture taken March 20, 2019
(photo credit: REUTERS/LINDSEY WASSON)
Following the recent outbreak of measles in Israel, an expert committee has recommended that the Health Ministry refashion the timing methodology for administering the MMR vaccine to children in order to "significantly reduce the risk of infection" spreading through communities in Israel.
The first dose of the MMR vaccine is normally administered to children around the age of one and the second dose between the ages of four and six. However, the Committee on Infectious Diseases explained that advancing the timing of the second dose to children at the age of two will help fight the disease and prevent the next outbreak, according to Israel Hayom. This recommended methodology will significantly reduce the morbidity rate and the risk of infection among Israeli children ages two to six.
The experts decided that the first dose should still be given when children are a year old, instead of advancing it to nine months – noting that changing the schedule of the second dose will already cause major "logistical challenges" for the Tipot Halav health clinics around the country.
The committee's recommendations will most likely take several years to implement due to these logistical issues, such as the need for additional nurses, budget, vaccines, etc. Also for a few years, the second dose will be administered between the ages of two and six, depending on the child's age, until the current cycle of children being vaccinated has been completed.
There were two other possible recommendations that the committee decided not to move ahead with – including the idea of increasing the strength of the first dose.
The original plan was to administer the first dose at nine months, then again at one year and then a third time in the first grade (age 6). In addition, Dr. Arik Haas of the Health Ministry's Public Health Service division stated that the measles vaccine is also more effective when given to children over the age of one.
The second alternative was to advance the timing of the second dose and deliver it to children at one and a half years of age. However, experts noted that it might not give children the required amount of time between vaccinations for the MMR doses to work properly.
"It was found that the children do not receive the vaccine on time, and a significant portion receive the first dose only at the age of 15 months or later," Prof. Manfred Green, chairman of the Committee for the Elimination of Measles said. "Therefore, the most important action continues to be to ensure that the vaccine is given at the age of 12 months." 
However, one member of the committee, Chairman of the Association of Public Health Physicians Dr. Haggay Levine, said that administering an extra dose will not only exhaust current vaccine efforts, but it will also cause confusion within the clinics, determining who has received the right number of doses and who hasn't.
The committee reiterated that the "most important action" in preventing measles from spreading among young children is to provide as high of a dose as possible for the first round of the MMR vaccine, which will be given to the child at the age of one. Thestatement concluded by explaining their reasoning behind their recommendation to the Health Ministry, which was mostly affected by case studies showing the morbidity rates of children who have contracted measles between the ages of two and six being problematically high, as well as the fact that in most developed countries the vaccine is normally administered before the first grade – thinking that Israel should follow suit.


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