A recently published major CDC study (1) investigating the root causes of measles vaccine failures confirmed definitively what I already knew to be true in 1995 after Professor Klaus Hedman completed the immunological IgG avidity results of the measles vaccine failures I had studied, which I linked to the clinical picture of measles vaccine failures, i.e. the severity of the disease (2).

I remember my hands almost shaking when I started testing the hypothesis:

Measles virus-recognized vaccine failures with a high-avidity IgG antibody response should have milder disease and often a long time since vaccination.

The genius of Hedman's test lay in the fact that previously there was no method that would have been able to reliably distinguish between failures that occurred at the beginning of vaccination (primary vaccination failure=low IgG avidity) and failures that occur with the waning of immunity (secondary vaccination failure=high IgG avidity).

It just so happened that the hypothesis was proven with our research (2). 

It took us many years before we finally got the 1999 original observation (2) published in a small, somewhat modest scientific journal. The resistance was ferocious (US CDC, WHO, pharmaceutical industry), because at that time in the 1990s there had already been 40 years of fierce scientific debate about the correctness of the then-prevailing belief that "a successful measles vaccination gives lifelong protection" without any means of proving against or in favor of the belief. The subject involved major issues related to the prestige of institutions, as well as major financial and logistical issues and perspectives. There was no question that our research could have been published in the most authoritative publications.

The belief that a successful measles vaccination provides lifelong protection was based on the medical classic of the Danish doctor Peter Ludvig Panum, in which he described the measles epidemic that raged in the Faroe Islands in 1846 (3). During the epidemic, practically everyone except those who had measles 65 years earlier got sick from the disease brought to the islands by a ship. Because the measles vaccine uses live, albeit weakened, viruses, it was thought to work like a natural infection. In the Faroe Islands epidemic, 175 died of measles. Fifty (30%) of infants under one year of age died of measles that year (3; page 21) because they lacked the placental-derived measles antibodies.

This medical classic remains a valid scientific reference when referring to the incubation period of measles. When Panum, with his calculations, had found out precisely the incubation period of measles, he gained a wild reputation as a knower on the island, because he could accurately predict when different individuals would contract the disease.

Before filming the epidemic, Panum studied the island's hygienic conditions and would visit e.g. in the burial ground. This passage is my favorite (3; page 7):

“According to the statement of an official intimately acquainted with conditions, onanism is probably not rare on the Faroe Islands. Among other examples, I can cite the instance of a mother who, when her son desired to marry, forbade him to do so, and taught him to practice onanism as a substitute. The unfortunate fellow carried this habit to such excess that his mind became weakened; and in his more lucid moments he cursed his mother with the most horrible oaths, because “she had wasted away his oil of life.””

Then em. the parties tried everything to ensure that our review of the new global measles vaccination strategy (4), commissioned by the journal Expert Opinion in Pharmacotherapy, would never be published. In the end, one really positive peer review from Australia was enough for a positive publication decision. By the way, Australia was in favor of one shot for a long time until 2010s.

Different parties had their own reasons for trying to censor our results.

The pharmaceutical industry didn't like the fact that it could no longer be printed on the product information (label) that "one successful measles vaccination gives lifelong protection against measles".

The US CDC had its prestige at stake. The CDC stated in its communication throughout the 2000s, even though the USA, like Finland, began to give two MMR vaccinations (Measles=measles, Parotitis=mumps, Rubella=rubella) already in 1989, that the most recent large measles epidemic of the early 1990s was primarily due to failed vaccinations, i.e. NOT because that the vaccination would lose its effectiveness over time.

The World Health Organization (WHO) faced a logistical and financial horror scenario when the global implementation of the two-shot program was ahead.

Finally, around 2010 onwards, the CDC confirmed with smaller studies that our original findings were correct, around 2016, the WHO, referring to our review (4), stood behind the two-shot program. We wrote an editorial about this in Duodecim (Finnish Medical journal) at the time. (5)

The CDC's latest massive study (1) points to our review, which outlines the strategic basis for a new global measles vaccine. The most recent study includes 4,056 confirmed measles cases reported to the CDC in the 2000s, of which 2,799 (69%) were unvaccinated, 475 (12%) were vaccinated with breakthrough infections, and 782 (19%) had unknown vaccination status.

This new CDC study conclusively proved our thesis that vaccinated patients with breakthrough infection often have mild disease and that the most significant measles resurgence in the US in the early 1990s to date was due to a weakening of immunity, not because vaccination failed in the first place in measles patients, i.e. a second measles vaccination is a booster and is often not one that corrects a failed vaccination. 

References

1. Leung J, Munir NA, Mathis AD, Filardo TD, Rota PA, Sugerman DE, Sowers SB, Mercader S, Crooke SN, Gastañaduy PA. The Effects of Vaccination Status and Age on Clinical Characteristics and Severity of Measles Cases in the United States in the Post-Elimination Era, 2001-2022. Clin Infect Dis. 2024 Sep 13:ciae470. doi: 10.1093/cid/ciae470. Epub ahead of print. PMID: 39271123. The Effects of Vaccination Status and Age on Clinical Characteristics and Severity of Measles Cases in the United States in the Post-Elimination Era, 2001-2022 - PubMed

2. Paunio M, Hedman K, Davidkin I, Valle M, Heinonen OP, Leinikki P, Salmi A, Peltola H. Secondary measles vaccine failures identified by measurement of IgG avidity: high occurrence among teenagers vaccinated at a young age. Epidemiol Infect. 2000 Apr;124(2):263-71. doi: 10.1017/s0950268899003222. PMID: 10813152; https://pubmed.ncbi.nlm.nih.gov/10813152/

3. Panum, Peter Ludwig. (1846). Observations made during the epidemic of measles on the Faroe Islands in the year 1846. https://www.medicine.mcgill.ca/epidemiology/hanley/vaccinations/PanumMeasles.pdf

4. Paunio M, Hedman K, Davidkin I, Peltola H. IgG avidity to distinguish secondary from primary measles vaccination failures: prospects for a more effective global measles elimination strategy. Expert Opin Pharmacother. 2003 Aug;4(8):1215-25. doi: 10.1517/14656566.4.8.1215. PMID: 12877632. IgG avidity to distinguish secondary from primary measles vaccination failures: prospects for a more effective global measles elimination strategy - PubMed

5. Editorial. Mikko Paunio, Klaus Hedman, Irja Davidkin ja Heikki Peltola. The Finnish method is a great help in the fight against measles (Finnish). Medical periodical Duodecim 2017;133(3):237-8 https://www.duodecimlehti.fi/duo13540