Another study regarding an outbreak in Brazil, in which it is stated, "The history of previous vaccination did not diminish the number of complications of the cases studied. The results of this work show changes in age distribution of measles leading to sizeable outbreaks among teenagers and young adults."

De Oliveira SA, Soares WN, Dalston MO, de Almeida MT, Costa AJ. Disciplina de Doenças Infecciosas e Parasitárias, Universidade Federal Fluminense Niterói, RJ, Brasil. Clinical and epidemiological findings during a measles outbreak occurring in a population with a high vaccination coverage. Rev Soc Bras Med Trop. 1995 Oct-Dec;28(4):339-43.

From March 1991 to April 1992, 250 measles suspected cases were studied in the Municipality of Niterói, State of Rio de Janeiro. The median age found was 11 years and 76.0% of the cases were in school age children. Exposure histories were present in 149 patients and schools were the most frequent sites of transmission (45.0%). vaccination status was known for 127 studied cases and 76.4% of them had received measles vaccine before their first birthday. One or more complications were reported for 68 cases and in 8.9% of the studied cases hospitalization was required. Frequency of complications varied according to each age group studied and were more commonly encountered among children < 1 year of age (55.6%). The history of previous vaccination did not diminish the number of complications of the cases studied. The results of this work show changes in age distribution of measles leading to sizeable outbreaks among teenagers and young adults.