Measles, mumps, and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine

Seagle, Emma E; Bednarczyk, Robert A.; Hill, Tenisha; Fiebelkorn, Amy Parker; Hickman, Carole J.; Icenogle, Joseph P.; Belongia, Edward A.; McLean, Huong Q.

doi:10.1016/j.vaccine.2017.12.075

Cited by 79 publications

(65 citation statements)

References 21 publications

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“…Consistent with literature, waning immunity of measles and rubella specific IgG antibodies after vaccination was present, but much slower after a second dose, staying well above the cut-off for seropositivity [29,30,33]. This indicates long lasting immunological humoral memory-when extended with similar rate of waning.…”

Section: Discussionsupporting

confidence: 88%

Seroepidemiology of Measles, Mumps and Rubella on Bonaire, St. Eustatius and Saba: The First Population-Based Serosurveillance Study in Caribbean Netherlands

et al. 2019

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The National Immunization Program (NIP) on Bonaire, St. Eustatius and Saba (i.e., Caribbean Netherlands (CN)) includes the measles‐mumps‐rubella (MMR) vaccine since 1988/89. Seroepidemiological data is an important tool to evaluate the NIP, hence a cross-sectional representative population-based serosurveillance study was conducted for the first time in CN in mid-2017. Participants (n = 1829, aged 0–90 years) donated a blood sample and completed a health-related questionnaire. MMR-specific IgG antibodies were determined using a bead-based multiplex immunoassay and risk factors were analyzed using logistic regression models. Overall seroprevalence was high for measles (94%), but lower for mumps and rubella (both 85%). In NIP eligibles, including women of childbearing age, rubella seroprevalence (88%) exceeded the threshold for protection (85%); however, for measles (89%) this protective level (95%) was not met. MMR seropositivity was lowest in children who became CN resident at 11–17 years of age (especially for measles (72%)), mostly originating from Latin America and other non-Western countries. Interestingly, rubella seroprevalence was lowest in non-NIP eligible adults from Dutch overseas territories and Suriname (75%). Taken together, MMR immunity is generally good in CN, nonetheless some risk groups were identified. Additionally, we found evidence for a unique island epidemiology. In light of recent regional measles outbreaks, disease monitoring remains of utmost importance.

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Section: Discussionsupporting

confidence: 88%

Seroepidemiology of Measles, Mumps and Rubella on Bonaire, St. Eustatius and Saba: The First Population-Based Serosurveillance Study in Caribbean Netherlands

et al. 2019

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“…We noted that 23% of the subjects who received two doses of measles vaccine did not show IgG response, similarly to those receiving only one dose of vaccine (25%) (Figure 1). This percentage appeared higher than that reported by other authors [17,20,32,33], thus, it is advisable to monitor the immune status of vaccines 10-15 years since vaccination, in order to evaluate the immune protection against measles and, eventually, implement a possible prophylactic Vaccines 2020, 8, 66 9 of 12 measure. On the other hand, a long-term high rate of seropositivity persisted after natural infection; indeed, subjects enrolled in this study who reported measles infection history were all seropositive.…”

Section: Discussionmentioning

confidence: 74%

“…Since previous studies reported that the measles protective antibody titer was decreasing over time after the administration of the second dose of MMR vaccine [17][18][19][20][21], our aim was to evaluate this phenomenon in our cohort. The vaccinated subjects (110) were divided into three groups, on the basis of the time elapsed since the administration of the second dose of vaccine: eleven years (35 subjects), 12-14 years (39 subjects) and ≥15 years (36 subjects).…”

Section: Decline Of Neutralizing Ab Titersmentioning

confidence: 99%

“…Epidemiologic studies have shown that the level of functional neutralizing antibodies at the time of exposure to the wild-type (WT) virus during a measles outbreak is a good correlate of protection from infection, with higher titers needed to prevent infection rather than to prevent the disease [16]. According to literature, levels of anti-measles antibodies tend to decline over the life course, as demonstrated by measuring the level of measles neutralizing antibodies in the subjects' sera at different times after vaccination [17][18][19][20]. Moreover, this phenomenon appears to occur faster following vaccination rather than after naturally acquired infection [21,22].…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence to Measles Virus after Vaccination or Natural Infection in an Adult Population, in Italy

et al. 2020

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An increase in measles cases worldwide, with outbreaks, has been registered in the last few years, despite the availability of a safe and highly efficacious vaccine. In addition to an inadequate vaccination coverage, even in high-income European countries studies proved that some vaccinated people were also found seronegative years after vaccination, thus increasing the number of people susceptible to measles infection. In this study, we evaluated the immunization status and the seroprevalence of measles antibodies among 1092 healthy adults, either vaccinated or naturally infected, in order to investigate the persistence of anti-measles IgG. Among subjects who received two doses of measles vaccine, the neutralizing antibody titer tended to decline over time. In addition, data collected from a neutralization assay performed on 110 healthy vaccinated subjects suggested an inverse correlation between neutralizing antibody titers and the time elapsed between the two vaccinations, with a significant decline in the neutralizing titer when the interval between the two doses was ≥11 years. On the basis of these results, monitoring the serological status of the population 10-12 years after vaccination could be important both to limit the number of people who are potentially susceptible to measles, despite the high efficacy of MMR vaccine, and to recommend a booster vaccine for the seronegatives.

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“…Universal immunization programs have been implemented in many countries worldwide and have significantly lowered the incidence and spread of infectious disease. The effective measles, mumps, and rubella (MMR) vaccine is widely administered globally (); however, recent studies have demonstrated a decline in protective antirubella antibodies in countries with universal vaccination program, including among women of reproductive age—thus increasing the risk of rubella infection and severe birth defects due to congenital rubella syndrome ().…”

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confidence: 99%

High BMI: A New Determinant of Impaired Rubella Immunity During Pregnancy?

Andersen

2018

Obesity

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Universal immunization programs have been implemented in many countries worldwide and have significantly lowered the incidence and spread of infectious disease. The effective measles, mumps, and rubella (MMR) vaccine is widely administered globally (1); however, recent studies have demonstrated a decline in protective antirubella antibodies in countries with universal vaccination programs, including among women of reproductive age-thus increasing the risk of rubella infection and severe birth defects due to congenital rubella syndrome (2,3).While various factors have been associated with declining rubella immunity following childhood immunization, Hui et al. (4) present compelling evidence in this issue to suggest that elevated body mass index (BMI) may impair serological immunity against rubella in pregnant women. In this large-scale retrospective cohort study, pregnant women with BMI > 25.0 kg/m 2 were more likely to present with serological rubella nonimmunity (rubella IgG antibody titer < 10 IU/mL), as compared to women with BMI < 25.0 kg/m 2 . Interestingly, the risk of rubella nonimmunity in women with high BMI was greater in women born in Hong Kong, where rubella immunization is mandatory during childhood. The positive association between rubella nonimmunity and high BMI persisted after controlling for potential confounding factors, such as maternal age, parity, short stature, and year and location of birth, which could impact participation in immunization programs.Obesity can impair the regulation of immune responses by promoting lipid deposition in lymphoid tissues, alterations in leukocyte profiles and activity, and chronic inflammation. While studies have previously demonstrated that obesity negatively impacts the efficacy of vaccines against influenza, hepatitis B, and tetanus (5), the current work of Hui et al. (4) is novel in that it is one of few studies to find an association between high BMI and immunity against rubella and the first study to identify this trend in pregnant women-a population most at risk for conferring severe effects of rubella infection to offspring.While obesity initiatives often focus on reducing the risk of chronic diseases stemming from metabolic dysfunction (e.g., cardiovascular disease, type 2 diabetes mellitus) (5), these findings emphasize the importance of targeting overweight and obesity as a means to reduce the risk of infectious disease. Given that this current study was conducted in geographical areas where mandatory rubella immunization programs have been implemented, these findings call into question the long-term success of these initiatives in preventing rubella outbreaks where the prevalence of overweight and obesity is high. Further investigation may be warranted to determine the need for serological screening and booster immunizations on the basis of BMI, particularly within the context of antenatal care, as a means to promote population health.O

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Measles, mumps, and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine

Cited by 79 publications

References 21 publications

Seroepidemiology of Measles, Mumps and Rubella on Bonaire, St. Eustatius and Saba: The First Population-Based Serosurveillance Study in Caribbean Netherlands

Seroepidemiology of Measles, Mumps and Rubella on Bonaire, St. Eustatius and Saba: The First Population-Based Serosurveillance Study in Caribbean Netherlands

Seroprevalence to Measles Virus after Vaccination or Natural Infection in an Adult Population, in Italy

High BMI: A New Determinant of Impaired Rubella Immunity During Pregnancy?

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