Measles Virus Neutralizing Antibody Response and Durability Two Years after One or Two Doses of Measles–Mumps–Rubella Vaccine among Young Seronegative Healthcare Workers

Jang, Byungki; Kim, Han Wool; Kim, Han-Sung; Park, Ji Young; Seo, Hyeonji; Kim, Yong Kyun

doi:10.3390/vaccines10111812

Cited by 8 publications

(1 citation statement)

References 54 publications

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“…This possibly indicates a post-transplant infection, even if this is not the case in any patients according to their medical history. It is striking that the titres are low, even if higher titres would be expected after an infection [ 36 , 37 ]. T-cell mediated response plays a critical role in MMR vaccination [ 38 ] as well as in measles infection [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Diminished measles immunity after paediatric liver transplantation—A retrospective, single-centre, cross-sectional analysis

Laue,

Junge,

Leiskau

et al. 2024

PLoS ONE

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Liver transplantation in childhood has an excellent long-term outcome, but is associated with a long-term risk of infection. Measles is a vaccine-preventable infection, with case series describing severe courses with graft rejection, mechanical ventilation and even death in liver transplant recipients. Since about 30% of liver transplanted children receive liver transplants in their first year of life, not all have reached the recommended age for live vaccinations. On the contrary, live vaccines are contraindicated after transplantation. In addition, vaccination response is poorer in individuals with liver disease compared to healthy children. This retrospective, single-centre, cross-sectional study examines measles immunity in paediatric liver transplant recipients before and after transplantation. Vaccination records of 239 patients, followed up at Hannover Medical School between January 2021 and December 2022 were analysed. Twenty eight children were excluded due to stem cell transplantation, regular immunoglobulin substitution or measles vaccination after transplantation. More than 55% of all 211 children analysed and 75% of all those vaccinated at least once are measles seropositive after transplantation—48% after one and 84% after two vaccinations—which is less than in healthy individuals. Interestingly, 26% of unvaccinated children also showed measles antibodies and about 5–15% of vaccinated patients who were seronegative at the time of transplantation were seropositive afterwards, both possibly through infection. In multivariable Cox proportional hazards regression, the number of vaccinations (HR 4.30 [95% CI 2.09–8.83], p<0.001), seropositivity before transplantation (HR 2.38 [95% CI 1.07–5.30], p = 0.034) and higher age at time of first vaccination (HR 11.5 [95% CI 6.92–19.1], p<0.001) are independently associated with measles immunity after transplantation. In contrast, older age at testing is inversely associated (HR 0.09 [95% CI 0.06–0.15], p<0.001), indicating a loss of immunity. Vaccination in the first year of life does not pose a risk of non-immunity. The underlying liver disease influences the level of measles titres of twice-vaccinated patients; those with acute liver failure being the lowest compared to children with metabolic disease. In summary, vaccine response is poorer in children with liver disease. Liver transplant candidates should be vaccinated before transplantation even if this is earlier in the first year of life. Checking measles IgG and re-vaccinating seronegative patients may help to achieve immunity after transplantation.

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Section: Discussionmentioning

confidence: 99%

Diminished measles immunity after paediatric liver transplantation—A retrospective, single-centre, cross-sectional analysis

Laue,

Junge,

Leiskau

et al. 2024

PLoS ONE

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Seronegative Vaccinees May Not Benefit From Multiple Booster Doses of MMR Vaccine in Restoring Immunity

Anichini,

Terrosi,

Alessandri

et al. 2024

Journal of Medical Virology

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Despite the availability of a highly efficacious vaccine, a global resurgence of measles infections has occurred, largely due to decreased vaccination coverage and waning immunity following the two‐dose vaccination schedule. This study aims to assess the cellular immune response in individuals who did not respond to the two‐dose MMR vaccine and evaluate the efficacy and durability of immune responses after booster doses. An observational study was conducted involving 24 individuals who were seronegative for measles years after completing the two‐dose MMR vaccine schedule. Of these, 11 seroconverted after a single booster dose, while 13 required an additional booster. Antibody levels were monitored 1 and 3 years post‐booster. Cellular immune responses were evaluated in 10 nonresponders by in vitro stimulation of PBMCs with UV‐inactivated measles virus. In nonresponders, measles virus stimulation did not induce significant alterations in T, B, or NK cell populations, indicating a lack of measles‐specific immune memory. However, stimulation with rubella induced a significant immune response. Booster doses in subjects with waning antibodies resulted in low IgG titers, which significantly declined over 3 years. Neutralizing antibody titers were also low for both double and single booster recipients. This study highlights the limited long‐term efficacy of booster doses in individuals with waning immunity or nonresponsiveness to the measles vaccine. Current vaccination strategies relying on booster doses may not be sufficient for sustained protection in these individuals. Improving vaccine formulations to elicit stronger and longer‐lasting immunity is essential for effective measles control and elimination.

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COVID-19 vaccines and beyond

Liu,

Li,

Han

2024

Cell Mol Immunol

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Measles Virus Neutralizing Antibody Response and Durability Two Years after One or Two Doses of Measles–Mumps–Rubella Vaccine among Young Seronegative Healthcare Workers

Cited by 8 publications

References 54 publications

Diminished measles immunity after paediatric liver transplantation—A retrospective, single-centre, cross-sectional analysis

Diminished measles immunity after paediatric liver transplantation—A retrospective, single-centre, cross-sectional analysis

Seronegative Vaccinees May Not Benefit From Multiple Booster Doses of MMR Vaccine in Restoring Immunity

COVID-19 vaccines and beyond

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