Mumps Antibody Response in Young Adults After a Third Dose of Measles-Mumps-Rubella Vaccine

Fiebelkorn, Amy Parker; Coleman, Laura; Belongia, Edward A.; Freeman, Sandra K.; York, Daphne; Bi, Daoling; Zhang, Cheryl; Ngo, Laurie; Rubin, Steven A.

doi:10.1093/ofid/ofu094

Cited by 58 publications

(39 citation statements)

References 31 publications

(40 reference statements)

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“…The study population and exclusion criteria have been previously described in detail [17, 22]. Briefly, the study population included healthy young adults aged 18–28 years who received care from the Marshfield Clinic (Marshfield, WI) or who participated in a longitudinal study examining immune response to a second dose of MMR vaccine at Marshfield Clinic.…”

Section: Methodsmentioning

confidence: 99%

“…There are no parameters of the immune response that are known to reliably assure protection from symptomatic wild-type mumps virus infection, although neutralizing antibody is assumed to be essential. Recently, neutralizing mumps antibody titers were measured by in vitro plaque reduction neutralization (PRN) from a large cohort of individuals who received MMR3 in a nonoutbreak setting [17]. There was a modest rise in PRN titers 1 month post-MMR3, but titers returned to near baseline by 1 year post-MMR3.…”

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confidence: 99%

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Mumps Virus Nucleoprotein and Hemagglutinin-Specific Antibody Response Following a Third Dose of Measles Mumps Rubella Vaccine

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Fiebelkorn

McGrew

et al. 2017

Open Forum Infectious Diseases

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BackgroundRecent mumps outbreaks among 2-dose measles mumps rubella (MMR) vaccine recipients have raised questions regarding the potential benefits of a third dose of vaccine (MMR3). If MMR3 provides a sustained elevation in mumps antibody, it may be beneficial for certain at-risk groups or as an outbreak control measure.MethodsSera were collected immediately prior to MMR3 and at 1 month and 1 year post-MMR3 from 656 healthy adults aged 18–28 years in a nonoutbreak setting. Immunoglobulin G (IgG) was measured by enzyme-linked immunosorbent assay (ELISA) using whole mumps virus (commercial ELISA), hemagglutinin (HN; major neutralizing target), and nucleoprotein (NP; immunodominant) antigens. ELISA measurements were compared with in vitro plaque reduction neutralization (PRN) titers, and baseline antibody was compared with post-MMR3 levels.ResultsThere were modest but statistically significant (P < .05) increases in mumps antibody at 1 month post-MMR3 by all 3 ELISA methods and by PRN titer. At 1 year post-MMR3, mumps antibody declined toward baseline but remained elevated (P < .05). The correlation between PRN titers and ELISA measurements was poor (r2 = .49), although sera with the highest amount of HN IgG also had the highest PRN titers.ConclusionsIndividuals with the lowest baseline PRN titers had the largest increase in frequency of samples that became positive for HN and NP by ELISA. A third dose of MMR may benefit certain individuals with a low level of mumps virus–neutralizing antibody, especially in the context of an outbreak or other high-risk setting. Additionally, poor correlation among serologic tests does not allow effective prediction of PRN titer by ELISA.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Mumps Virus Nucleoprotein and Hemagglutinin-Specific Antibody Response Following a Third Dose of Measles Mumps Rubella Vaccine

Latner

Fiebelkorn

McGrew

et al. 2017

Open Forum Infectious Diseases

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“…Institutional Review Boards of the Marshfield Clinic Research Foundation and the Centers for Disease Control and Prevention approved the study. Sample size determination and exclusion criteria were previously described[13]. …”

Section: Methodsmentioning

confidence: 99%

Measles Virus Neutralizing Antibody Response, Cell-Mediated Immunity, and Immunoglobulin G Antibody Avidity Before and After Receipt of a Third Dose of Measles, Mumps, and Rubella Vaccine in Young Adults

et al. 2015

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Background Two doses of measles-mumps-rubella (MMR) vaccine are 97% effective against measles, but waning antibody immunity and two-dose vaccine failures occur. We administered a third MMR dose (MMR3) to young adults and assessed immunogenicity over 1 year. Methods Measles virus (MeV) neutralizing antibody concentrations, cell-mediated immunity (CMI), and IgG antibody avidity were assessed at baseline, 1-month, and 1-year after MMR3. Results Of 662 subjects at baseline, 1 (0.2%) was seronegative (<8 mIU/mL) and 23 (3.5%) had low (8-120 mIU/mL) MeV neutralizing antibodies. At 1-month post-MMR3, 1 (0.2%) subject was seronegative and 6 (0.9%) had low neutralizing antibodies with only 21/662 (3.2%) showing a ≥4-fold rise in neutralizing antibodies. At 1-year post-MMR3, none were negative and 10 (1.6%) of 617 subjects had low neutralizing antibodies. CMI results showed low-levels of spot-forming cells after stimulation, suggesting T-cell memory, but the response was minimal post-MMR3. MeV IgG avidity results did not correlate with neutralization results. Conclusions Most subjects were seropositive pre-MMR3 and very few had a secondary immune response post-MMR3. Similarly, CMI and avidity results showed minimal qualitative improvements in immune response post-MMR3. We did not find compelling data to support a routine third dose of MMR vaccine.

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“…The merit of such a modification to the current ACIP recommended vaccine schedule was recently explored, but was found to not be supportive (9). In that study, the magnitude and duration of mumps virus neutralizing antibody responses after a third dose of MMR vaccine among 685 young adults was assessed.…”

Section: Current Considerations and Future Directionsmentioning

confidence: 99%

Emerging Mumps Infection

Rubin

Kennedy

2016

Pediatric Infectious Disease Journal

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Mumps Antibody Response in Young Adults After a Third Dose of Measles-Mumps-Rubella Vaccine

Cited by 58 publications

References 31 publications

Mumps Virus Nucleoprotein and Hemagglutinin-Specific Antibody Response Following a Third Dose of Measles Mumps Rubella Vaccine

Mumps Virus Nucleoprotein and Hemagglutinin-Specific Antibody Response Following a Third Dose of Measles Mumps Rubella Vaccine

Measles Virus Neutralizing Antibody Response, Cell-Mediated Immunity, and Immunoglobulin G Antibody Avidity Before and After Receipt of a Third Dose of Measles, Mumps, and Rubella Vaccine in Young Adults

Emerging Mumps Infection

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