Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a Postelimination Environment

LeBaron, Charles W.; Beeler, Judith; Sullivan, Bradley J.; Forghani, Bagher; Bi, Daoling; Beck, Carol L.; Audet, Susette; Gargiullo, Paul

doi:10.1001/archpedi.161.3.294

Cited by 111 publications

(82 citation statements)

References 44 publications

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“…25 Similarly, in the United States, increased antibody titers in response to a second MMR dose rapidly returned to prebooster levels, and most subjects (72%, 13/18) with low titers 10 years after boosting were also in the lowest quartile for antibodies before boost. 26 This "return" to the level of protection afforded by the first dose based on time elapsed since the second dose is consistent with the similar VE we observed after 1 or 2 doses (95.9% vs 94.2%, respectively) during our recent school outbreak investigation. 15 The risk associated with an early age at first dose was present but less pronounced in children born to vaccinated mothers than in children born to infected mothers.…”

Section: Discussionsupporting

confidence: 89%

Measles in Children Vaccinated With 2 Doses of MMR

et al. 2013

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OBJECTIVE: A previous measles outbreak investigation in a high school in Quebec, Canada identified 2-dose vaccine effectiveness of 94%. The risk of measles in 2-dose recipients was significantly higher (2–4 times) when measles vaccine was first administered at 12 versus ≥15 months of age, with no significant effect of the age at second dose. Generalizability of this association was also assessed in the expanded provincial data set of notified cases. METHODS: This matched case–control study included only 2-dose recipients. All confirmed (laboratory or epidemiologically linked) cases in patients aged 5 to 17 years were included. Each case was matched to 5 controls. RESULTS: A total of 102 cases and 510 controls were included; 89% of cases were in patients 13 to 17 years old. When the first dose was administered at 12 to 13 months compared with ≥15 months of age, the risk of measles in participants outside the outbreak school was 6 times higher (95% confidence interval, 1.33–29.3) and was 5.2 times higher (95% confidence interval, 1.91–14.3) in the pooled estimate (participants from the outbreak school + outside that school). CONCLUSIONS: A significantly greater risk of measles among 2-dose recipients whose first dose was given at 12 to 13 months rather than ≥15 months of age is confirmed in the larger Quebec data set. The mechanism remains unknown, but vaccine failures in 2-dose recipients could have substantial implications for measles elimination efforts through 2-dose vaccination. The optimal age at first dose may warrant additional evaluation.

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Section: Discussionsupporting

confidence: 89%

Measles in Children Vaccinated With 2 Doses of MMR

et al. 2013

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“…Adolescent and young adults aged between 15 and 30 years were identified as a group that may require booster vaccination. Several studies showed that, by this age, the level of measles and rubella antibodies were lower than other age groups studied [11,18,22,24,26,29,30,32,36,42,84,88,91,96]. Several authors recommended that teens be re-vaccinated [24,32,36,42].…”

Section: Major Findings Of the Reviewmentioning

confidence: 99%

“…However, if the mother was vaccinated, this decline was significantly faster, exposing the infant to risk of infection earlier [6,13,16,19,20,25,33,101]. Apart from unvaccinated infants, the lowest sero-positivity rate for measles was found in young adults (19-25 years) [3,29,75].…”

mentioning

confidence: 99%

A 16-year review of seroprevalence studies on measles and rubella

Dimech¹,

Mulders

2016

Vaccine

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“…Both cases in our study who had received both vaccination doses (2014-10 and 2014-11) were secondary cases and did not result in further transmission. Studies have shown that in areas with no endemic measles virus circulation, antibody titres will decline over time [28]. This might be one explanation for the occurrence of measles in two-dose vaccinated cases in our study.…”

Section: Discussionmentioning

confidence: 45%

Phylogenetic and epidemiological analysis of measles outbreaks in Denmark, 2013 to 2014

et al. 2015

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Despite the introduction of safe, effective vaccines decades ago and joint global public health efforts to eliminate measles, this vaccine-preventable disease continues to pose threats to children’s health worldwide. During 2013 and 2014, measles virus was introduced into Denmark through several independent importations. This resulted in a number of secondary cases (n = 7), with two clusters in 2013 and one in 2014. In total, there were 44 cases of measles. Most cases (n = 41) were laboratory confirmed by detection of measles virus genome by real-time reverse transcription (RT)-PCR and IgM antibodies. The viruses from confirmed cases were genotyped by sequencing. Only one genotype circulated each year, i.e. D8 and B3, respectively. Sequencing of measles virus from different clinical specimens from the same patients revealed that sequence variants of measles viruses might co-exist and co-transmit during an outbreak. The majority of the cases were unvaccinated (n = 27) or recipients of one dose of measles-mumps-rubella (MMR) vaccine (n = 7). In addition, two fully vaccinated adult cases were reported in 2014. We demonstrate the transmission of measles virus in a population in which the two-dose MMR vaccination coverage rate was 80% and how even vaccinated individuals may be at risk of contracting measles once transmission has been established.

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Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a Postelimination Environment

Abstract: Measles antibody persisted in all vaccinees available for follow-up 10 years after a second dose of vaccine, with no seronegative results detected. Declining titers suggest the need for vigilance in ensuring disease protection for the vaccinated population.

Cited by 111 publications

References 44 publications

Measles in Children Vaccinated With 2 Doses of MMR

Measles in Children Vaccinated With 2 Doses of MMR

A 16-year review of seroprevalence studies on measles and rubella

Phylogenetic and epidemiological analysis of measles outbreaks in Denmark, 2013 to 2014

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