The immunoglobulin M response to rubella vaccine in young adult women

Abstract

SUMMARYRubella vaccination histories were taken from 333 young women working in the head office of a retail organization: 29 % said they had had vaccine and 47 % said they had not. The remainder did not know. Forty-six per cent of those < 25 years old (who should have been offered vaccine at school), and 6 % of those > 25 years old, said they had been vaccinated. When screened for immunity to rubella by radial haemolysis (RH) 3 % had a low level of antibody (< 15 i.u./ml) and 11 % had no antibody. After immunization with Cendevax the specific rubella IgM response was measured by an IgM antibody capture radioimmunassay (MACRIA). It was only detectable in the group without RH antibody, and was present in 26/31 of them. The IgM response to Cendevax was strongest in specimens taken 20-39 days after immunization, but in 10 out of 11 cases tested was still present at around 71 days. The specific IgM responses to Cendevax were very similar to those in women given Almevax in an earlier study, when measured in parallel tests.Taking both vaccines together, specific IgM was present in 35 out of 36 vaccinees without pre-existing antibody tested between 40 and 77 days post-immunization. Detection of specific IgM by MACRIA would therefore be an effective means of determining susceptibility retrospectively in rubella vaccinees found to be pregnant.

Evaluation of Three Immunoassays Used for Detection of Anti-Rubella Virus Immunoglobulin M Antibodies

“…Results may depend on how much time has elasped between infection and sample collection. RV IgM may be detectable for more than 1 year following infection or vaccination and may occasionally be detected after asymptomatic reinfection (12,19,26). IgM antibodies generated in rheumatoid arthritis or polyclonal IgM a The specificities of three RV IgM assays (Abbott AxSYM, Bayer ADVIA Centaur, and bioMerieux VIDAS) were estimated with a panel of RV IgM-negative samples (n ϭ 220) whose status was assigned prior to any testing with the assays assessed.…”

Maturation of immunoglobulin G avidity after rubella vaccination studied by an enzyme linked immunosorbent assay (Avidity‐ELISA) and by haemolysis typing

“…Careful typing ofthe haemolytic zones is therefore a useful adjunct in a diagnostic laboratory, which is highlighted by the fact that one third of all rubella serodiagnoses (>400 patients) obtained during 1985-1987 a t the Department of Virology, University of Helsinki, were obtained by IgM examinations performed because of a soft RH zone [Hedman et al, 1986;our unpublished data]. In many studies, rubella-IgM has occurred less regularly after (primary) vaccination than after natural rubella [Al-Nakib et al, 1975;Diment and Chantler, 1981;Meegan et al, 1983;Mortimer et al, 1984;Suni et al, 19841. Similarly, IgM was observed in only 69% of our previously seronegative recipients of the Cendehill vaccine 2 months after injection. This result contrasts with the high frequency (> 10%) of prolonged (1.5 years) IgM responses, a phenomenon that was also previously observed [Al-Nakib et al, 1975;Meegan et al, 1983;Mortimer et al, 1984;Storch and Myers, 1984;OShea et al, 19851.…”

“…In many studies, rubella-IgM has occurred less regularly after (primary) vaccination than after natural rubella [Al-Nakib et al, 1975;Diment and Chantler, 1981;Meegan et al, 1983;Mortimer et al, 1984;Suni et al, 19841. Similarly, IgM was observed in only 69% of our previously seronegative recipients of the Cendehill vaccine 2 months after injection. This result contrasts with the high frequency (> 10%) of prolonged (1.5 years) IgM responses, a phenomenon that was also previously observed [Al-Nakib et al, 1975;Meegan et al, 1983;Mortimer et al, 1984;Storch and Myers, 1984;OShea et al, 19851. On the other hand, all the "vaccination reinfections" remained IgM-negative, as in a study employing a sensitive M-antibody capture radioimmunoassay [Mortimer et al, 19841. The antibody response to the attenuated rubella virus vaccines is weaker and more slowly evolving than the response to natural infection [Ogra et al, 1971;Serdula et al, 1974;Grillner, 1975;Perkins, 19851. Considering the similarity of the rate of occurrence of low-avidity IgG in the avidity-ELISA technique after vaccination and after natural rubella, it was interesting to observe that the soft haemolysis seemed to occur less regularly here, especially in the Cendehill group, than after natural rubella [Hedman et al, 19861.…”

Rubella vaccines: past, present and future

“…Most adult women who are vaccinated have been screened and shown to be susceptible to rubella. However, in cases where the woman has not been tested, it is often possible to determine her immune status retrospectively, by testing a serum sample taken within 8 weeks of immunization for rubella-specific IgM, which can usually be detected if there was no prior immunity [55,56].…”

“…DE5 vaccinees are more likely to have low antibody concentrations, become seronegative and exhibit booster antibody responses than RA27/3 vaccinees [65,66], which is why the RA27/3 vaccine strain is now the most widely used. Rubella-specific IgM can be detected in serum of most vaccinees between 3 and 8 weeks after immunization if sensitive techniques are employed [56,57,59]. Using an M-antibody capture radioimmunoassay (MACRIA), low levels of IgM antibodies have been detected in 18 of 53 (33 9 %) vaccinees 1 year after immunization [52] and in 7 of the 18, 3 years after immunization (S. O'Shea, J. M. Best and J. E. Banatvala, unpublished results).…”