Vaccination and Immunity toward Measles: A Serosurvey in Future Healthcare Workers

Abstract

Measles is a very contagious infectious disease, and vaccination is the only medical aid to counter the spread of the infection. The aim of this study was to evaluate the influence of vaccination schedule and type of vaccine, number of doses, and sex on the immune response. In a population of Italian medical students (8497 individuals born after 1980 with certificate of vaccination and quantitative measurement of antibodies against measles), the prevalence of positive antibodies to measles and antibody titer was measured. Vaccination schedule such as number of doses and vaccine type (measles alone or combined as measles, mumps and rubella (MMR)) and sex were the variables considered to influence the immune response. The vaccination schedule depends on the year of birth: students born before 1990 were prevalently vaccinated once and with measles vaccine alone (not as MMR). One dose of vaccine induces a significantly (p < 0.0001) higher positive response and antibody titer than two doses, in particular when measles alone is used (p < 0.0001). Females have a significantly higher percentage of positive response (p = 0.0001) than males but only when the MMR formulation was used. Multiple linear regression confirms that sex significantly influences antibody titer when only MMR is used, after one (p = 0.0002) or two (p = 0.0060) doses. In conclusion, vaccination schedule and, partially, sex influence immune response to measles vaccination. Most notably, the measles vaccine alone (one dose) is more effective than one and two doses of MMR.

Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis

“…After exclusion of duplicate articles in the two databases, there were nine eligible studies [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ( Table 1 ), of which eight were quantitative [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] and one was qualitative [18] . The remaining 88 studies did not match the inclusion criteria [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , ...…”

Rubella Serosurvey Among Future Healthcare Workers

“…Indeed, two doses of the vaccine do not increase seropositivity and surprisingly result in a lower antibody titer. An adequate explanation is not at this moment available, except considering two factors: (1) One dose was administered at an older age (around 8 years) than the first dose, when the vaccine was administered twice (~2 years of age), and (2) the greater efficacy of the vaccine alone, widely used in the past, especially in females, in the single-dose vaccination schedule compared to the combined MMR vaccine, as already demonstrated for that vaccine against measles ( 21 ). Furthermore, our results clearly demonstrate that the antibody titer is significantly greater when the vaccine is administered in adolescence compared with that in childhood.…”