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Mumps antibody response in young adults after a third dose of measles-mumps-rubella vaccine
Amy Parker Fiebelkorn1, Laura A Coleman2, Edward A Belongia2
1National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
Background:
Mumps outbreaks in populations with high 2-dose measles-mumps-rubella (MMR) vaccine coverage raise the question whether a third dose of MMR vaccine (MMR3) is needed. However, data on the immunogenicity of MMR3 are limited. We assessed mumps virus neutralizing antibody levels pre- and post-MMR3 in a nonoutbreak setting.
Methods:
Mumps antibody titers were assessed at baseline, 1 month, and 1 year after MMR3 in subjects aged 18-28 years.
Results:
At baseline, 5 of 656 (0.8%) subjects had seronegative mumps neutralizing antibody titers and 38 (5.8%) had low titers. One year post-MMR3, these numbers declined to 3 (0.5%) and 16 (2.4%), respectively. Subjects with low baseline titers were more likely to have low 1-month and 1-year titers (R (2) = 0.81-0.87, P < .0001). Compared to baseline, geometric mean titers were significantly higher at 1 month (P < .0001) and 1 year (P < .01) post-MMR3; however, reverse cumulative distribution curves showed only minimal shifts in mumps titers from baseline to 1 month and 1 year.
Conclusions:
Very few subjects had negative or low baseline mumps titers. Nonetheless, mumps titers had modest but significant increases when measured 1 month and 1 year post-MMR3. This temporary increase in titers could decrease susceptibility to disease during outbreaks, but may have limited value for routine use in vaccinated populations.
Insights
A third dose of the measles-mumps-rubella (MMR) vaccine modestly increased mumps antibody titers temporarily in young adults. This boost may offer short-term protection during outbreaks but has limited value for routine vaccination.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Mumps outbreaks occur despite high 2-dose measles-mumps-rubella (MMR) vaccine coverage.
- The need for a third MMR dose (MMR3) is questioned due to limited immunogenicity data.
Purpose of the Study:
- To assess mumps virus neutralizing antibody levels before and after a third MMR dose.
- To evaluate the immunogenicity of MMR3 in a non-outbreak setting.
Main Methods:
- Antibody titers were measured at baseline, 1 month, and 1 year post-MMR3.
- The study included subjects aged 18-28 years.
Main Results:
- Most subjects had adequate mumps antibody titers at baseline (99.2%).
- One year after MMR3, geometric mean titers increased significantly, but reverse cumulative distribution curves showed minimal shifts.
- Low baseline titers predicted lower titers post-vaccination.
Conclusions:
- MMR3 resulted in modest, temporary increases in mumps antibody titers.
- The temporary titer increase may offer some protection during outbreaks.
- Routine use of MMR3 in highly vaccinated populations may have limited long-term value.
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