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USEFULNESS OF EVALUATION OF ANTIMEASLES ANTIBODIES IN PRETERM BABIES
G S Chopra1, P K Sarkar2, A Dhulia3
1Classified Specialist (Pathology and Immunology), Command Hospital(Eastern Command), Calcutta-27.
Insights
Measles vaccination at 9 months may be ineffective for preterm infants due to lower maternal antibodies. This study suggests administering the measles vaccine at 5 months for preterm babies to ensure effective immunity.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- The World Health Organization recommends measles vaccination at 9 months, based on typical seroconversion rates.
- Preterm infants may have diminished passively transferred maternal IgG antibodies, potentially impacting vaccine efficacy.
- Maternal antibody levels can influence infant immune responses to vaccination.
Purpose of the Study:
- To investigate the antimeasles antibody levels and seroconversion rates in preterm infants.
- To determine the optimal timing for measles vaccine administration in preterm neonates.
- To assess the impact of maternal antibodies on measles vaccine response in premature infants.
Main Methods:
- Serum samples were collected from 50 preterm infants (gestational age < 37 weeks) at birth, 3 months, and 5 months.
- Antimeasles antibody levels were quantified using enzyme-linked immunosorbent assay (ELISA) kits.
- Seroconversion was monitored to assess the development of active immunity.
Main Results:
- At birth, 32% of preterm infants had positive antimeasles antibodies, 60% were weakly positive, and 8% were negative.
- By 3 months of age, 50% of infants were seronegative, 40% weakly positive, and only 2% positive.
- At 5 months, 98% of preterm infants demonstrated seronegativity, indicating a delayed seroconversion.
Conclusions:
- The majority of preterm infants achieve seroconversion by 5 months of age.
- Current 9-month measles vaccination schedule may not be optimal for preterm infants.
- Administering the measles vaccine at 5 months is recommended for preterm infants to enhance protection.
Abstract:
As per WHO recommendations, measles vaccine is administered at the age of 9 months which is based on studies demonstrating seroconversion (from positive to negative) at this age. However this contention may not hold good in preterm babies since they may have lower initial levels of passively transferred IgG antimeasles antibodies of maternal origin. To explore this possibility, 50 preterm babies (gestational age less than 37 weeks) were studied for antimeasles antibodies. Serum samples were collected at birth and then at 3 months and 5 months of age in all the cases. Antimeasles antibody assay was done in all the serum samples using ELISA kits. At birth 32% of infants were positive for antimeasles antibodies whereas 60% were weakly positive and 8% were negative. At 3 months of age 50% were sero negative, 2% positive and 40% weakly positive. The sero negativity was found to be 98% at 5 months with only 2% remaining positive. Since seroconversion is seen to occur in this vast majority of preterm infants at the age of 5 months, antimeasles vaccine should be administered at this age to this subset of more vulnerable babies.
