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Long-term Dynamics of Measles Virus-Specific Neutralizing Antibodies in Children Vaccinated Before 12 Months of Age
Maaike van der Staak1,2, Hinke I Ten Hulscher1, Alina M Nicolaie1
1Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Insights
Early measles vaccination before 8.5 months may blunt antibody responses to the measles, mumps, and rubella (MMR) vaccine. This can lead to loss of protective antibody levels, suggesting routine early vaccination is not advised.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Measles is highly contagious, posing risks to unvaccinated individuals.
- Early measles vaccination (under 12 months) offers protection but may reduce effectiveness of later doses.
- Concerns exist regarding blunted antibody responses and lower vaccine effectiveness with early vaccination.
Purpose of the Study:
- To investigate the long-term impact of early measles, mumps, and rubella (MMR) vaccination on measles virus (MeV)-specific neutralizing antibodies.
- To compare antibody responses in children receiving early MMR vaccination versus those on a standard schedule.
Main Methods:
- Study included children with early MMR (6-12 months) and standard MMR schedules.
- Measles virus (MeV)-specific neutralizing antibodies were measured using a plaque reduction neutralization test.
- Antibody levels were assessed before vaccination at 14 months and up to 6 years post-vaccination.
Main Results:
- A significant association was found between the age of first MMR vaccination and later antibody levels.
- Children vaccinated before 8.5 months showed faster antibody decay and lost protective levels within 6 years.
- Most children seroconverted after the first dose, but early vaccination impacted long-term immunity.
Conclusions:
- Routine infant vaccination before 8.5 months may result in blunted MeV-specific antibody responses to subsequent MMR vaccination.
- Early MMR vaccination should be reserved for high-risk situations like measles outbreaks.
- Further research may be needed to optimize infant vaccination strategies.
Background:
Measles is a highly contagious disease, presenting a significant risk for unvaccinated infants and adults. Measles vaccination under the age of 12 months provides early protection but has also been associated with blunting of antibody responses to subsequent measles vaccinations and assumed to have lower vaccine effectiveness.
Methods:
Our study included children who received an early measles, mumps, and rubella (MMR) vaccination between 6 and 12 months of age (n = 79, given in addition to the regular MMR vaccination schedule at 14 months and 9 years) and a group without additional early vaccination (n = 44). We evaluated measles virus (MeV)-specific neutralizing antibodies before vaccination at 14 months and up to 6 years thereafter using a plaque reduction neutralization test according to the standard set by the World Health Organization.
Results:
We found a significant association between age of first MMR and MeV-specific neutralizing antibody levels later in life. Although most children who received early vaccination seroconverted after the first dose, children vaccinated before 8.5 months of age exhibited a markedly faster antibody decay and lost their protective neutralizing antibody levels over 6 years.
Conclusions:
Routine vaccination of infants under 8.5 months of age may lead to blunted MeV-specific antibody responses to subsequent MMR vaccination. Early MMR vaccination should only be considered during measles outbreaks or in other situations of increased risk of MeV infection. Clinical Trials Registration. EudraCT 2013-003078-28.
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