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Investigating the measles susceptibility gap in Ontario infants
Shelly Bolotin1, James Wright2, Elizabeth McLachlan3
1Public Health Ontario, Toronto, Ontario M5G 1M1, Canada; Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto M5T 3M7, Canada.
Background:
Prior to receiving their first dose of measles-containing vaccine, infants may be protected against infection either via antibodies obtained transplacentally from their mothers or by herd immunity. However, there is evidence that transplacental protection may wane well-before the age of first measles vaccination.
Methods:
We conducted a cross-sectional study of infants <12 months of age at The Hospital for Sick Children (SickKids) in Toronto, Ontario, and their mothers. We calculated the probability of measles susceptibility in infants and predicted the mean antibody titre by age.
Results:
Measles seroprevalence decreased with age, starting at 70.4 % (38/54) in the first month of life and declining to 0.0 % (0/18) by four months of age. Regression models adjusted for maternal place of birth and measles immunity status indicated that the odds of susceptibility approximately tripled with every increasing month of age.
Interpretation:
Infants in our study are likely susceptible to measles for the majority of their first year of life. All measles-exposed infants should be presumed susceptible, regardless of age. High population-level measles vaccine coverage is essential to protect this susceptible population.
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