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Measles-mumps-rubella booster and post-COVID-19 immunity: A retrospective cohort study
Ladislav Štěpánek1, Marie Nakládalová2, Alena Boriková2
1Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Zdravotníků 248/7, 77900 Olomouc, Czech Republic; Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77900 Olomouc, Czech Republic.
Background:
The potential cross-protective effect of measles, mumps, and rubella (MMR) vaccination against coronavirus disease 2019 (COVID-19) is debated. Although immunological studies suggest cross-reactivity between MMR-induced immunity and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), epidemiological evidence remains inconclusive. This study examined the association between an additional MMR dose and both COVID-19 clinical and serological outcomes in an adult cohort with verified pre-pandemic measles immunity.
Methods:
In 2019, prior to the COVID-19 pandemic, 3027 healthcare workers from a Czech university hospital underwent measles serology testing. Seronegative individuals were offered a single additional MMR dose. Between 2020 and 2021, 261 individuals from the original sample subsequently contracted COVID-19 and underwent post-infection SARS-CoV-2 immunoglobulin G (IgG) serology testing, having remained unvaccinated against COVID-19 until that time.
Results:
Among 212 women and 49 men (mean age: 42.7 years), 150 were measles-seropositive (without additional vaccination) and 111 were measles-seronegative but received an additional MMR dose. Following COVID-19, 216 participants (82.8 %) exhibited SARS-CoV-2 IgG seropositivity. No significant relationship was observed between measles immunity or MMR vaccine administration and COVID-19 clinical characteristics. However, individuals who received an additional MMR dose were significantly more likely to develop SARS-CoV-2 IgG seropositivity (88.3 % vs. 78.7 %; p = 0.042). Regression analysis confirmed additional MMR vaccination as an independent predictor of post-COVID-19 seropositivity (odds ratio 1.81, 95 % confidence interval 1.17-2.81, p = 0.008), irrespective of the interval between MMR vaccination and COVID-19 symptom onset. No correlation was found between pre-pandemic measles antibody titers and SARS-CoV-2 antibody levels (r = 0.09, p = 0.246).
Conclusion:
While no protective effect of adult MMR vaccination on COVID-19 clinical outcomes was observed, a significant immunological interaction was identified. These findings align with the concept of trained immunity and warrant further investigation.
Insights
An additional measles, mumps, and rubella (MMR) vaccine dose in adults did not affect COVID-19 clinical outcomes but increased SARS-CoV-2 IgG seropositivity, suggesting an immunological interaction. Further research into trained immunity is warranted.
Area of Science:
- Immunology
- Vaccinology
- Infectious Diseases
Background:
- The cross-protective effect of measles, mumps, and rubella (MMR) vaccination against COVID-19 is debated.
- Immunological studies suggest cross-reactivity, but epidemiological evidence is inconclusive.
- This study investigated MMR's impact on COVID-19 outcomes in adults with pre-existing measles immunity.
Purpose of the Study:
- To examine the association between an additional MMR dose and clinical/serological COVID-19 outcomes.
- To assess the impact of MMR vaccination on SARS-CoV-2 immunoglobulin G (IgG) seropositivity post-infection.
Main Methods:
- 3027 healthcare workers had measles serology in 2019.
- Seronegative individuals received an additional MMR dose.
- 261 participants who contracted COVID-19 (unvaccinated against COVID-19) underwent SARS-CoV-2 IgG testing.
Main Results:
- No significant association between measles immunity/MMR and COVID-19 clinical characteristics.
- Individuals receiving an additional MMR dose showed higher SARS-CoV-2 IgG seropositivity (88.3% vs. 78.7%).
- Additional MMR vaccination independently predicted post-COVID-19 seropositivity (OR 1.81).
Conclusions:
- Adult MMR vaccination showed no protective effect on COVID-19 clinical outcomes.
- A significant immunological interaction was identified, supporting the concept of trained immunity.
- Findings warrant further investigation into MMR's role in modulating immune responses to SARS-CoV-2.
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