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Low Measles Seropositivity in Vaccinated Children
Huy Quang Quach1, Sara P Jones2, Iype Joseph2
1Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA Network Open
|August 27, 2025
Summary
Despite high measles vaccination rates in Indian children, significant immunity gaps and breakthrough infections persist, challenging elimination goals. Further research is needed to address suboptimal vaccine responses and strengthen immunization programs.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- India's measles elimination goal is hindered by ongoing outbreaks.
- High measles vaccine coverage does not always translate to complete population immunity.
Purpose of the Study:
- To determine measles seroprevalence in vaccinated Indian children.
- To investigate demographic factors influencing measles antibody responses.
- To identify potential gaps in vaccine-induced immunity.
Main Methods:
- A cross-sectional study of 684 vaccinated children and 544 mothers in Kerala and Tamil Nadu (2018-2023).
- Quantification of measles-specific immunoglobulin G (IgG), neutralizing antibodies, and IgM in serum samples.
- Analysis of demographic factors and vaccine doses in relation to antibody titers.
Main Results:
- 90.8% of children had positive measles-specific IgG and 91.5% had protective neutralizing antibodies.
- Female children showed higher antibody titers than males; titers were stable over time and not dose-dependent in children.
- Differential measles-specific IgM profiles in siblings suggested breakthrough infections despite high IgG and neutralizing antibody levels.
Conclusions:
- Substantial measles immunity gaps exist in highly vaccinated Indian children, indicating breakthrough infections.
- These findings challenge India's measles elimination efforts and highlight the need to strengthen the immunization program.
- Addressing suboptimal immune responses to measles vaccination is crucial for achieving elimination goals beyond simply increasing vaccine coverage.
