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Vaccine Response Assessment in Children Using Dried Blood Spots: The DRIVE Study.

Paula Rodríguez-Molino^1,2,3,4, Ana Rodríguez Galet⁵, Iker Falces-Romero^2,4,6

¹General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.

The Journal of Infectious Diseases

|May 25, 2026

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Dried blood spots (DBS) offer a reliable method for assessing vaccine immunity in children. Optimized cut-offs improve accuracy, especially for immunocompromised individuals, aiding global immunization monitoring.

Area of Science:

Pediatric immunology
Vaccinology
Diagnostic accuracy studies

Background:

Dried blood spots (DBS) offer a minimally invasive alternative to serum for serological surveillance.
Pediatric data on DBS for vaccine immunity assessment are limited, especially in immunocompromised children.
This study addresses the need for reliable pediatric DBS data in high-resource settings.

Purpose of the Study:

To evaluate the diagnostic accuracy of DBS for assessing vaccine-induced immunity in a pediatric cohort.
To compare DBS performance against serum samples in both immunocompromised and non-immunocompromised children.
To determine optimal DBS cut-off values for IgG antibodies against six vaccine-preventable diseases.

Main Methods:

Prospective observational study of 134 children and adolescents at La Paz University Hospital, Madrid.

Keywords:

Dried blood spots antibodies children and adolescents immunization pediatrics serology vaccination

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Quantification of IgG antibodies against diphtheria, tetanus, pertussis, measles, mumps, and rubella using chemiluminescence assay.

ROC curve analysis to establish optimal DBS cut-off values for each pathogen.

Main Results:

DBS demonstrated high sensitivity (>95%) and specificity (>85%) for most pathogens using serum cut-offs.
Lower performance was noted for pertussis sensitivity and rubella/mumps specificity.
Optimized DBS cut-offs improved specificity for rubella and mumps, maintaining >80% sensitivity in immunocompromised children for most pathogens.

Conclusions:

Dried blood spots (DBS) are a reliable and practical tool for assessing vaccine-induced immunity in pediatric populations.
Ease of collection and transport makes DBS valuable, particularly in resource-limited settings.
Population-specific cut-offs are crucial for ensuring diagnostic accuracy, especially in immunocompromised children, to support immunization monitoring.