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Seroprotection after Measles Vaccination in Children with Sickle Cell Anemia Receiving Hydroxyurea

Alexandra Power-Hays1, Abigail Leigh Kincaid2, Kathryn E McElhinney3

  • 1University of Cincinnati College of Medicine, United States.

Blood Advances
|July 14, 2026
PubMed

Insights

Children with sickle cell anemia (SCA) achieve good measles immunity after vaccination. Early hydroxyurea treatment may enhance protection, suggesting timely vaccination and treatment are key for measles seroprotection in SCA patients.

Area of Science:

  • Pediatrics
  • Immunology
  • Hematology

Background:

  • Children with sickle cell anemia (SCA) may exhibit altered immune responses to routine vaccines.
  • The impact of SCA on measles vaccination antibody response and seroprotection is not well-established.
  • Global measles resurgence necessitates understanding vaccine efficacy in vulnerable pediatric populations like those with SCA.

Purpose of the Study:

  • To evaluate anti-measles antibody seroprotection in children with SCA after measles vaccination.
  • To investigate the influence of age and concurrent hydroxyurea treatment on measles vaccine response in children with SCA.

Main Methods:

  • Retrospective cohort study of children with SCA enrolled in the TREAT trial (NCT02286154).
  • Assessed anti-measles IgG antibody levels via ELISA to determine seroprotection (≥ 200 IU/L) after the first (MV1) and second (MV2) measles vaccine doses.
  • Analyzed the association between age, hydroxyurea treatment, and measles seroprotection.

Main Results:

  • High rates of seroprotection were observed: 94% after MV1 (33/35 children) and 92% after MV2 (46/50 children).
  • Increased age at MV2 was linked to decreased odds of seroprotection (OR 0.25, p=0.02).
  • Hydroxyurea treatment did not impair seroprotection; earlier initiation correlated with increased seroprotection (OR 4.4, p=0.02).

Conclusions:

  • The majority of children with SCA achieve adequate measles seroprotection post-vaccination, comparable to the general population.
  • Timely measles vaccination is crucial for establishing protective immunity in children with SCA.
  • Early initiation of hydroxyurea treatment may enhance measles vaccine response in children with SCA.

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