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Rubella, measles and mumps antibodies following vaccination of children. A potential rubella problem
Insights
Vaccine efficacy for rubella, measles, and mumps in children shows varying failure rates over time. Postponing vaccinations until 15 months may improve rubella and measles vaccine effectiveness.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Vaccinology
Background:
- Assessing the long-term immunogenicity of childhood vaccines is crucial for public health.
- Rubella, measles, and mumps vaccines are standard components of pediatric immunization schedules.
- Understanding serologic failure rates informs vaccination timing and reimmunization strategies.
Purpose of the Study:
- To determine the efficacy of rubella, measles, and mumps vaccines in a cohort of children.
- To evaluate the impact of vaccination age on vaccine failure rates.
- To assess the need for potential changes in current vaccination policies.
Main Methods:
- Serum antibody levels were measured in 168 children post-vaccination.
- Vaccine efficacy was assessed by serologic failure rates at mean post-vaccination intervals.
- Data were analyzed based on age at vaccination and specific vaccine strains.
Main Results:
- Serologic failure rates were 36% for rubella (4.7 years post-vaccination), 18% for measles (6.5 years), and 9% for mumps (4.5 years).
- Children vaccinated before 14 months of age exhibited higher failure rates for rubella and measles.
- A significant proportion (24%) of children vaccinated with the HPV77 DE5 rubella strain at or after 14 months had low antibody titers.
Conclusions:
- Current rubella, measles, and mumps vaccines demonstrate variable long-term efficacy.
- Postponing rubella and measles vaccination to at least 15 months of age may enhance effectiveness.
- The HPV77 DE5 rubella strain warrants further investigation due to suboptimal antibody responses in some children.
Abstract:
One hundred sixty-eight children immunized by one suburban Minneapolis clinic during routine pediatric visits had serum antibodies measured to determine the efficacy of rubella (HPV77 DE5 strain), measles (Edmonston B and Moraten strains), and mumps (Jeryl Lynn strain) vaccines. Serologic failure rates at the mean postvaccination times tested were as follows: rubella, 36% (4.7 years); measles, 18% (6.5 years); and mumps, 9% (4.5 years). Antibody titers shortly after vaccination were not done, so seronegative subjects may never have responded or their titers may have declined with time; our rubella data suggest the former. Children vaccinated with rubella and measles at less than 14 months of age had higher failure rates than those vaccinated at a later age. This supports postponement of rubella and measles vaccinations until at least 15 months of age. In addition to current measles reimmunization policies, consideration also should be given to reimmunizing girls who were given rubella vaccine at less than 14 months of age. Twenty-four percent (19/79) of children vaccinated with HPV77 DE5 strain rubella at 14 months or older had rubella hemagglutination-inhibiting titers less than 8. This is disturbing and, if confirmed by others, would prompt the use of a different strain of rubella vaccine for routine immunization.