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Boosting effect of a second dose of measles vaccine given to 12-year-old children
1Department of Epidemiology, National Bacteriological Laboratory, Stockholm, Sweden.
Insights
The measles, mumps, and rubella (MMR) vaccine booster in 12-year-olds showed lower antibody levels than natural measles infection. Long-term protection from single and two-dose MMR vaccination programs requires further study.
Area of Science:
- Immunology
- Public Health
- Pediatrics
Background:
- Sweden introduced a two-dose measles, mumps, and rubella (MMR) vaccination program in 1982 for children at 18 months and 12 years.
- By 1993, many 12-year-olds receiving the MMR booster had already been vaccinated against measles in infancy.
Purpose of the Study:
- To investigate the effectiveness of a measles, mumps, and rubella (MMR) booster dose in 12-year-old children.
- To compare antibody levels after vaccination versus natural measles infection.
Main Methods:
- Studied 163 12-year-old children, comparing 122 previously vaccinated children with 41 unvaccinated children.
- Measured neutralizing antibody titers before and after a measles, mumps, and rubella (MMR) booster dose.
- Compared antibody levels in vaccinated children, naturally immune children, and those receiving their first MMR dose.
Main Results:
- Previously vaccinated children had lower pre-booster antibody levels (reciprocal titre 8) than naturally immune children (reciprocal titre 20).
- Post-booster antibody levels were 13 in vaccinated children and 23 in naturally immune children.
- Antibody protection from vaccination was slightly lower than from natural infection, even after a booster.
Conclusions:
- The measles component of the MMR vaccine provides a booster effect, but antibody levels may be lower than after natural infection.
- Further follow-up studies are recommended to assess the long-term protection offered by both single-dose and two-dose MMR vaccination schedules.
Abstract:
In Sweden, a two-dose programme of vaccination against measles, mumps and rubella (MMR) was introduced in 1982 and the target groups were children aged 18 months and 12 years. In 1993 the first age group of 12-year-olds that were vaccinated with MMR at 18 months will appear. The majority of the 12-year-old vaccines for many years, however, had already been vaccinated against measles and the MMR measles component was thus a booster dose. As the benefit of a booster dose against measles has been questioned, this was studied in a group of 163 12-year-old children, 122 of whom had been vaccinated against measles as young children. Of the 41 unvaccinated children, 23 had a history of clinical measles. The mean neutralizing titre level of the earlier vaccinated children, prior to the booster, was lower than that of the naturally immune children (reciprocal titre level 8 versus 20). After the booster the corresponding titre levels were 13 and 23. Among the seronegative children receiving their first dose, this figure amounted to 14. A moderate rise in titre was seen in those with low prevaccination titres. As the antibody protection afforded by vaccination was slightly lower than that of natural infection, even after a booster, follow-up studies must be recommended to evaluate the long-term protection of both a single and a two-dose programme.