Early Measles Vaccination During an Outbreak in the Netherlands: Short-Term and Long-Term Decreases in Antibody Responses Among Children Vaccinated Before 12 Months of Age. (11th April 2019)

• Record Type: Journal Article
• Authors: Brinkman, Iris D; de Wit, Jelle; Smits, Gaby P; ten Hulscher, Hinke I; Jongerius, Maria C; Abreu, Taymara C; van der Klis, Fiona R M; Hahné, Susan J M; Koopmans, Marion P G; Rots, Nynke Y; van Baarle, Debbie; van Binnendijk, Robert S
• Is Part Of: Journal of infectious diseases. Volume 220:Number 4(2019)
• Page Start: 594
• Page End: 602
• Publication Date: 2019-04-11
• Subjects: Antibody response -- timing of vaccination -- protection -- antibody avidity; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiz159
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: The majority of infants will not be protected by maternal antibodies until their first measles vaccination, between 12 and 15 months of age. This provides incentive to reduce the age at measles vaccination, but immunological consequences are insufficiently understood, and long-term effects are largely unknown. Methods: A total of 79 infants who received early measles vaccination between 6 and 12 months age and a second dose at 14 months of age were compared to 44 children in a control group who received 1 dose at 14 months of age. Measles virus–specific neutralizing antibody concentrations and avidity were determined up to 4 years of age. Results: Infants who first received measles vaccination before 12 months of age had a long-term decrease in the concentration and avidity of measles virus–specific neutralizing antibodies, compared with infants in the control group. For 11.1% of children with a first dose before 9 months of age, antibody levels at 4 years of age had dropped below the cutoff for clinical protection. Conclusions: Early measles vaccination provides immediate protection in the majority of infants but yields a long-term decrease in neutralizing antibody responses, compared to vaccination at a later age. Additional vaccination at 14 months of age does not improve this. Over the long term, this may result in an increasing number of children susceptible to measles. Abstract : Measles vaccination before 9 months of age results in reduced levels of measles virus neutralizing antibodies. Additional vaccination only leads to a short-term increase in antibody levels. Among children who received early vaccination, the number with nonprotective antibody levels increased over the long term.