Elsevier

Vaccine

Volume 19, Issues 11–12, 8 December 2001, Pages 1363-1368
Vaccine

Correlations between measles, mumps, and rubella serum antibody levels in Olmsted County school children

https://doi.org/10.1016/S0264-410X(00)00376-5Get rights and content

Abstract

We examined correlations between serum antibody levels to determine whether individuals with low levels of antibody to one component of the measles, mumps, and rubella (MMR) vaccine were also likely to have low antibody levels to the other MMR vaccine components. Our results indicate that children who had a low antibody level to one component of the MMR vaccine had a modest probability of having a low antibody level to either of the other MMR vaccine components. Overall, we found small, but statistically significant, correlations between antibody levels that were largely unaffected by race, sex, age at immunization, and time since immunization. While the correlations we observed were modest, ∼25% of our population was seronegative for at least one component of the MMR vaccine. Therefore, our results support the current policy of continuing to administer the trivalent MMR vaccine even when only a single low antibody titer is observed.

Introduction

Wide spread use of the measles–mumps–rubella (MMR) vaccine has significantly reduced both the morbidity and mortality attributable to infection with measles, mumps, and rubella viruses. Measles outbreaks continue to be a significant public health problem, however, and both measles and mumps cases have occurred in vaccinated individuals [1], [2], [3], [4], [5], [6], [7].

Previous studies have indicated that primary measles, mumps, and rubella vaccine failures occur in ∼2–7% of vaccinated individuals. Specifically, primary measles vaccine failure appears to occur in ∼2–5% of age-appropriately vaccinated children [8], [9], [10], while primary mumps vaccine failure occurs in 3–7% of vaccinated children [11], [12]. Primary rubella vaccine failure has been shown to occur in ∼2–5% of vaccinated children [13], [14], [15], [16], [17]. Previous studies have also examined the effect of various factors on serum antibody levels to the individual components of the MMR vaccine, including the age at vaccination and the time since vaccination [18], [19], [20], [21], [22], [23]. To the best of our knowledge, however, no studies have specifically examined the intraindividual correlation between measles, mumps, and rubella serum antibody levels. Therefore, it is not clear if individuals with low levels of antibody to one component of the MMR vaccine are also likely to have low antibody levels to the other MMR vaccine components. Decreased circulating antibody to all three antigens could represent receipt of an inadvertently inactivated vaccine, due to inappropriate handling or storage of the vaccine. If so, we would expect high correlations between the antibody levels to all three vaccine antigens. Similarly, some individuals might be unable to process and present all three MMR antigens due to an underlying immunologic defect, causing an overall depression of all three antibody levels. Such a generalized depression of the immune response might also result in a high correlation between antibody levels. Alternatively, if an individual processes and presents different antigens in different ways, we would expect more variability and less correlation between antibody levels.

It is also unclear whether factors such as sex, race, age at immunization, and time since immunization are associated with low antibody levels to all three vaccine components. If such associations are evident, vaccination strategies may need to be changed to improve vaccine response in the groups which fail to respond to all three vaccine components. To better understand these questions, we examined the correlations between serum measles, mumps, and rubella antibody levels in children living in Olmsted County, MN.

Section snippets

Subjects

Many of the details of subject identification and recruitment have been previously published [18], [24], [25], [26]. Briefly, we collected serum samples from a volunteer group of children aged 5–13 attending elementary schools in Olmsted County, MN. Olmsted County has a highly vaccinated population and lacks circulating wild measles, mumps, and rubella viruses, as indicated by the lack of resident measles, mumps, or rubella cases in the lifetimes of the study participants (personal

Results

A total of 763 children participated in our study. The majority of the study participants were Caucasian (95%), and 49% were female. The mean age of study participants at the time of enrolment was 8.8 years (range: 5–12), while the mean age of the children at the time of vaccination was 15.7 months (range: 10–20). Measles levels were not available for two children, mumps levels were not available for three children, and rubella antibody levels were not available for 129 children.

On average,

Discussion

Our results indicate that children who have a low circulating antibody level to one component of the MMR vaccine have a modest probability of having a low antibody level to either of the other MMR vaccine components. Overall, we found small, but statistically significant, correlations between antibody levels that were largely unaffected by race, sex, age at immunization, and time since immunization.

Taken together, our results suggest that low antibody responses were not due to vaccination with

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