Measles virus neutralizing antibody response, cell-mediated immunity, and immunoglobulin G antibody avidity before and after receipt of a third dose of measles, mumps, and rubella vaccine in young adults

Amy Parker Fiebelkorn, Laura A. Coleman, Edward A. Belongia, Sandra K. Freeman, Daphne York, Daoling Bi, Ashwin Kulkarni, Susette Audet, Sara Mercader, Marcia McGrew, Carole J. Hickman, William J. Bellini, Rupak Shivakoti, Diane E. Griffin, Judith Beeler

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Two doses of measles, mumps, and rubella (MMR) vaccine are 97% effective against measles, but waning antibody immunity to measles and failure of the 2-dose vaccine occur. We administered a third MMR dose (MMR3) to young adults and assessed immunogenicity over 1 year. Methods. Measles virus (MeV) neutralizing antibody concentrations, cell-mediated immunity (CMI), and immunoglobulin G (IgG) antibody avidity were assessed at baseline and 1 month and 1 year after MMR3 receipt. Results. Of 662 subjects at baseline, 1 (0.2%) was seronegative for MeV-neutralizing antibodies (level, <8 mIU/mL), and 23 (3.5%) had low antibody levels (8-120 mIU/mL). One month after MMR3 receipt, 1 subject (0.2%) was seronegative, and 6 (0.9%) had low neutralizing antibodies, with only 21 of 662 (3.2%) showing a ≥4-fold rise in neutralizing antibodies. One year after MMR3 receipt, no subject was seronegative, and 10 of 617 (1.6%) had low neutralizing antibody levels. CMI analyses showed low levels of spot-forming cells after stimulation, suggesting the presence of T-cell memory, but the response was minimal after MMR3 receipt. MeV IgG avidity did not correlate with findings of neutralization analyses. Conclusions. Most subjects were seropositive before MMR3 receipt, and very few had a secondary immune response after MMR3 receipt. Similarly, CMI and avidity analyses showed minimal qualitative improvements in immune response after MMR3 receipt. We did not find compelling data to support a routine third dose of MMR vaccine.

Original languageEnglish (US)
Pages (from-to)1115-1123
Number of pages9
JournalJournal of Infectious Diseases
Volume213
Issue number7
DOIs
StatePublished - Apr 1 2016

Keywords

  • Cell-mediated immunity
  • Immunization
  • Measles
  • Measles vaccine immunogenicity
  • Measles virus antibody avidity
  • Mumps
  • Rubella (MMR) vaccine
  • Third dose of measles
  • Vaccinepreventable disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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