Measles mumps and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine.

Friday, 2nd of March 2018

Vaccine. 2018 Feb 1;36(6):818-826. doi: 10.1016/j.vaccine.2017.12.075. Epub 2018 Jan 6.

Measles mumps and rubella antibody patterns of persistence and rate of decline following the second dose of the MMR vaccine.

Seagle EE¹ Bednarczyk RA² Hill T³ Fiebelkorn AP⁴ Hickman CJ⁵ Icenogle JP⁵ Belongia EA³ McLean HQ⁶.

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Abstract

BACKGROUND:

Antibodies to measles mumps and rubella decline 3% per year on average and have a high degree of individual variation. Yet individual variations and differences across antigens are not well understood. To better understand potential implications on individual and population susceptibility we reanalyzed longitudinal data to identify patterns of seropositivity and persistence.

METHODS:

Children vaccinated with the second dose of measles mumps rubella vaccine (MMR2) at 4-6 years of age were followed up to 12 years post-vaccination. The rates of antibody decline were assessed using regression models accounting for differences between and within subjects.

RESULTS:

Most of the 302 participants were seropositive throughout follow-up (96% measles 88% mumps 79% rubella). The rate of antibody decline was associated with MMR2 response and baseline titer for measles and age at first dose of MMR (MMR1) for rubella. No demographic or clinical factors were associated with mumps rate of decline. One month post-MMR2 geometric mean titer (GMT) to measles was high (3892 mIU/mL) but declined on average 9.7% per year among those with the same baseline titer and <2-fold increase post-MMR2. Subjects with ≥2-fold experienced a slower decline (≤7.4%). GMT to rubella was 149 one month post-MMR2 declining 2.6% and 5.9% per year among those who received MMR1 at 12-15 months and >15 months respectively. GMT to mumps one month post-MMR2 was 151 declining 9.2% per year. Only 14% of subjects had the same persistence trends for all antigens.

CONCLUSIONS:

The rate of antibody decay varied substantially among individuals and the 3 antigen groups. A fast rate of decline coupled with high variation was observed for mumps yet no predictors were identified. Future research should focus on better understanding waning titers to mumps and its impacts on community protection and individual susceptibility in light of recent outbreaks in vaccinated populations.

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