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

Thursday, 28th of June 2018

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

Author links open overlay pane lEmma E.Seagle^abRobert A.Bednarczyk^bTenishaHill^aAmy ParkerFiebelkorn^cCarole J.Hickman^dJoseph P.Icenogle^dEdward A.Belongia^aHuong Q.McLean^a

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https://doi.org/10.1016/j.vaccine.2017.12.075Get rights and content

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.