Early disappearance of maternal anti-measles mumps rubella and varicella antibodies in Indian infants.

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Vaccine. 2019 Mar 7;37(11):1443-1448. doi: 10.1016/j.vaccine.2019.01.043. Epub 2019 Feb 11.

Early disappearance of maternal anti-measles mumps rubella and varicella antibodies in Indian infants.

Malshe N¹ Palkar S¹ Kulkarni R² Lalwani S¹ Mishra AC² Arankalle V³.

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Abstract

BACKGROUND:

Immunization of children with vaccines against Measles Mumps Rubella and Varicella (MMRV) is practiced globally with varied recommendations. In India measles vaccine is administered alone or as MMR at 9 months age. Varicella vaccine is not routinely used. Immunization age is a function of disappearance of maternal antibodies and natural exposure of the children to the pathogens. In view of the measles-WHO-initiative we aimed to assess if the current immunization age for measles is still valid. In addition the kinetics of IgG and IgM antibodies against rubella mumps and varicella viruses was also examined.

METHODS:

This cross-sectional study was conducted at a tertiary care hospital in Pune India. A total of 600 children 150 each in 6-month/9-month (no vaccination) and 12-month/15-month (minimum 4 weeks post-measles-vaccine) cohorts were included. History of these infections and birth status (term/preterm) was recorded. All serum samples were screened for IgG-anti-MMRV-antibodies while IgG-positives were tested for specific IgM antibodies (ELISA).

RESULTS:

At 6-months the prevalence of MMRV antibodies was 4.7% 2.7% 10.7% 5.3% respectively depicting disappearance of maternal antibodies in majority of the children. Birth status did not influence antibody positivity. Despite vaccination at ∼9-months >25% children were still susceptible to measles virus at the age of 12/15-months. The ratio of clinical:subclinical infections was 4:10 (measles) and 12:1 (varicella). All the mumps/rubella IgM positives (1 and 2 respectively) represented subclinical infections.

CONCLUSION:

Demonstration of early disappearance of maternal antibodies against MMRV viruses leading to the risk of these infections at an early age emphasize need for early immunization of Indian children. Suboptimal response to measles vaccine needs to be seriously addressed especially in view of the WHOs initiative for measles eradication.

Copyright © 2019 Elsevier Ltd. All rights reserved.

KEYWORDS:

Maternal antibody; Measles; Mumps; Rubella; Vaccination; Varicella

PMID: 30765170 DOI: 10.1016/j.vaccine.2019.01.043