Early Measles Vaccination During an Outbreak in the Netherlands: Short-Term and Long-Term Decreases in Antibody Responses Among Children Vaccinated Before 12 Months of Age
Early Measles Vaccination During an Outbreak in the Netherlands: Short-Term and Long-Term Decreases in Antibody Responses Among Children Vaccinated Before 12 Months of Age
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DOI：
10.1093/infdis/jiz159
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发表时间：
2019-08-15
影响因子：
6.4
通讯作者：
van Binnendijk, Robert S.
中科院分区：
文献类型：
--
作者：
Brinkman, Iris D.;de Wit, Jelle;van Binnendijk, Robert S.
背景大多数婴儿在12至15个月大的第一次接种麻疹疫苗之前不会受到母体抗体的保护。这为降低麻疹疫苗接种年龄提供了动力，但免疫学后果尚未得到充分了解，长期影响在很大程度上是未知的。共有79名婴儿在6至12个月大时接受了早期麻疹疫苗接种，并在14个月大时接受了第二剂疫苗，与对照组的44名儿童进行了比较，对照组的44名儿童在14个月大时接受了1剂疫苗。麻疹病毒特异性中和抗体浓度和亲和力测定到4岁。与对照组婴儿相比，在12个月之前首次接受麻疹疫苗接种的婴儿麻疹病毒特异性中和抗体的浓度和亲和力长期下降。对于11.1%的儿童在9个月之前首次接种疫苗，4岁时的抗体水平已降至临床保护临界值以下。早期麻疹疫苗接种为大多数婴儿提供了即时保护，但与较晚年龄的疫苗接种相比，中和抗体反应会长期下降。在14个月大时接种疫苗并不能改善这种情况。从长远来看，这可能会导致越来越多的儿童易患麻疹。
Background. The majority of infants will not be protected by maternal antibodies until their first measles vaccination, between 12 and 15 months of age. This provides incentive to reduce the age at measles vaccination, but immunological consequences are insufficiently understood, and long-term effects are largely unknown.Methods. A total of 79 infants who received early measles vaccination between 6 and 12 months age and a second dose at 14 months of age were compared to 44 children in a control group who received 1 dose at 14 months of age. Measles virus-specific neutralizing antibody concentrations and avidity were determined up to 4 years of age.Results. Infants who first received measles vaccination before 12 months of age had a long-term decrease in the concentration and avidity of measles virus-specific neutralizing antibodies, compared with infants in the control group. For 11.1% of children with a first dose before 9 months of age, antibody levels at 4 years of age had dropped below the cutoff for clinical protection.Conclusions. Early measles vaccination provides immediate protection in the majority of infants but yields a long-term decrease in neutralizing antibody responses, compared to vaccination at a later age. Additional vaccination at 14 months of age does not improve this. Over the long term, this may result in an increasing number of children susceptible to measles.