Measles remains a major threat to human health despite widespread vaccination. While we know that maternal antibodies can impair vaccine-induced immunity, the relative contributions of pre-existing immunity levels, maternal and infant characteristics on vaccine responses remain unclear, hampering evidence-based vaccination policy development. Here we combine serological data from 1,505 individuals (aged 0–12 years) in a mother–infant cohort and in a child cohort with empirical models to reconstruct antibody trajectories from birth. We show that while highly heterogeneous across a population, measles antibody evolution is strongly predictive from birth at the individual level, including following vaccination. Further, we find that caesarean section births were linked with 2.56 (95% confidence interval: 1.06–6.37) increased odds of primary vaccine failure, highlighting the long-term immunological consequences of birth route. Finally, we use our new understanding of antibody evolution to critically assess the population-level consequences of different vaccination schedules, the results of which will allow country-level evaluations of vaccine policy.

尽管广泛接种疫苗，麻疹仍然是对人类健康的主要威胁。虽然我们知道母源抗体会损害疫苗诱导的免疫力，但现有免疫水平、母婴特征对疫苗反应的相对贡献仍不清楚，这阻碍了基于证据的疫苗接种政策的制定。在这里，我们将母婴队列和儿童队列中 1,505 名个体（0-12 岁）的血清学数据与经验模型相结合，以重建从出生起的抗体轨迹。我们发现，虽然人群中存在高度异质性，但麻疹抗体的进化从出生起就可以在个体水平上进行强有力的预测，包括接种疫苗后。此外，我们发现剖腹产分娩与初次疫苗接种失败的几率增加 2.56（95% 置信区间：1.06-6.37）相关，凸显了出生途径的长期免疫学后果。最后，我们利用对抗体进化的新理解来严格评估不同疫苗接种计划对人口水平的影响，其结果将允许对疫苗政策进行国家一级的评估。