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Long-term dynamics of measles virus-specific neutralizing antibodies in children vaccinated before 12 months of age
Clinical Infectious Diseases ( IF 8.2 ) Pub Date : 2024-11-04 , DOI: 10.1093/cid/ciae537
Maaike van der Staak, Hinke I ten Hulscher, Alina M Nicolaie, Gaby P Smits, Rik L de Swart, Jelle de Wit, Nynke Y Rots, Robert S van Binnendijk

Background Measles is a highly contagious disease presenting a significant risk for unvaccinated infants and adults. Measles vaccination under the age of 12 months provides early protection, but has also been associated with blunting of antibody responses to subsequent measles vaccinations and assumed to have lower vaccine effectiveness. Methods Our study included children who received an early measles, mumps and rubella (MMR) vaccination between 6 and 12 months of age (n=79, given in addition to the regular MMR vaccination schedule at 14 months and 9 years) and a group without additional early vaccination (n=44). We evaluated measles virus (MeV)-specific neutralizing antibodies before vaccination at 14 months and up to 6 years thereafter using a plaque reduction neutralization test according to the standard set by the WHO. Results We show a significant association between age of first MMR and MeV-specific neutralizing antibody levels later in life. Although most children who received early vaccination seroconverted after the first dose, children vaccinated before 8·5 months of age exhibited a markedly faster antibody decay and lost their protective neutralizing antibody levels over 6 years. Conclusions Routine vaccination of infants under 8·5 months of age may lead to blunted MeV-specific antibody responses to subsequent MMR vaccination. Early MMR vaccination should only be considered during measles outbreaks or in other situations of increased risk of MeV infection.

中文翻译:


12 月龄前接种疫苗的儿童麻疹病毒特异性中和抗体的长期动态



背景 麻疹是一种高度传染性疾病,对未接种疫苗的婴儿和成人构成重大风险。12 个月以下的麻疹疫苗接种可提供早期保护,但也与对后续麻疹疫苗接种的抗体反应减弱有关,并被认为疫苗有效性较低。方法 我们的研究包括在 6 至 12 个月大时接受早期麻疹、腮腺炎和风疹 (MMR) 疫苗接种的儿童 (n=79,除了 14 个月和 9 岁的常规 MMR 疫苗接种计划外) 和一组没有额外早期疫苗接种的儿童 (n=44)。我们根据 WHO 制定的标准,在接种疫苗前 14 个月和之后长达 6 年使用斑块减少中和试验评估了麻疹病毒 (MeV) 特异性中和抗体。结果我们显示首次 MMR 年龄与以后生活中 MeV 特异性中和抗体水平之间存在显着关联。尽管大多数接受早期疫苗接种的儿童在第一剂后发生血清转化,但在 8·5 个月大之前接种疫苗的儿童表现出明显更快的抗体衰减,并在 6 年内失去了保护性中和抗体水平。结论 8·5 个月以下婴儿的常规疫苗接种可能导致对后续 MMR 疫苗接种的 MeV 特异性抗体反应减弱。只有在麻疹疫情期间或 MeV 感染风险增加的其他情况下,才应考虑早期 MMR 疫苗接种。
更新日期:2024-11-04
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