PEDIATRICS Vol. 97 No. 1 January 1996, pp. 53-58
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Changing Levels of Measles Antibody Titers in Women and Children in the United States: Impact on Response to Vaccination

Lauri E. Markowitz MD1, Paul Albrecht MD2, Philip Rhodes PhD1, Ruth Demonteverde MD, MPH3, Emmett Swint MS1, Edmond F. Maes PhD1, Clydette Powell MD, MPH3, Peter A. Patriarca MD1, and Kaiser Permanente Measles Vaccine Trial Team4

1 National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
2 Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland
3 Los Angeles County Department of Health Services, Los Angeles County Health Department
4 Southern California Kaiser-Permanente Medical Care Program, Los Angeles

Objectives. In the United States, younger women are more likely to have immunity to measles from vaccination and are less likely to have been exposed to the wild virus than are older women. To evaluate changes in measles antibody titers in women in the United States and children’s responses to measles vaccination, we analyzed data from a measles vaccine trial.

Methods. Sera collected from children before vaccination at 6, 9, or 12 months of age and from their mothers were assayed for measles antibodies by plaque reduction neutralization. Responses to vaccination with Merck Sharp & Dohme live measles virus vaccines at 9 months (Attenuvax) and 12 months (M-M-R II) were also analyzed.

Results. Among women born in the United States (n = 614), geometric mean titers (GMTs) of measles antibodies decreased with increasing birth year. For those born before 1957, 1957 through 1963, and after 1963, GMTs were 4798, 2665, and 989, respectively. Among women born outside of the United States (n = 394), there were no differences in GMTs by year of birth Children of younger women born in the United States were less likely than those of older women to be seropositive at 6, 9, or 12 months. The response to the vaccines varied by maternal birth year for children of women born in the United States. Among 9-month-old children, 93% of those whose mothers were born after 1963 responded, compared with 77% and 60% of those whose mothers were born in 1957 through 1963 and before 1957, respectively. Among 12-month-old children, 98% of those born to the youngest mothers responded, compared with 90% and 83% of those whose mothers were born in 1957 through 1963 and before 1957. The responses of children of women born outside of the United States were not associated with maternal year of birth.

Conclusions. An increasing proportion of children in the United States will respond to the measles vaccine at younger ages because of lower levels of passively acquired maternal measles antibodies.

Submitted on October 31, 1994
Accepted on February 24, 1995




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