R&D Center Belgium, GSK, Wavre, Belgium.
Clinical Laboratory Sciences, GSK, Rixensart, Belgium.
Vaccine. 2019 Aug 23;37(36):5323-5331. doi: 10.1016/j.vaccine.2019.07.049. Epub 2019 Jul 22.
Measles and mumps outbreaks still occur in countries that have successfully implemented universal routine immunization programs. Measles outbreaks are mostly associated to absent or incomplete vaccination, whereas for mumps outbreaks the combined effects of waning of immunity and circulating new strains are incriminated. It is therefore increasingly useful to characterize the long-lasting immunity induced by measles-, mumps, and rubella (MMR)-containing vaccines. In this 10-year study, 1887 healthy children aged 12-22 months, randomized to receive 1 or 2 doses of MMR-containing vaccines (Priorix or Priorix-Tetra; GSK), were included in an antibody persistence analysis. A total of 364 children in the 1-dose group received a second dose out of study according to their local vaccination schedule between Years 4 and 10 post-dose 1, and were included in a separate post-hoc analysis to evaluate the effect of the second dose when given later. Anti-measles, -mumps and -rubella antibody titers were measured by commercial ELISA kits (Enzygnost, Siemens) after each vaccine dose and at Years 1, 2, 4, 6, 8 and 10 post-vaccination. Antibodies against measles and rubella declined moderately after vaccination but remained well above the seropositivity threshold after 10 years. The anti-measles antibody titers elicited by Priorix-Tetra remained about 2-fold higher throughout the study as compared with Priorix. A second dose of MMR vaccine later in life had a minor and transient effect on anti-measles and anti-rubella waning titers. In contrast, anti-mumps antibody levels remained relatively stable over the 10-year follow-up and a second dose of MMR vaccine, given anytime over the 10-year period, had a boosting effect on anti-mumps antibody titers and seropositivity rates. In conclusion, 1 or 2 doses of MMR-containing vaccines given to children in their second year of life induced antibody responses against measles, mumps and rubella viruses that persisted at least up to 10 years post-vaccination. Clinical trial registration number: NCT00226499.
麻疹和风疹疫苗仍在成功实施常规免疫接种计划的国家爆发。麻疹爆发主要与未接种或不完全接种疫苗有关，而腮腺炎爆发则与免疫力下降和循环新毒株有关。因此，越来越有必要对麻疹、腮腺炎和风疹（MMR）疫苗诱导的长期免疫进行描述。在这项为期 10 年的研究中，将 1887 名 12-22 月龄的健康儿童随机分为 1 剂或 2 剂 MMR 疫苗（Priorix 或 Priorix-Tetra；GSK）组，纳入抗体持久性分析。根据其接种计划，1 剂组中有 364 名儿童在接种第 1 剂后第 4 至 10 年之间接受了第 2 剂，在事后分析中纳入了第 2 剂接种时间较晚的单独分析，以评估第 2 剂的影响。在每次接种疫苗后和接种后第 1、2、4、6、8 和 10 年，使用商业 ELISA 试剂盒（Enzygnost，Siemens）测量抗麻疹、腮腺炎和风疹抗体滴度。接种疫苗后，麻疹和风疹抗体适度下降，但在 10 年后仍远高于血清阳性阈值。与 Priorix 相比，Priorix-Tetra 诱导的抗麻疹抗体滴度在整个研究期间始终保持约 2 倍的高水平。在生命后期接种第 2 剂 MMR 疫苗对麻疹和风疹抗体衰减的影响较小且短暂。相比之下，10 年随访期间，抗腮腺炎抗体水平相对稳定，在 10 年内的任何时间接种第 2 剂 MMR 疫苗都可提高抗腮腺炎抗体滴度和血清阳性率。总之，在儿童第二年接种 1 剂或 2 剂 MMR 疫苗可诱导针对麻疹、腮腺炎和风疹病毒的抗体反应，接种后至少持续 10 年。临床试验注册号：NCT00226499。
