van der Staak Maaike, Ten Hulscher Hinke I, Nicolaie Alina M, Smits Gaby P, de Swart Rik L, de Wit Jelle, Rots Nynke Y, van Binnendijk Robert S
Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.
Clin Infect Dis. 2025 Apr 30;80(4):904-910. doi: 10.1093/cid/ciae537.
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.
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 World Health Organization.
We found 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.
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. Clinical Trials Registration. EudraCT 2013-003078-28.
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月龄以下儿童接种麻疹疫苗可提供早期保护，但也与后续麻疹疫苗接种的抗体反应减弱有关，且被认为疫苗效力较低。
我们的研究纳入了在6至12月龄时接受早期麻疹、腮腺炎和风疹（MMR）疫苗接种的儿童（n = 79，在14月龄和9岁时按照常规MMR疫苗接种程序额外接种）以及未进行额外早期接种的一组儿童（n = 44）。我们根据世界卫生组织设定的标准，采用蚀斑减少中和试验，在14月龄接种疫苗前以及此后直至6岁时评估麻疹病毒（MeV）特异性中和抗体。
我们发现首次MMR接种年龄与后期生活中MeV特异性中和抗体水平之间存在显著关联。虽然大多数接受早期接种的儿童在首剂接种后血清转化，但8.5月龄前接种疫苗的儿童抗体衰减明显更快，且在6年内失去了保护性中和抗体水平。
8.5月龄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。仅在麻疹暴发或其他MeV感染风险增加的情况下才应考虑早期MMR疫苗接种。临床试验注册。EudraCT 2013 - 003078 - 28。
