Lutz Chelsea S, Nguyen Huong Q, McClure David L, Masters Nina B, Chen Min-Hsin, Colley Heather, Sowers Sun B, Crooke Stephen N, Marin Mona
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infect Dis. 2025 Apr 9;12(4):ofaf188. doi: 10.1093/ofid/ofaf188. eCollection 2025 Apr.
In the United States, 2 doses of measles-mumps-rubella (MMR)-containing vaccines are recommended routinely during childhood; a third dose may be given under certain circumstances. We present observed seroprotection rates and estimate long-term dynamics of measles, mumps, and rubella neutralizing antibody (nAb) levels among 2- and 3-dose MMR (MMR2 and MMR3, respectively) vaccinees.
Persons who received MMR2 at age 4-12 years or MMR3 at age 18-31 years were enrolled in 1994-1995 and 2009-2010, respectively. Per cohort, sera were collected before vaccination (baseline) and at various intervals ranging from 1 month to 10 years postvaccination to assess nAb levels. Annual changes in nAb levels per virus and cohort were estimated through 10 years postvaccination using generalized estimating equations. Models were stratified by baseline nAb levels.
Among MMR2 participants (n = 621), 93.7%, 73.4%, and 83.9% had protective nAb levels against measles, mumps, and rubella, respectively, at the 10-year visit; among MMR3 participants (n = 665), 90.5%, 69.1%, and 100% had protective nAb levels, respectively, at the 9-11-year visit. Estimated nAb levels declined annually across both cohorts, all viruses, and baseline nAb strata, though patterns and magnitude varied. More than one-quarter of participants had mumps nAb levels below the presumed seroprotection threshold at the terminal visits.
These findings indicate that even when MMR antibodies wane, protection against disease is largely retained. Waning of mumps antibodies was greater than for measles and rubella in both 2- and 3-dose vaccinees, likely because a greater proportion failed to mount a robust initial response.
在美国，建议儿童期常规接种2剂含麻疹-腮腺炎-风疹（MMR）成分的疫苗；在某些情况下可接种第3剂。我们展示了观察到的血清保护率，并估计了2剂MMR（分别为MMR2）和3剂MMR（MMR3）疫苗接种者中麻疹、腮腺炎和风疹中和抗体（nAb）水平的长期动态变化。
分别于1994 - 1995年和2009 - 2010年招募4至12岁接种MMR2或18至31岁接种MMR3的人群。每个队列在接种疫苗前（基线）以及接种后1个月至10年的不同时间间隔采集血清，以评估nAb水平。使用广义估计方程估计接种疫苗后10年内每种病毒和队列的nAb水平的年度变化。模型按基线nAb水平分层。
在MMR2参与者（n = 621）中，在第10年随访时，分别有93.7%、73.4%和83.9%的人针对麻疹、腮腺炎和风疹具有保护性nAb水平；在MMR3参与者（n = 665）中，在第9至11年随访时，分别有90.5%、69.1%和100%的人具有保护性nAb水平。两个队列、所有病毒以及基线nAb分层的估计nAb水平均逐年下降，尽管模式和幅度有所不同。超过四分之一的参与者在末次随访时腮腺炎nAb水平低于假定的血清保护阈值。
这些发现表明，即使MMR抗体减弱，对疾病的保护作用在很大程度上仍然保留。在2剂和3剂疫苗接种者中，腮腺炎抗体的减弱均大于麻疹和风疹，可能是因为更大比例的人未能产生强烈的初始反应。
