Long-term immunogenicity after measles vaccine vs. wild infection: an Italian retrospective cohort study

Abstract

The persistence of specific IgG after measles infection and after measles vaccination has not been sufficiently investigated. Current evidence suggests that immunity after the disease is life-long, whereas the response after two doses of measles-containing vaccine declines within 10–15 years. This study evaluated the proportion of individuals with detectable anti-measles IgG in two groups, those vaccinated with two doses of anti-MMR vaccine and those with a self-reported history of measles infection. Among the 611 students and residents who were tested, 94 (15%) had no detectable protective anti-measles IgG. This proportion was higher among vaccinated individuals (20%; GMT = 92.2) than among those with a self-reported history of measles (6%; GMT = 213.3; p < .0001). After one or two MMR vaccine booster doses, the overall seroconversion rate was 92%. An important proportion of people immunized for measles did not have a protective IgG titer in the years after vaccination, but among those who had a natural infection the rate was three-fold lower. This finding should be considered in the pre-elimination phase, given the resurgence of measles cases among individuals who after being vaccinated lost their circulating IgG after several years, especially if they failed to receive a natural booster.

Keywords

• long time immunogenicity
• measles elimination era
• natural booster
• additional booster
• healthcare workers