title: Antibody persistence for 3 years following two doses of tetravalent measles-mumps-rubella-varicella vaccine in healthy children.
abstract: Two doses of a varicella-containing vaccine in healthy children <12 years are suggested to induce better protection than a single dose. Persistence of immunity against measles, mumps, rubella, and varicella as well as varicella breakthrough cases were assessed 3 years after two-dose measles, mumps, rubella, and varicella (MMRV) vaccination or concomitant MMR (Priorix™) and varicella (Varilrix™) vaccination. Four hundred ninety-four healthy children, 12-18 months old at the time of the first dose, received either two doses of MMRV vaccine (GlaxoSmithKline Biologicals) 42-56 days apart (MMRV, N = 371) or one dose of MMR and varicella vaccines administered simultaneously at separate sites, followed by another MMR vaccination 42-56 days later (MMR + V, N = 123). Three hundred-four subjects participated in 3-year follow-up for persistence of immunity and occurrence of breakthrough varicella (MMRV, N = 225; MMR + V, N = 79). Antibodies were measured by ELISA (measles, mumps, rubella) and immunofluorescence (varicella). Contacts with individuals with varicella or zoster and cases of breakthrough varicella disease were recorded. Three years post-vaccination seropositivity rates in subjects seronegative before vaccination were: MMRV-measles, 98.5% (geometric mean titer [GMT] = 3,599.6); mumps, 97.4% (GMT = 1,754.5); rubella, 100% (GMT = 51.9); varicella, 99.4% (GMT = 225.5); MMR + V-measles, 97.0% (GMT = 1,818.8); mumps, 93.8% (GMT = 1,454.6); rubella, 100% (GMT = 53.8); and varicella, 96.8% (GMT = 105.8). Of the subjects, 15-20% reported contact with individuals with varicella/zoster each year. After 3 years, the cumulative varicella breakthrough disease rate was 0.7% (two cases) in the MMRV group and 5.4% (five cases) in the MMR + V group.
  
  
  CONCLUSIONS
  Immunogenicity of the combined MMRV vaccine was sustained 3 years post-vaccination. (208136/041/NCT00406211).
authors.affiliation: Children's Department of Pediatrics, University Medicine Hospital, Johannes Gutenberg-University, Langenbeckstrasse 1, 55101 Mainz, Germany. markus.knuf@hsk-wiesbaden.de
authors.forename: Markus
authors.initials: M
authors.lastname: Knuf
authors.forename: Fred
authors.initials: F
authors.lastname: Zepp
authors.forename: Klaus
authors.initials: K
authors.lastname: Helm
authors.forename: Hartwig
authors.initials: H
authors.lastname: Maurer
authors.forename: Albrecht
authors.initials: A
authors.lastname: Prieler
authors.forename: Dorothee
authors.initials: D
authors.lastname: Kieninger-Baum
authors.forename: Martine
authors.initials: M
authors.lastname: Douha
authors.forename: Paul
authors.initials: P
authors.lastname: Willems
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D002644:Chickenpox / Q000276:immunology*; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000276:immunology*; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008457:Measles / Q000276:immunology*; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000276:immunology*; D009107:Mumps / Q000276:immunology*; D009109:Mumps virus / Q000276:immunology; D012409:Rubella / Q000276:immunology*; D012412:Rubella virus / Q000276:immunology; D014611:Vaccination; D017778:Vaccines, Combined
chemical_list: D000914:Antibodies, Viral; D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined; C050102:measles, mumps, rubella, varicella vaccine