title: Measles Virus Neutralizing Antibody Response, Cell-Mediated Immunity, and Immunoglobulin G Antibody Avidity Before and After Receipt of a Third Dose of Measles, Mumps, and Rubella Vaccine in Young Adults.
abstract: BACKGROUND
  Two doses of measles, mumps, and rubella (MMR) vaccine are 97% effective against measles, but waning antibody immunity to measles and failure of the 2-dose vaccine occur. We administered a third MMR dose (MMR3) to young adults and assessed immunogenicity over 1 year.
  
  
  METHODS
  Measles virus (MeV) neutralizing antibody concentrations, cell-mediated immunity (CMI), and immunoglobulin G (IgG) antibody avidity were assessed at baseline and 1 month and 1 year after MMR3 receipt.
  
  
  RESULTS
  Of 662 subjects at baseline, 1 (0.2%) was seronegative for MeV-neutralizing antibodies (level, <8 mIU/mL), and 23 (3.5%) had low antibody levels (8-120 mIU/mL). One month after MMR3 receipt, 1 subject (0.2%) was seronegative, and 6 (0.9%) had low neutralizing antibodies, with only 21 of 662 (3.2%) showing a ≥ 4-fold rise in neutralizing antibodies. One year after MMR3 receipt, no subject was seronegative, and 10 of 617 (1.6%) had low neutralizing antibody levels. CMI analyses showed low levels of spot-forming cells after stimulation, suggesting the presence of T-cell memory, but the response was minimal after MMR3 receipt. MeV IgG avidity did not correlate with findings of neutralization analyses.
  
  
  CONCLUSIONS
  Most subjects were seropositive before MMR3 receipt, and very few had a secondary immune response after MMR3 receipt. Similarly, CMI and avidity analyses showed minimal qualitative improvements in immune response after MMR3 receipt. We did not find compelling data to support a routine third dose of MMR vaccine.
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Amy Parker
authors.initials: AP
authors.lastname: Fiebelkorn
authors.affiliation: Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Coleman
authors.affiliation: Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
authors.affiliation: Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Freeman
authors.affiliation: Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Daphne
authors.initials: D
authors.lastname: York
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Daoling
authors.initials: D
authors.lastname: Bi
authors.affiliation: Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Kulkarni
authors.affiliation: Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring.
authors.forename: Susette
authors.initials: S
authors.lastname: Audet
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sara
authors.initials: S
authors.lastname: Mercader
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Marcia
authors.initials: M
authors.lastname: McGrew
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Carole J
authors.initials: CJ
authors.lastname: Hickman
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: William J
authors.initials: WJ
authors.lastname: Bellini
authors.affiliation: W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Rupak
authors.initials: R
authors.lastname: Shivakoti
authors.affiliation: W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Griffin
authors.affiliation: Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring.
authors.forename: Judith
authors.initials: J
authors.lastname: Beeler
mesh_terms: D000293:Adolescent; D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D000915:Antibody Affinity; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000502:physiology*; D007115:Immunization Schedule; D007074:Immunoglobulin G / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008459:Measles virus / Q000276:immunology*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000276:immunology*; D009500:Neutralization Tests; D016017:Odds Ratio; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D022542:Measles-Mumps-Rubella Vaccine
keywords: cell-mediated immunity; immunization; measles; measles vaccine immunogenicity; measles virus antibody avidity; third dose of measles, mumps, rubella (MMR) vaccine; vaccine-preventable disease