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Evidence available as of 1991 that vaccine-induced immunity wanes or is unknown - in progress
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2054370&dopt=Abstract
Serological response to measles revaccination in a highly
immunized military dependent adolescent population.
Veit BC, Schydlower M, McIntyre S, Simmons D, Lampe RM, Fearnow RG, Stewart
J.
Department of Clinical Investigation, William Beaumont Army Medical Center, El
Paso, Texas 79920-5001.
In the spring of 1986, there was a measles outbreak in the city of El Paso,
Texas, with 92 cases reported to the City-County Health Department. Of those
92 cases, 31 (32%) occurred within a public high school's student population
of 2524. A mass measles vaccination program was undertaken at that high school
in order to limit the outbreak. The student enrollment included a military
dependent population of 368 students. Despite documented histories of prior
measles immunizations in this military dependent subgroup, three individuals
contracted the disease. Since this subgroup of students represented a highly
immunized adolescent population, it was of interest to serologically determine
their immune status prior to and following reimmunization with the expectation
that such a study would provide information relating to the level of
"protective" immunity. Prevaccination and postvaccination sera were obtained
from 95 students. Results of measuring anti-measles antibody activity by ELISA
indicate that 13 (14%) students responded to revaccination and experienced a
fourfold or greater rise in IgG antibody levels. There were no detectable IgM
responses. All of the students who responded to revaccination produced an
anamnestic response (IgG boost only). Since most of these individuals had
received first immunizations at 15 months of age or older,
these findings suggest that secondary
vaccine failure (waning immunity) was responsible for the putative "lowered"
immunity in these individuals, instead of primary vaccine failure (maternal
antibody suppression). These findings support current recommendations
for measles booster revaccination of school-age children and adolescents.
PMID: 2054370 [PubMed - indexed for MEDLINE]
AN: 91274326
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1831579&dopt=Abstract
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Intradermal hepatitis B vaccination.
Rivey MP, Peterson J.
School of Pharmacy, University of Montana, Missoula 59812.
The availability of vaccine since 1982 for immunization against hepatitis B
virus (HBV) has had minimal impact on the disease; mass immunization has been
suggested. Intradermal vaccination, which has precedent in prophylaxis of
other infectious diseases, has been investigated as a low-cost alternative to
traditional intramuscular HBV vaccination. Results of open and comparative
trials indicate similar seroconversion rates for intradermal and intramuscular
HBV vaccination routes in healthy adults.
However, antibody titers and, presumably, duration of antibody protection
appear to be decreased with
intradermal
HBV
vaccination. Limited data suggest that demographic factors such as age
and gender may affect vaccine responsiveness to intradermal HBV vaccine.
Adverse skin reactions are common but do not represent a deterrent to
continued intradermal HBV vaccination. There is a need for large-scale
prospective comparative trials to substantiate the value of intradermal HBV
vaccination. Nevertheless, the potential economic and epidemiologic benefit of
intradermal vaccination justifies continued investigation for prevention of
HBV infection.
Publication Types:
PMID: 1831579 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1670725&dopt=Abstract
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Phase II trial of whole-cell pertussis vaccine vs an
acellular vaccine containing agglutinogens.
Miller E, Ashworth LA, Robinson A, Waight PA, Irons LI.
Public Health Laboratory Service, Communicable Disease Surveillance Centre,
Colindale, London, UK.
An acellular pertussis vaccine containing agglutinogens 2 and 3, pertussis
toxin, and filamentous haemagglutinin was developed by the Centre for Applied
Microbiology and Research in the UK. 188 infants were entered into a
randomised blind trial and received either the acellular or a whole-cell
vaccine, combined with diphtheria and tetanus toxoids, in a 3, 5, and 8-10
month schedule. Local reactions were similar in the two groups but
significantly fewer infants had systemic symptoms after the acellular vaccine.
Mean log-antibody titres to the agglutinogen and toxin components were higher
with the acellular than with the whole-cell vaccine.
Persistence of antibodies one year
after the third dose was also better in the
acellular
group.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 1670725 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1830374&dopt=Abstract
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Complete seroconversion by low-dose intradermal injection
of recombinant hepatitis B vaccine in hemodialysis patients.
Ono K, Kashiwagi S.
Ono Geka Clinic, Kyushu University, Fukuoka, Japan.
The present study was undertaken to find out if the seroconversion rate of
hemodialysis (HD) patients was enhanced by the intradermal (i.d.) inoculation
of recombinant hepatitis B (HB) vaccine. Thirty-five HBs-Ag, HBs-Ab and HBc-Ag,
HBc-Ab negative HD patients were divided into three groups: 14 patients in
group I received 5 micrograms HBs Ag i.d. every 2 weeks, 13 patients in group
II were given 2.5 micrograms HBs vaccine i.d. every 2 weeks, 5 times, then
every week. The remaining 8 patients in group III were immunised with 10
micrograms HBs Ag every 4 weeks 5 times intramuscularly (i.m.), then 5
micrograms i.d., every 2 weeks until complete seroconversion. Antibody
response to i.m. injection was poor and only 37.5% of patients developed anti-HBs
at a titer of 10 mIU/ml or more at 16 weeks after the start of immunisation.
However, this poor response was improved by i.d. injection. The time of
seroconversion was significantly earlier and the rate of response was higher
in group I. The poor response in group II was markedly improved by doubling
the inoculation rate. Overall, 100% of
seroconversion
was finally obtained by multiple
i.d.
immunisation.
However, the anti-HBs
titers were lower in all patients and declined in some patients after the
immunisation
was stopped. The last
seroconverted
patient in each group lost protective antibody levels at the 39th week. These
patients became antibody positive again at the 52nd week with a booster dose.
We feel that the i.d.
route remains a useful and cheaper method of obtaining prophylaxis against
HBs
in high-risk HD patients but it would seem to be prudent to monitor these
patients serially to assess the persistence of anti-HBs
in the serum.
PMID: 1830374 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2139280&dopt=Abstract
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WHO strategy for the global elimination of new cases of
hepatitis B.
Ghendon Y.
World Health Organization, Geneva, Switzerland.
Hepatitis B infection and its sequelae remain major public health problems
internationally despite the existence of sensitive tests to screen blood and
blood products for hepatitis B surface antigen (HBsAg) and immunogenic
vaccines. Since the human hepatitis B virus has no known animal reservoir, a
systematic vaccination programme against hepatitis B, including vaccination of
all newborns and young children within the framework of the WHO Expanded
Programme on Immunization, as well as protection of high-risk individuals,
together with the testing of all blood and blood products for HBsAg, could
eliminate hepatitis B virus infection and its sequelae.
However, for the successful
realization of this programme,
many important and difficult problems need to be solved, especially
those related to vaccination strategy,
determination of the duration of immunity, investigation of the
mechanisms of perinatal and horizontal virus transmission, and improvement of
the immunogenicity of hepatitis B vaccine. The problem of the hepatitis B
carrier is also paramount as the eradication of hepatitis B can be achieved
only after the 300 million carriers of the disease in the world today are
either cured or dead.
PMID: 2139280 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2179836&dopt=Abstract
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Duration of live measles vaccine-induced immunity.
Markowitz LE, Preblud SR, Fine PE, Orenstein WA.
Division of Immunization, Centers for Disease Control, Atlanta, GA 30333.
Publication Types:
From the article: Similar
to immunity after natural measles infection, live measles vaccine-induced
immunity has been thought to be lifelong. Vaccinees who subsequently develop
measles have been considered primary vaccine failures, defined as the failure
of the initial vaccination to elicit an appropriate immune response. Primary
vaccine failures are believed to be caused by (1) interference by maternal
antibody when vaccination occurs at a young age, (2) technical problems, such
as improper vaccine storage or administration, or (2) other unknown reasons.
Transmission of measles among older children in the United States, most of
whom have been appropriately vaccinated, has raised the question of whether
waning vaccine-induced immunity may also be responsible for some vaccine
failures. Current vaccination policy as well as mathematical models assume
that vaccine-induced immunity is life-long. If waning vaccine-induced
immunity does occur, changes in measles vaccination strategies might be
necessary. The purpose of this paper is to review information concerning the
duration and quality of measles vaccine-induced immunity.
Discussion: Several types of
studies have been applied to evaluate the duration and quality of measles
vaccine-induced immunity. The few reports of measles disease in persons who
had seroconverted after vaccination document that secondary vaccine failure
can occur. In addition two studies provide data on the potential magnitude of
the risk of secondary vaccine failure. However, most data suggest that waning
immunity is uncommon.
Many questions concerning the
duration of vaccine-induced immunity remain to be answered, including what
percentage of cases reported in previously vaccinated persons in the United
States is caused by primary or secondary vaccine failure, whether different
measles vaccine strains produce immunity which is more or less "durable",
whether reexposure to wild measles virus is important for maintenance of
vaccine-induced immunity and whether it is possible to identify individuals at
risk for waning immunity.
The consequences of waning measles
vaccine-induced immunity may be minor for individuals if secondary vaccine
failure is associated with mild disease. However, waning vaccine-induced
immunity could be of greater consequence to a population. Although persons
with subclinical reinfection have not been shown to transmit virus, it is not
known whether this is true for persons with secondary vaccine failure. If
these individuals are able to transmit disease to other susceptibles, waning
immunity, even in a small percentage of persons, may impede realization of the
goal of measles elimination. Revaccination may be successful in decreasing
the number of persons who become susceptible due to waning immunity. However,
it is not known whether revaccination of such persons will result in sustained
immunity.
Questions concerning duration of
vaccine-induced immunity and secondary vaccine failure were raised at the time
of vaccine licensure and discussed 10 to 15 years later when outbreaks
occurred in vaccinated children. Now, 26 years after licensure, many of the
same issues remain unresolved. Although waning immunity has been documented
to occur in a small proportion of vaccinees, the epidemiologic significance of
this is still unclear. -
PMID: 2179836 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2239007&dopt=Abstract
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[The results of multiyear observations on the duration of
the maintenance of immunity in those vaccinated and revaccinated against and
recovered from measles]
[Article in Russian]
Sliusar' LI, Sokhin AA, Radomskaia FS, Degtiareva GV, Panasenko LI,
Litvinova TP, Komarevskaia RV, Bol'shinskaia ZhI.
The results of 5-year observations on the duration of immunity to measles
virus in persons vaccinated and revaccinated against measles, as well as in
persons having had this infection, are presented. The intensity of immunity
was determined in the same persons with the use of the passive
hemagglutination test. The study
revealed differences in the formation, intensity and duration of postvaccinal
immunity. A significant decrease in the concentration of antibodies over the
period of 5 years was established in 50.0-52.3% of vaccines.
Revaccination with live measles vaccine is an effective measure for enhancing
immunity to measles virus in persons with initial antibody titers less than
1:10-1:20, but revaccination made in a single injection is not sufficient for
the stable maintenance of measles morbidity at the sporadic level.
Postinfectious immunity is characterized by stability and has no tendency
towards decrease. Persons having had measles have no need in additional
measures irrespective of the time elapsed after the disease.
PMID: 2239007 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2194379&dopt=Abstract
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Yeast-derived hepatitis B vaccine in dental students. A
three-year follow-up study.
Zanetti AR, Tanzi E, Pozzi A, Romano L, Bergamini F.
Institute of Virology, University of Milan, Italy.
Sixty health adults (56 dental students and four post-graduates of the Dental
Faculty in Milan; mean age 26.4 years, range 22-42 years) were vaccinated with
a recombinant DNA vaccine (Engerix B, Smith Kline and French; 20 micrograms
given i.m. at time 0, 1 and 6 months). One month after the third injection,
98.3% (59/60) vaccinees showed anti-HBs at levels higher than 10 mIU ml-1
(geometric mean titre 734.8 mIU ml-1). One year after the beginning of
vaccination (i.e. 6 months after the third injection of vaccine), 46 vaccinees
showed anti-HBs titre higher than 100 mIU ml-1 (24 between 100 and 1000 mIU
ml-1 and 22 higher than 1000 mIU ml-1) and
14
vaccinees
had anti-HBs
below 100 mIU
ml-1 (12 between 10 and 99 mIU ml-1 and 2 below 10 mIU ml-1).
Since duration of antibody is directly
related to the height of the initial response, the 14 vaccinees with
lower anti-HBs titres were given a fourth dose of vaccine. All boosted
vaccinees showed a vigorous anti-HBs response and the post-booster anti-HBs
GMT increased to 1570 mIU ml-1 compared with 47.8 mIU ml-1 attained before the
boosting injection. At three years from the beginning of vaccination, all
vaccinees who showed anti-HBs titres higher than 100 mIU ml-1 after the
primary vaccination and all but one of the boosted vaccinees were still anti-HBs
positive.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 2194379 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2278542&dopt=Abstract
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Comment in:
Mild measles and secondary vaccine failure during a
sustained outbreak in a highly vaccinated population.
Edmonson MB, Addiss DG, McPherson JT, Berg JL, Circo SR, Davis JP.
Department of Pediatrics, University of Wisconsin, Madison 53792.
A prolonged school-based outbreak of measles provided an opportunity to study
"vaccine-modified" mild measles and secondary vaccine failure. Thirty-six
(97%) of 37 unvaccinated patients had rash illnesses that met the Centers for
Disease Control clinical case definition of measles, but 29 (15%) of 198
vaccinated patients did not, primarily because of low-grade or absent fever.
Of 122 patients with seroconfirmed measles, 10 patients (all previously
vaccinated) had no detectable measles-specific IgM and significantly milder
illness than either vaccinated or unvaccinated patients with IgM-positive
serum. Of 108 vaccinated patients with seroconfirmed measles, 17 patients
(16%) had IgM-negative serology or rash illnesses that failed to meet the
clinical case definition; their mean age (13 years), age at the time of
vaccination, and time since vaccination did not differ from those of other
vaccinated patients. The occurrence of
secondary vaccine failure and vaccine-modified measles does not appear to be a
major impediment to measles control in the United States but may lead to
underreporting of measles cases and result in overestimation of vaccine
efficacy in highly vaccinated populations.
PMID: 2278542 [PubMed - indexed for MEDLINE]
AN: 90230400
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2523251&dopt=Abstract
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The hepatitis B immunization programme in Singapore.
Goh KT, Doraisingham S, Tan KL, Oon CJ, Ho ML, Chen AJ, Chan SH.
A voluntary immunization programme to prevent perinatal transmission of
hepatitis B virus (HBV) infection in Singapore was implemented on 1 October
1985 as an integral component of the national childhood immunization programme.
Up to April 1988, a total of 68,845 mothers who attended government maternal
and child health clinics were screened for the disease. Of these, 2432 (3.5%)
were positive for hepatitis B surface antigen (HBsAg) and 904 (1.3%) for
hepatitis B e antigen (HBeAg). Virtually all the babies born to carrier
mothers completed the full immunization schedule; and in addition, those of
HBeAg-positive mothers were given a dose of hepatitis B immunoglobulin at
birth. The hepatitis B immunization programme was extended on 1 September 1987
to cover all newborns. About 90% of the 15,943 babies delivered in government
institutions from September 1987 to April 1988 were immunized at birth, with
the subsequent doses being administered at maternal and child health clinics
at 4-6 weeks and 5 months later. More
than 85% of the children given the full course of plasma-derived and
yeast-derived hepatitis B vaccine from birth continued to have protective
antibody to HBV
two years after immunization. The programme is being closely monitored
to assess the duration of immunity and the need for booster doses, while
seronegative adults are also being encouraged to be vaccinated.
PMID: 2523251 [PubMed - indexed for MEDLINE]
Somewhere between 0 and 14% did not continue to have
protective antibodies even 2 years later. - SM
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2526418&dopt=Abstract
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Duration of immunity to hepatitis B vaccination in
institutionalized mentally retarded patients.
Torre D, Broggini M, Botta V, Sampietro C.
Division of Infectious Diseases Regional Hospital and Foundation E. and S.
Macchi, Varese, Italy.
Susceptible individuals of an institution for the mentally retarded (20
residents and six staff members) were vaccinated with Hevac B Pasteur (5
micrograms, months 0, 1, 2, 14). There
were protective levels of anti-HBs
in 75% of residents and 100% of staff members after 15 months from the first
dose of the vaccine. After a 4-year follow-up period, there were persistent
and protective levels of anti-HBs
in 80% of residents, compared with 66% in staff members. In addition,
no clinical hepatitis B infections were observed during this period.
PMID: 2526418 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2528297&dopt=Abstract
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Factors influencing the immune response to hepatitis B
vaccine, booster dose guidelines, and vaccine protocol recommendations.
Hollinger FB.
Department of Virology, Baylor College of Medicine, Houston, Texas 77030.
The clinical course and immunodiagnosis of hepatitis B infection is discussed.
Immunization is necessary to prevent the clinical disease, the development of
carriers, and the transmission of the hepatitis B virus to susceptible
persons. Host factors that can curtail the immune response include increasing
age, obesity, smoking cigarettes, and having a medical condition that
compromises the immune system. Increasing the dose of vaccine, administering
the inoculations intramuscularly, and giving the vaccine more frequently can
enhance the immune response. The
duration of immunity following vaccination has not yet been defined,
but booster dose guidelines for selected groups are provided. Finally,
recommendations for developing and implementing hepatitis B immunization
protocols are presented.
Publication Types:
PMID: 2528297 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2929807&dopt=Abstract
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The role of secondary vaccine failures in measles
outbreaks.
Mathias RG, Meekison WG, Arcand TA, Schechter MT.
Department of Health Care and Epidemiology, University of British Columbia,
Vancouver.
An outbreak of measles in 1985-86 in a community where measles vaccine trials
had been carried out from 1974-76 allowed the assessment of the role of
secondary vaccine failures in previously immunized children. A total of 188
children from the vaccine trial were followed. Of these, 175 seroconverted
initially while 13 (6 per cent) required re-immunization (primary failure). A
total of 13 cases of measles, eight of which were laboratory and/or
physician-confirmed, were reported in this cohort. Of these, nine cases
occurred in the 175 subjects who had hemagglutination inhibition test (HI) and
neutralizing antibody responses following the initial immunization. These nine
cases represent secondary vaccine failures. An additional four cases occurred
in the 13 subjects with primary vaccine failure.
We conclude that secondary vaccine
failures occur and that while primary failures account for most cases,
secondary vaccine failures contribute to the occurrence of measles cases in an
epidemic. A booster dose of measles vaccine may be necessary to reduce
susceptibility to a sufficiently low level to allow the goal of measles
elimination to be achieved.
PMID: 2929807 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2529345&dopt=Abstract
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Deltoid versus buttock as preferred site of injection for
hepatitis B vaccine.
Hellgren TE.
Several factors concerning effectiveness of the hepatitis B virus (HBV)
vaccination have been discovered: site of injection, indications for
revaccination, testing for immunity, persistence of HBV antibody following
vaccination, and age of recipient. The site may be important in provoking an
appropriate antibody response. The deltoid is recommended rather than the
gluteal. It is suggested that recipients of gluteal vaccinations receive
revaccination in the deltoid.
Revaccination is also recommended five years after the original series due to
possible loss of antibody response. This is especially important to
those with continued exposure to HBV such as medical personnel. However,
caution is suggested as undetectable antibody appears to be an unreliable
predictor of susceptibility to infection. It is also recommended that testing
for immunity after vaccination be conducted only in those in whom a suboptimal
response is expected, i.e., gluteal injection recipients and immunocompromised
patients. Age of the recipient appears
to be a major confounder influencing the duration of vaccine-induced immunity.
The physician's consideration of these factors when administering the
HBV vaccine should increase the overall effectiveness of immunization.
Publication Types:
PMID: 2529345 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2963570&dopt=Abstract
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Duration of immunity after hepatitis B vaccination:
efficacy of low-dose booster vaccine.
Horowitz MM, Ershler WB, McKinney WP, Battiola RJ.
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Although the efficacy of hepatitis
vaccine is well documented, the duration of immunity of healthy adults after
vaccination is unknown. We studied 245 hospital employees 3 years after
primary vaccination with hepatitis B vaccine to determine the prevalence of
immunity indicated by levels of antibody to hepatitis B surface antigen of 10
mIU/mL or greater; and to compare the immunogenicity of low-dose intradermal
vaccine with standard-dose intramuscular vaccine in persons found to be
seronegative. Thirty-eight percent of employees studied had antibody levels
less than 10 mIU/mL. Low levels were associated with smoking, older age, and
higher body-mass index. Seventy-eight percent of persons with low antibody
levels responded to a single booster vaccine. Two micrograms of intradermal
vaccine was as effective as 20 micrograms of intramuscular vaccine in inducing
an antibody response; however, intradermal vaccine was associated with more
local reactions (42% compared with 17%).
Many healthy adults will need periodic
boosters of hepatitis B vaccine to maintain production of antibody to
hepatitis B surface antigen; low-dose intradermal booster schedules may
be feasible.
PMID: 2963570 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3660859&dopt=Abstract
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Hepatitis B vaccine: prospects for duration of immunity.
Krugman S, Davidson M.
Department of Pediatrics, NYU Medical Center, New York 10016.
The duration of hepatitis B vaccine-induced immunity was studied in a group of
54 seronegative health professionals who received plasma-derived hepatitis B
vaccine (Merck's Heptavax) in 1978 and 1979. Five to seven years later, 52
vaccinees received a booster dose of yeast recombinant hepatitis B vaccine
(Merck's Recombivax). Of 54 vaccinees, 47 (87 percent) had a favorable anti-HBs
response (greater than 10 S/N RIA units) and 7 (13 percent) had low (2.1-10
S/N) or undetectable levels (less than 2.1 S/N) one year after primary
immunization. After five to seven
years, the anti-HBs
values had declined to undetectable levels in 25 percent and to low levels in
23 percent. A booster dose of vaccine induced an
anamnestic
response in 90 percent of
vaccinees by two weeks. The
results of this study indicate that persons who respond favorably to primary
immunization may be protected for at least seven years.
PMID: 3660859 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3021273&dopt=Abstract
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Prevalence of antibody to poliovirus in England and Wales
1984-6.
White PM, Green J.
Serum from 995 subjects aged 6 months to 99 years was screened at a dilution
of 1/8 for neutralising antibodies to poliovirus. Of these samples, 975 (98%)
contained antibody to at least one serotype, and 763 (77%) contained antibody
to all three, an improvement since previous studies. Children
aged 8 to 15, however, had a low prevalence of antibody to poliovirus type 3,
with only four (40%) of those aged 12 protected. This finding is possibly due
to the waning of antibodies induced by the type 3 component of oral poliovirus
vaccine and emphasises
the continued importance of a booster dose of vaccine for those leaving
school.
PMID: 3021273 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4001723&dopt=Abstract
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Challenge with rubella virus after loss of detectable
vaccine-induced antibody.
Schiff GM, Young BC, Stefanovic' GM, Stamler EF, Knowlton DR, Grundy BJ,
Dorsett PH.
Studies were conducted of experimental
challenge with rubella virus in vaccinees whose possession of vaccine-induced
antibody after vaccination had been documented and whose antibody level had
become undetectable or very low over time. The challenge virus was the
Howell strain, which had been shown to produce typical clinical and laboratory
features of rubella in susceptible persons. The challenge of the vaccinees
resulted in local viral replication in all but one; in viremia, a primary
immunologic response, and a secondary antibody response in some; and
usually in illness without a rash or
in subclinical infection. The results emphasize the importance of
continuing careful clinical and laboratory surveillance of vaccinees for
determining the persistence of vaccine-induced immunity and of considering
methods for identifying and revaccinating the minority of vaccinees who lose
such immunity.
PMID: 4001723 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4055805&dopt=Abstract
Rubella in teenagers: epidemiology and prophylaxis in Siena,
Italy.
Cellesi C, Bandinelli ML, Grazia Cusi M, Di Cairano ML, Valensin PE, Barberi
A, Rossolini A.
Six hundred and fifty-three teenagers (aged 11-13 year) living in Siena and its
surroundings (Tuscany, Italy) were the sample for serological screening intended
to ascertain immunity to rubella. It was found that 324 of the teenagers
(49.62%) lacked antibodies and, hence, were unprotected against the infection.
Out of the 324 girls, 196 (around 3/5) were vaccinated using live vaccine. Post-vaccinal
complications, with clinical signs of rubella infection, were recorded in almost
one third of the vaccinees. Virus isolation from the blood was, in every case,
not possible after either 10 or 30 days from vaccination.
The serological findings, expressed in
hemagglutination
inhibition antibodies, could be summarized in the following way: (i)
antibodies at low titre
were found in only eight out of 184 girls (4.35%) ten days after vaccination;
(ii) serological conversion was recorded in 187 out of 188 girls (99.47%) 30
days after vaccination; (iii) the
titres
were moderately high but much lower than those recorded for the natural
infection. The results are discussed in the context of their implications
for the strategies of rubella vaccination as far as the safety and the
effectiveness of the vaccine are concerned, with emphasis on the duration of the
protective immunity.
PMID: 4055805 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6693863&dopt=Abstract
The use of IgM tests for analysis of the causes of measles
vaccine failures: experience gained in an epidemic in Hungary in 1980 and
1981.
Nagy G, Kosa S, Takatsy S, Koller M.
Following a period of 6 years of low measles incidence, an epidemic occurred
in Hungary with more than 11,000 reported cases between September 1980 and
August 1981. About 60% of the cases had a documented history of previous
measles vaccination. Serum samples obtained from 7815 patients were examined
for measles antibody by haemagglutination inhibition (HI). In addition to
conventional antibody titration, most of the sera or their IgM fraction
obtained by a simple ion exchange chromatography were tested for the presence
of measles-specific IgM antibodies by 2-mercaptoethanol (2-ME) treatment, and
in 300 patients also by the fluorescent antibody (FA) technique. Laboratory
results confirmed the diagnosis of measles in 5356 patients and supported it
in 685 cases. Primary antibody response was found in 96.1% of unvaccinated and
in 77.4% of previously vaccinated patients. The percentage of secondary
antibody responses increased with increasing time from vaccination only in
patients vaccinated before their first birthday, whereas in those who were
immunized when over 12 months old, the distribution of primary and secondary
antibody responses was independent from the time that had elapsed since
vaccination. Therefore, secondary
vaccine failure due to waning immunity account for only 6.2% of previously
vaccinated patients, whereas in 93.8% of patients, including the majority of
those with secondary antibody response, a primary failure of vaccination due
to unsuccessful immunization was incriminated.
PMID: 6693863 [PubMed - indexed for MEDLINE]
AN: 84113582
This abstract was put here because although most
vaccine failures were considered to be "primary", secondary vaccine failures did
occur. - SM
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6241767&dopt=Abstract
-
Immunogenicity of HBV vaccine in healthy Chinese children.
Hwang LY, Beasley RP, Stevens CE, Szmuness W.
The immunogenic response of healthy Chinese children to three different doses
of hepatitis B virus (HBV) vaccine was compared. One hundred susceptible
children received two doses of 10, 20 or 40 micrograms a month apart. A month
following the first dose 33% of all the children had antibodies. The response
rate rose to 78% a month later and 99% four months later.
Ninety percent of the 100 children
still had antibody at 12 months after vaccination was initiated. The
response rate, antibody levels and persistence of antibody were directly
related to the dose of vaccine and inversely to the age of children. No
adverse reactions were observed.
Publication Types:
- Clinical Trial
- Randomized Controlled Trial
PMID: 6241767 [PubMed - indexed for MEDLINE]
-
- Obviously, after 12 months 10% did not. - SM
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6879006&dopt=Abstract
-
Measles vaccine in the People's Republic of China.
Xiang JZ, Chen ZH.
The strains of measles virus and the method used in the production of further
attenuated live-virus vaccine in the People's Republic of China were studied.
Observation of clinical reactions and serologic responses to immunization with
Shanghai-191 measles vaccine, which is produced on a large scale with a
locally isolated viral strain, revealed that this vaccine is adequately safe
and immunogenic. Epidemiologic data showed a significant decrease in
measles-associated morbidity after the introduction of mass vaccination in
1965. The duration of immunity induced
by Shanghai-191 measles vaccine was studied for eight years in a region in
which interference due to natural measles infection had been minimized by mass
vaccination of children. Although immunity appeared to persist for at least
eight years, the results suggested that primary vaccination does not confer
lifelong immunity. Reactions and antibody responses to this vaccine
were compared with those to two vaccines from abroad, the Schwarz and
Leningrad-16 strains. The hemagglutination-inhibiting (HAI) antibody titer
induced by Shanghai-191 vaccine was higher than that induced by Leningrad-16
vaccine and lower than that induced by Schwarz vaccine; however, these
differences were not significant. Preliminary studies on the preparation of
measles vaccine in human diploid cells have yielded promising results.
PMID: 6879006 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=230111&dopt=Abstract
-
Poliovirus antibodies in age groups: an assessment of
obligatory vaccination in Belgium.
Lamy ME, Cornu C, Desmyter J.
Since 1967, compulsory oral vaccination before 2 years of age has been nearly
the only form of poliovaccination practiced in Belgium, and there have been
almost no cases of polio. In recent
sera from 2,225 Belgians, 2 year olds lacked demonstrable
seroneutralizing
antibody, in 31% for type 1, in 8% for type 2, and in 21% for type 3. The lack
of antibodies grew as the children reached 11--12 years, at which age 65%
lacked antibody for type 1, 15% for type 2, and 54% for type 3; only 19% had
antibodies against all types. It is argued that this decline of antibodies is
not due to insufficient vaccination in former years, but is a strong example
of the waning of vaccine-acquired serum antibody. Antibody rates went
up after age 12. The highest rates of types 1 and 3 antibodies were seen at
age 20--59. There was some decrease of antibody after 60 years. Mean antibody
titers paralleled positivity rates. Results of two laboratories studying
different populations with different standard techniques were similar. The
data support revaccination at school entrance.
PMID: 230111 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=688165&dopt=Abstract
-
The measles epidemic in Calgary, 1974-1975: the duration of
protection conferred by vaccine.
O'Neil AE. -
- From the article:
Individual immunity to measles, derived from live vaccine, wanes with time.
PMID: 688165 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=645653&dopt=Abstract
-
The changing epidemiology of pertussis in young infants.
The role of adults as reservoirs of infection.
Nelson JD.
We reviewed 400 bacteriologically confirmed cases of pertussis in infants and
children during the past 18 years. Several changes in the epidemiology have
occurred in the most recent six-year period. The incidence of whooping cough
in children has decreased by at least 50%, but the proportion of cases
occurring in infants younger than 12 weeks of age has doubled to 30% of all
cases. Formerly most young infants acquired their illness from siblings or
other children, but in the recent period adults in the household were the most
common source of infection to neonates and young infants.
This observation plus the increasingly
high level of immunization in preschool and school-aged children suggest that
young adults with waning immunity and mild illness are a major reservoir for
transmission of pertussis to infants too young to be immunized.
PMID: 645653 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=830888&dopt=Abstract
A measles outbreak among adolescents.
Weiner LB, Corwin RM, Nieburg PI, Feldman HA.
In a May, 1975, outbreak, 147 adolescents, ages 12 to 19 years, were
identified as having measles by a physician or school nurse. One junior high
school, with an enrollment of 1,122, contributed 131 of the cases. Of the 147
students, 54 were seen by physicians who also supplied their immunization
records; 19 of 54 (35%) had received live measles virus vaccine without
measles immune globulin, after age one year. The remaining 35 received: killed
virus vaccine only (1), K + L (4), L + MIG (4), L at less than 1 year of age
(4), L + ? MIG (4), immune serum globulin only, for exposure (6), no vaccine
but history of measles previously (9); history uncertain (3). Hemagglutination-inhibition
antibody titers were consistent with the diagnosis of acute measles in 11
children. No index case was identified and no secondary cases occured within
the families of the 54 cases. This
measles outbreak among seemingly immunized adolescents raises a serious
question as to the duration of such protection.
PMID: 830888 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1126572&dopt=Abstract
-
Duration of circulating and secretory antibody and
cell-mediated immunity following immunization.
Waldman RH, Ganguly R.
An important consideration in
evaluating vaccines is the duration of immunity. The only really important
measure of this immunity is the protection against infections and/or illness
at various time intervals, following natural or artificial challenge. There
are few data of this sort, more commonly immunity is estimated by measuring
serum antibody, in many instances an erroneous measure. Serum antibody levels
to respiratory viruses fall only slightly 6 months following infection or
immunization. It is difficult to assess the duration of antibody for much
longer than this, because of problems with
intercurrent
infection. With respiratory bacterial infections, e.g. pneumococcal
pneumonia, parenterally-induced immunity probably lasts for only several
months. Secretory antibody induced by inactivated viral vaccines, seems to
persist for about a year, after having reached a peak level at about 4-6 weeks
following immunization. Work with the live attenuated polio virus vaccine
indicates longer lasting immunity, with detectable antibody persisting for up
to 34 months. Restimulation with the inactivated polio virus vaccine produced
no evidence of a secondary response (memory). Following booster immunization
with influenza very little evidence of memory is seen. Cell-mediated immunity
(CMI): in guinea pigs BCG sensitization can be demonstrated for at least 2-9
months. In humans, intracutaneous BCG immunization leads to positive
tuberculin reaction in 6-10 weeks, and skin sensitivity lasts an average of
about 4 years. There is contradicting data as to the duration of protection
against infection following BCG immunization. Local and systemic CMI have been
shown to exist independently of each other in experimental animals and man.
PMID: 1126572 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=5362859&dopt=Abstract
-
Persistence of measles antibody in the absence of
circulating natural virus five years after immunization of an isolated virgin
population with Edmonston B vaccine.
Brown P, Gajdusek DC, Tsai T. -
- From the abstract: In the
absence of circulating natural measles virus in an isolated Pacific atoll
community after immunization of 136 immunologically virgin individuals from 1
to 24 years of age with Edmonston B strain live attenuated measles vaccine,
serum levels of HI antibody remained stable between 1 and 2 1/2 years after
immunization, but decline 2 to 3-fold by 5 years after immunization. Sera
having the highest antibody titers at 1 year showed the greatest decline, with
a resultant narrowing of the titer range at 5 years. Individuals with
even undetectable HI antibody levels at 5 years, nevertheless showed
neutralizing antibody at a serum dilution of at least 1:2, and thus
presumably remain immune from
infection.
PMID: 5362859 [PubMed - indexed for MEDLINE]
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