Top

Published in:

01-03-2012 | Original Paper

Antibody persistence for 3 years following two doses of tetravalent measles–mumps–rubella–varicella vaccine in healthy children

Authors: Markus Knuf, Fred Zepp, Klaus Helm, Hartwig Maurer, Albrecht Prieler, Dorothee Kieninger-Baum, Martine Douha, Paul Willems

Published in: European Journal of Pediatrics | Issue 3/2012

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. Conclusion: Immunogenicity of the combined MMRV vaccine was sustained 3 years post-vaccination. (208136/041/NCT00406211).

Advisory Committee on Immunization Practices. June 29–30, 2006. Atlanta, Georgia. Record of the proceedings. http://www.cdc.gov/vaccines/recs/acip/meetings.htm#min. Accessed 25 October 2010

Arvin A, Gershon A (2006) Control of varicella: why is a two-dose schedule necessary? Pediatr Infect Dis J 25:475–476PubMedCrossRef

Australian Government, Department of Health and Ageing, National Health and Medical Research Council (2008) Australian immunisation handbook, 9th edn. National Health and Medical Research Council, Canberra

Banz K, Iseli A, Aebi C, Brunner M, Schmutz AM, Heininger U (2009) Economic evaluation of varicella vaccination in Swiss children and adolescents. Hum Vaccin 5:847–857PubMed

Banz K, Wagenpfeil S, Neiss A, Hammerschmidt T, Wutzler P (2004) The burden of varicella in Germany: potential risks and economic impact. Eur J Health Econ 5:46–53PubMedCrossRef

Boelle PY, Hanslik T (2009) Varicella in non-immune persons: incidence, hospitalization and mortality rates. Epidemiol Infect 129:599–606CrossRef

Centers for Disease Control and Prevention (2007) Varicella. In: Atkinson W, Hamborsky J, McIntyre L, Wolfe S (eds) Epidemiology and prevention of vaccine-preventable diseases, 10th edn. Public Health Foundation, Washington, pp 175–196

Galil K, Lee B, Strine T, Carraher C, Baughman AL, Eaton M, Montero J, Seward J (2002) Outbreak of varicella at a day-care center despite vaccination. N Engl J Med 347:1909–1915PubMedCrossRef

Gil A, San-Martin M, Carrasco P, González A (2004) Epidemiology of severe varicella-zoster virus infection in Spain. Vaccine 22:3947–3951PubMedCrossRef

10.

Goh P, Lim FS, Han HH, Willems P (2007) Safety and immunogenicity of early vaccination with two doses of tetravalent measles–mumps–rubella–varicella (MMRV) vaccine in healthy children from 9 months of age. Infection 35:326–333PubMedCrossRef

11.

Grose C (2005) Varicella vaccination of children in the United States: assessment after the first decade 1995–2005. J Clin Virol 33:89–95PubMedCrossRef

12.

Hammerschmidt T, Bisanz H, Wutzler P (2007) Universal mass vaccination against varicella in Germany using an MMRV combination vaccine with a two-dose schedule: an economic analysis. Vaccine 25:7307–7312PubMedCrossRef

13.

Heininger U, Seward JF (2006) Varicella. Lancet 368:1365–1376PubMedCrossRef

14.

Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF (2005) Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992–2002. J Infect Dis 191:2002–2007PubMedCrossRef

15.

Knuf M, Faber J, Barth I, Habermehl P (2008) A combination vaccine against measles, mumps, rubella and varicella. Drugs Today (Barc) 44:279–292CrossRef

16.

Knuf M, Habermehl P, Zepp F, Mannhardt W, Kuttnig M, Muttonen P, Prieler A, Maurer H, Bisanz H, Tornieporth N, Descamps D, Willems P (2006) Immunogenicity and safety of two doses of tetravalent measles–mumps–rubella–varicella vaccine in healthy children. Pediatr Infect Dis J 25:12–18PubMedCrossRef

17.

Kreth H, Lee BW, Kosuwon P, Salazar J, Meurice F, Bock H (2008) Varilrix^TM: 16 years of experience with the first refrigerator-stable varicella vaccine. BioDrugs 22:387–402PubMedCrossRef

18.

Kuter B, Hoffman Brown ML, Hartzel J, Williams WR, EvesiKaren A, Black S, Shinefield H, Reisinger KS, Marchant CD, Sullivan BJ, Thear M, Klopfer S, Xu J, Gress JO, Schödel F, Study Group for ProQuad (2006) Safety and immunogenicity of a combination measles, mumps, rubella and varicella vaccine (ProQuad®). Hum Vaccin 2:205–214PubMedCrossRef

19.

Kuter B, Matthews H, Shinefield H et al (2004) Ten year follow-up of healthy children who received one or two injections of varicella vaccine. Pediatr Infect Dis J 23(2):132–137PubMedCrossRef

20.

Lee LE, Ho H, Lorber E, Fratto J, Perkins S, Cieslak PR (2008) Vaccine-era varicella epidemiology and vaccine effectiveness in a public elementary school population, 2002–2007. Pediatrics 121:e1548–e1554PubMedCrossRef

21.

Lopez AS, Guris D, Zimmerman L, Gladden L, Moore T, Haselow DT, Loparev VN, Schmid DS, Jumaan AO, Snow SL (2006) One dose of varicella vaccine does not prevent school outbreaks: is it time for a second dose? Pediatrics 117:e1070–e1077PubMedCrossRef

22.

Marin M, Güris D, Chaves SS, Schmid S, Seward JF, Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC) (2007) Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 56:1–40PubMed

23.

Marin M, Meissner HC, Seward JF (2008) Varicella prevention in the United States: a review of successes and challenges. Pediatrics 122:e744–e751PubMedCrossRef

24.

Mauldin J, Carbone K, Hsu H, Yolken R, Rubin S (1990) Mumps virus-specific antibody titers from pre-vaccine era sera: comparison of the plaque reduction neutralization assay and enzyme immunoassays. J Clin Microbiol 43:4847–4851CrossRef

25.

Miron D, Lavi I, Kitov R, Hendler A (2005) Vaccine effectiveness and severity of varicella among previously vaccinated children during outbreaks in day-care centers with low vaccination coverage. Pediatr Infect Dis J 24:233–236PubMedCrossRef

26.

Nader S, Bergen R, Sharp M, Arvin AM (1995) Age-related differences in cell-mediated immunity to varicella-zoster virus among children and adults immunized with live attenuated varicella vaccine. J Infect Dis 171:13–17PubMedCrossRef

27.

National Advisory Committee on Immunization (NACI) (2004) Update on varicella. Can Commun Dis Rep 30:1–26

28.

Ngai AL, Staehle BO, Kuter BJ, Cyanovich NM, Cho I, Matthews H, Keller P, Arvin AM, Watson B, White CJ (1996) Safety and immunogenicity of one vs. two injections of Oka/Merck varicella vaccine in healthy children. Pediatr Infect Dis J 15:49–54PubMedCrossRef

29.

Nguyen HQ, Jumaan AO, Seward JF (2005) Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med 352:450–458PubMedCrossRef

30.

Quian J, Rüttimann R, Romero C, Dall’orso P, Cerisola A, Breuer T, Greenberg M, Verstraeten T (2008) Impact of universal varicella vaccination of one year-olds in Uruguay: 1997–2005. Arch Dis Child 93:845–850PubMedCrossRef

31.

Rawson H, Crampin A, Noah N (2001) Deaths from chickenpox in England and Wales 1995–7: analysis of routine mortality data. BMJ 323:1091–1093PubMedCrossRef

32.

Rozenbaum MH, van Hoek AJ, Vegter S, Postma MJ (2008) Cost-effectiveness of varicella vaccination programs: an update of the literature. Expert Rev Vaccines 7:753–782PubMedCrossRef

33.

Schuster V, Otto W, Maurer L, Tcherepnine P, Pfletschinger U, Kindler K, Soemantri P, Walther U, Macholdt U, Douha M, Pierson P, Willems P (2008) Immunogenicity and safety assessments after one and two doses of a refrigerator-stable tetravalent measles–mumps–rubella–varicella vaccine in healthy children during the second year of life. Pediatr Infect Dis J 27:724–730PubMedCrossRef

34.

Sharrar RG, LaRussa P, Galea SA, Steinberg SP, Sweet AR, Keatley RM, Wells ME, Stephenson WP, Gershon AA (2000) The postmarketing safety profile of varicella vaccine. Vaccine 19:916–923PubMedCrossRef

35.

Sheffer R, Segal D, Rahamani S, Dalal I, Linhart Y, Stein M, Shohat T, Somekh E (2005) Effectiveness of the Oka/GSK attenuated varicella vaccine for the prevention of chickenpox in clinical practice in Israel. Pediatr Infect Dis J 24:434–437PubMedCrossRef

36.

Varis T, Vesikari T (1996) Efficacy of high-titer live attenuated varicella vaccine in healthy young children. J Infect Dis 174:S330–S334PubMedCrossRef

37.

Vesikari T, Baer M, Willems P (2007) Immunogenicity and safety of a second dose of measles–mumps–rubella–varicella vaccine in healthy children aged 5 to 6 years. Pediatr Infect Dis J 26:153–158PubMedCrossRef

38.

Watson B, Boardman C, Laufer D, Piercy S, Tustin N, Olaleye D, Cnaan A, Starr SE (1995) Humoral and cell-mediated immune responses in healthy children after one or two doses of varicella vaccine. Clin Infect Dis 20:316–319PubMedCrossRef

39.

Zhou F, Harpaz R, Jumaan AO, Winston CA, Shefer A (2005) Impact of varicella vaccination on health care utilization. JAMA 294:797–802PubMedCrossRef

40.

Zhou F, Ortega-Sanchez IR, Guris D, Shefer A, Lieu T, Seward JF (2008) An economic analysis of the universal varicella vaccination program in the United States. J Infect Dis 197:S156–S164PubMedCrossRef

41.

Ziebold C, von Kries R, Lang R, Weigl J, Schmitt HJ (2001) Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 108:E79PubMedCrossRef

Title: Antibody persistence for 3 years following two doses of tetravalent measles–mumps–rubella–varicella vaccine in healthy children
Authors: Markus Knuf
Fred Zepp
Klaus Helm
Hartwig Maurer
Albrecht Prieler
Dorothee Kieninger-Baum
Martine Douha
Paul Willems
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: European Journal of Pediatrics / Issue 3/2012
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-011-1569-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Antibody persistence for 3 years following two doses of tetravalent measles–mumps–rubella–varicella vaccine in healthy children

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2012

Detection of pulmonary arterial morphology in tetralogy of Fallot with pulmonary atresia by computed tomography: 12 years of experience

Overweight children with type 1 diabetes have a more favourable lipid profile than overweight non-diabetic children

Mutation screening of BMP4 and Id2 genes in Chinese patients with congenital ureteropelvic junction obstruction

Massive macroglossia after palatoplasty

Tracheal agenesis: approach towards this severe diagnosis. Case report and review of the literature

Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial