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. 2014 Oct 18;1(3):ofu094.
doi: 10.1093/ofid/ofu094. eCollection 2014 Dec.

Mumps antibody response in young adults after a third dose of measles-mumps-rubella vaccine

Amy Parker Fiebelkorn  1 , Laura A Coleman  2 , Edward A Belongia  2 , Sandra K Freeman  2 , Daphne York  2 , Daoling Bi  1 , Cheryl Zhang  3 , Laurie Ngo  3 , Steven Rubin  3
Affiliations

Mumps antibody response in young adults after a third dose of measles-mumps-rubella vaccine

Amy Parker Fiebelkorn et al. Open Forum Infect Dis. .

Abstract

Background: Mumps outbreaks in populations with high 2-dose measles-mumps-rubella (MMR) vaccine coverage raise the question whether a third dose of MMR vaccine (MMR3) is needed. However, data on the immunogenicity of MMR3 are limited. We assessed mumps virus neutralizing antibody levels pre- and post-MMR3 in a nonoutbreak setting.

Methods: Mumps antibody titers were assessed at baseline, 1 month, and 1 year after MMR3 in subjects aged 18-28 years.

Results: At baseline, 5 of 656 (0.8%) subjects had seronegative mumps neutralizing antibody titers and 38 (5.8%) had low titers. One year post-MMR3, these numbers declined to 3 (0.5%) and 16 (2.4%), respectively. Subjects with low baseline titers were more likely to have low 1-month and 1-year titers (R (2) = 0.81-0.87, P < .0001). Compared to baseline, geometric mean titers were significantly higher at 1 month (P < .0001) and 1 year (P < .01) post-MMR3; however, reverse cumulative distribution curves showed only minimal shifts in mumps titers from baseline to 1 month and 1 year.

Conclusions: Very few subjects had negative or low baseline mumps titers. Nonetheless, mumps titers had modest but significant increases when measured 1 month and 1 year post-MMR3. This temporary increase in titers could decrease susceptibility to disease during outbreaks, but may have limited value for routine use in vaccinated populations.

Keywords: immunization; mumps; mumps immunogenicity; third-dose measles-mumps-rubella (MMR) vaccine; vaccine-preventable disease.

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Figures

Figure 1.
Figure 1.
Flow chart for enrollment, analysis, and vaccination of subjects with a third dose of measles-mumps-rubella (MMR) vaccine.
Figure 2.
Figure 2.
A, Flow chart of mumps antibody titer levels at baseline, 1 month, and 1 year. B, Percentage of subjects who had negative, low-seropositive, and high-seropositive mumps antibody titer levels at baseline, and 1 month and 1 year following a third dose of measles-mumps-rubella (MMR) vaccine.
Figure 3.
Figure 3.
Reverse cumulative distribution curve using log-transformed titers by percent of subjects who had neutralizing mumps antibody titers at baseline and 1 month and 1 year following a third dose of measles-mumps-rubella (MMR3) vaccine.
Figure 4.
Figure 4.
A, Comparison of individual mumps titer levels at baseline and 1 month following a third dose of measles-mumps-rubella (MMR) vaccine. Circles represent individual titer levels. The dark solid line represents the linear regression of the best-fit of the comparison. The light shading around the line represents the 95% confidence interval. The dotted lines represent the 95% confidence limit. B, Comparison of individual mumps titer levels at baseline and 1 year following a third dose of MMR vaccine. Circles represent individual titer levels. The dark solid line represents the linear regression of the best fit of the comparison. The light shading around the line represents the 95% confidence interval. The dotted lines represent the 95% confidence limit.
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