Differential Immune Responses to Primary Measles-Mumps-Rubella Vaccination in Israeli Children

Abstract

Measles remains an important cause of morbidity and mortality worldwide, primarily due to problems associated with delivery of the live attenuated vaccine to susceptible populations. In some developed countries, there is concern about the effects of immunization on the immune system. In this study, we analyzed the responses of 12-month-old Bedouin and Jewish children living in Israel to routine measles-mumps-rubella (MMR) vaccination. Seroconversion to measles was 99% in Bedouin and 79% in Jewish children (P < 0.01), and that to mumps and rubella was 92 to 100% in both groups. Measles neutralizing antibody titers were higher in Bedouin (333 ؎ 39 mIU/ml) than Jewish (122 ؎ 60 mIU/ml) children (P < 0.002). Immunoglobulin G levels were higher in Bedouin than Jewish children (P ‫؍‬ 0.007) and increased after vaccination (P ‫؍‬ 0.0009). Leukocyte (P < 0.02) and lymphocyte (P ‫؍‬ 0.04) counts were higher and CD4 lymphocyte percentages were lower (P < 0.001) in Bedouin than Jewish children before and after vaccination. Leukocyte counts and natural killer cell numbers did not change after vaccination, but lytic activity increased in Bedouin children (P < 0.005). Spontaneous proliferation of cultured peripheral blood mononuclear cells increased with vaccination, but there were no changes in the proliferative responses to phytohemagglutinin or tetanus toxoid. In summary, no adverse effects of MMR vaccination on immune function were detected. However, there were differences in underlying immunologic parameters and in response to the measles component of the vaccine between Bedouin and Jewish children. It is not known whether genetic differences or environmental exposure accounts for these differences.

Genetic Variation in the Response to Vaccination

“…In Bedouin, but not in Jewish children, natural killer cell activity increased after vaccination (p < 0.005). Differences between Bedouin and Jewish children with respect to these parameters (and others investigated) were not seen after mumps and rubella vaccination [33]. Although these data are intriguing, they should be interpreted with caution as the study was small.…”

“…The genetic influence on immune responses is further indicated by racial and ethnic differences in the response to vaccination [5, 33]. Such differences may in part be of genetic origin, but other factors, such as differences in household size, nutrition and socioeconomic status, may also play a role.…”

Immunological responses against Plasmodium falciparum Apical Membrane Antigen 1 vaccines vary depending on the population immunized

“…However, in the case of a malaria vaccine, it is not well documented whether it is possible to predict the immunological responses induced by a vaccine in a target population (i.e., malaria exposed children) from the response in another population (i.e., malaria naïve adults or malaria exposed adults). For other vaccines, such as measles-mumps-rubella vaccine [16, 17] and meningococcal vaccine [18], it has been reported that ethnicity and age factors affect antibody responses. In addition, other factors, such as nutritional status and environmental infections, are also thought to modify the immune response in the vaccine recipients (reviewed in [19]).…”

Sex, Age, and Race Effects on Immunogenicity of MenB-FHbp, A Bivalent Meningococcal B Vaccine: Pooled Evaluation of Clinical Trial Data

“…Although the current analysis was focused on immunogenicity only, it should be noted that a ). Sex, age, and race were selected as factors to include in this analysis because these characteristics have previously been associated with variable immunogenicity of numerous vaccines [10][11][12][15][16][17][18][19][20][21][22][23]. These demographic influences also interact with one another, illustrated in part by fluctuations in sex-dependent immune responses at different times throughout the lifespan [15,19,24].…”

“…Variability in vaccine responses based on age [10][11][12][13][14], sex [15][16][17][18][19], and race [20][21][22][23] has been observed for other vaccines. Therefore, it is important for public health authorities and medical practitioners to understand whether differences in vaccine efficacy occur in various populations in order to maximize vaccine benefit [15,16,18,24].…”