Five Cases of Measles Secondary Vaccine Failure with Confirmed Seroconversion after Live Measles Vaccination

Abstract

We report 5 patients with secondary vaccine failure (SVF) who were infected with natural measles 2, 5, 5, 7 and 12 years, respectively, after vaccination with further attenuated live measles vaccine during infancy. Their seroconversion had been confirmed after vaccination. Three of the 5 patients had mild (modified) measles, while the remaining 2 patients had typical measles. The hemagglutination inhibition antibody titers to measles virus in paired acute and convalescent sera showed a secondary response pattern in 4/5 patients, and a primary response pattern was present in the remaining patient. Measles IgM antibodies were present in all patients during the convalescent stage. The patient with the primary response pattern may have had a decrease in the B cell memory during the 5-year period between vaccination and infection. This may be the first SVF case report that confirms the existence of completely waning immunity in recipients of the further attenuated live measles vaccines.

The changing epidemiology of hospitalized pediatric patients in three measles outbreaks

“…A positive anti-measles IgM has been regarded as an indication of primary vaccine failure in some studies, 10,11,18 although there is some controversy. 17,19 In addition, the vaccinees who subsequently develop measles have been reported to have a milder illness than the non-vaccinees in some studies, 20,21 whereas other studies reported that there were no differences for clinical illness between the two groups. 8,22e24 In this study, we found that there were no differences between the anti-measles IgM antibody positive and negative groups in regard to the examined parameters including the MMR vaccination rate and the duration of fever (Table 4).…”

Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan

“…In this context, the Japan Pediatric Association, the Japan Child Health Association, and the Japanese Association of Pediatrics jointly appealed to the Ministry of Health, Labor and Welfare to promote vaccination against measles in July 2001 [14]. Although secondary vaccine failure (SVF) has increased in Japan and discussion on two dose measles immunization has begun [15,16], actual increase in vaccine coverage among children between 12 to 24 months-old become a priority in the present setting. The level of vaccine coverage within a community is necessary to develop appropriate measures.…”

Measles in Minsk, Belarus, 2001–2003: Clinical, virological and serological parameters

“…No serological data are available on measles outbreaks in Belarus. At the same time, outbreaks of modified measles among a highly vaccinated population occur because of secondary vaccine failure (Edmonson et al, 1990;Hirose et al, 1997). Such outbreaks are an important obstacle to the eradication of the disease world-wide.…”