A clinical and serologic study of 103 children with measles vaccine failure

Abstract

During the spring of 1971, 103 children with measles vaccine failure were studied. Seventy-six children had typical measles, 15 had mild modified measles, and 12 had an illness resembling the atypical measles syndrome; 6 of these latter 12 patients had previously received only live measles vaccine. Eighty-seven patients had serologic evidence of recent measles infection; 2-mercaptoethanol (2-ME) treatment of the acute-phase sera from these children revealed different antibody patterns by clinical category. The majority of sera from typical measles cases had ≥4-fold reduction in titer with 2-ME treatment, whereas the majority of sera from modified and atypical cases had no reduction in titer with 2-ME treatment. The acute-phase sera of 15 patients with vaccine failure were found to contain only gamma-G measles antibody when separated by sucrose gradient centrifugation. Thirteen of these sera were from children with modified or atypical illnesses. These findings suggest that some vaccine failures occur in patients who were antigenically simulated previously by measles virus and that illness in these children is likely to be less severe. During the spring of 1971, 103 children with measles vaccine failure were studied. Seventy-six children had typical measles, 15 had mild modified measles, and 12 had an illness resembling the atypical measles syndrome; 6 of these latter 12 patients had previously received only live measles vaccine. Eighty-seven patients had serologic evidence of recent measles infection; 2-mercaptoethanol (2-ME) treatment of the acute-phase sera from these children revealed different antibody patterns by clinical category. The majority of sera from typical measles cases had ≥4-fold reduction in titer with 2-ME treatment, whereas the majority of sera from modified and atypical cases had no reduction in titer with 2-ME treatment. The acute-phase sera of 15 patients with vaccine failure were found to contain only gamma-G measles antibody when separated by sucrose gradient centrifugation. Thirteen of these sera were from children with modified or atypical illnesses. These findings suggest that some vaccine failures occur in patients who were antigenically simulated previously by measles virus and that illness in these children is likely to be less severe.