Rubella Vaccine Research Articles

Experiences and Lessons Learned from the Measles-Rubella Vaccination Campaign 2023 Implemented in Private Schools of Kolkata

Abstract Background: Measles-Rubella vaccination campaign (MRVC) was conducted in West Bengal with a target to achieve more than 95% vaccination among children aged 9 months to 15 years. Materials and Methods: A concurrent mixed-method study was undertaken in Kolkata from June 2023 to July 2023 with the objectives to explore strategies adopted in MRVC to achieve target, and lessons learned, and to identify barriers to implement MRVC, particularly in elite private schools. Thirty private schools and three medical officers of the borough health office were interviewed. Both quantitative and qualitative analyses were conducted. Results: The vaccination coverage was 70.16%. Sensitization meeting with parents before MRVC was not conducted in eight schools; key messages communicated were on the safety and benefit of the measles and rubella (MR) vaccine. The main pre-implementation barriers identified were the short notice period, sessions conflicting with pre-planned school activities, and hesitancy of parents. Frequently reported barriers during the sessions were delays in starting sessions, 30-minute waiting period after vaccination, and the involvement of teachers in the documentation process. Missed children were immunized in local health facilities and community-based sessions. Conclusions: With one of every four students not getting the vaccine in the school campaign, the progress toward MR elimination will halt. The main reasons for poor performance were deficient coordination between the health and education department, lack of ownership by schools, and low visibility of the campaign. Observations from this study highlight the need for effective planning, better advocacy, judicious use of communication strategy, and school-led promotion of vaccination.

Factors Associated with Timely First-Dose Pentavalent and Measles–Rubella Vaccination: A Cross-Sectional Study in East New Britain, Papua New Guinea

Background: Immunization coverage varies across Papua New Guinea. In East New Britain (ENB) Province in 2022, only 65.5% and 50.2% of children under one year received their first dose of pentavalent (DTP1) and measles–rubella (MR1) vaccine, respectively. This study aimed to examine barriers and enablers to routine immunization in areas of un(der)-vaccination in ENB. Methods: A face-to-face survey was conducted with caregivers of children aged 12–23 months in ENB. We used Poisson regression to calculate incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for factors associated with timely receipt of DTP1 or MR1 vaccines, defined as a child who was vaccinated between –2 and +30 days of the vaccine schedule. Delayed receipt is defined as a child who was vaccinated >30 days from the recommended due date. Results: Among 237 caregivers surveyed, 59.9% of children were vaccinated within the “timely” window for DTP1 and 34.1% for MR1. Timely DTP1 receipt was associated with a facility-based birth (IRR:1.93; 95% CI: 1.10–3.38) and trusting healthcare workers “very much”, compared to “a little or moderately” (IRR:1.53; 95% CI: 1.17–1.99). For MR1, the caregiver having completed tertiary/vocational education (IRR:1.79; 95% CI: 1.15–2.78), reporting taking a child to be vaccinated is affordable (IRR:1.52; 95% CI: 1.04–2.22), and healthcare workers explaining immunization services and answering associated questions (IRR:1.68; 95% CI: 1.18–2.41) were associated with timely vaccination. Conclusions: Activities to improve timely vaccination in ENB could include strengthening healthcare worker interpersonal communication skills to optimize trust and incentivizing women to give birth in a health facility.

Effectiveness and Immunogenicity of the MMR Vaccine Against SARS-CoV-2 Among Healthcare Workers

The purpose of this study was to evaluate the effectiveness and immunogenicity of the measles–mumps–rubella (MMR) vaccine against SARS-CoV-2 in healthcare workers at one medical institution. The effectiveness of the MMR vaccine against SARS-CoV-2 was evaluated in overall healthcare workers (HCWs). In addition, neutralizing antibodies to SARS-CoV-2 were measured according to the subjects’ measles immunity status with serum samples collected before the coronavirus disease 2019 pandemic period. The effectiveness of the MMR vaccine for SARS-CoV-2 in all HCWs and measles IgG-positive subjects was 34% (adjusted odds ratio [aOR] = 1.20, 95% confidence interval [CI] = 0.53–2.70) and 34% (aOR = 0.66, CI = 0.38–18.4), respectively. The neutralizing antibody levels for SARS-CoV-2 were low in all groups regardless of the measles immune status. The MMR vaccine alone may not provide sufficient protection against SARS-CoV-2.

Randomized Comparative Study Assessing the Efficacy of Intralesional Measles, Mumps, and Rubella (MMR) Vaccine and Vitamin D3 in Treating Warts

Randomized Comparative Study Assessing the Efficacy of Intralesional Measles, Mumps, and Rubella (MMR) Vaccine and Vitamin D3 in Treating Warts

Verification of Immunity to Measles in Adults

Abstract Recently, there have been several measles outbreaks reported in the United States and globally. Declining rates of childhood vaccination and potential lack of complete coverage in the adult population could impact population levels of immunity against measles over the next decade and beyond. Therefore, it is important for primary care clinicians and others who provide vaccinations to verify the status of immunity to measles as part of routine clinical care for adult patients. Self-reported receipt of “childhood vaccinations” might not reflect actual receipt of the currently licensed live-virus measles, mumps, and rubella vaccine, depending upon an adult patient's age and childhood location. Most adult patients who do not have evidence of immunity to measles should receive measles, mumps, and rubella vaccination, as per longstanding recommendations from the Advisory Committee on Immunization Practices.

P-1419. Vaccine failure of the live-attenuated vaccine after liver transplantation depends on the vaccine strain

Abstract Background A recent conditional recommendation suggests considering live-attenuated vaccines for solid organ transplant recipients, yet the conditions of their safe and effective administration remain unclear. Primary vaccine failures after the first dose of live-attenuated vaccines (measles, rubella, and mumps) were significantly different between the vaccine strains. Methods This prospective study, conducted at Keio University Hospital from 2002 to August 2023, gave live-attenuated vaccines to liver transplant (LT) recipients fulfilling the criteria for live-attenuated vaccines, including humoral and cell-mediated immunity. Patient background information, immunization date, vaccine strain, immunosuppressive agents at the time of vaccination, and antibody titers were collected. Factors related to primary and secondary vaccine failure were evaluated to enhance the effectiveness of the live-attenuated vaccine program after LT. Kaplan–Meier curves for the proportion of remaining positive antibody titer after the first dose of indicated live-attenuated vaccine for post-liver transplant recipients. Results Among 67 LT recipients, 54, 55, 47, or 55 received at least one dose of live-attenuated vaccine for measles, rubella, varicella, or mumps, respectively. Measles vaccine with the AIK-C strain exhibited significantly lower primary failure rates than the CAM-70 strain (1/38 vs. 4/16, odds ratio: 0.08, 95% confidence interval [CI]: 0.01–0.80, p = 0.02) (Table 1). No primary failures were observed with the TO-336 strain of rubella, whereas 4 of 10 LT recipients with the Matsuura strain of rubella did not seroconvert. For mumps, the Hoshino strain showed lower primary failure rates than the Torii strain (15/52 vs. 3/3, p = 0.03). Among seroconverted LT recipients after the first dose of live-attenuated vaccine, the proportion of remaining positive antibody titer is shown by Kaplan–Meier curves (Figure 1). In the years following the first doses of measles, varicella, and mumps vaccines, the proportion of remaining positive antibody titers decreased gradually. Furthermore, the AIK-C strain exhibited a significantly lower risk of secondary vaccine failure compared to the CAM-70 strain (hazard ratio: 0.29, 95% CI: 0.12–0.72, p = 0.01) (Figure 2). Kaplan–Meier curves for the proportion of remaining positive antibody titer after the first dose of measles vaccine for post-liver transplant recipients with Log-rank test for the vaccine strains. Conclusion Vaccine strains are the most critical factor influencing primary and secondary vaccine failure in post-transplant live-attenuated vaccination. Disclosures Masayoshi Shinjoh, MD, PhD, Meiji Seika Pharma Co., Ltd: Honoraria|Mitsubishi Tanabe Pharma Corporation: Honoraria|MSD K.K.: Honoraria|Pfizer Japan Inc: Advisor/Consultant|Shionogi & Co., Ltd: Honoraria

Retrospective analysis in children with vaccination granuloma

Vaccine granulomas are acommon (0.3-1%) adverse event (AE) of (accidentally) subcutaneously administered vaccines and specific immunotherapies containing aluminum conjugates. The clinical symptoms with persistent itching subcutaneous nodules, predominantly affect infants and young children on the lateral thigh. To sensitize dermatologists to recognize this common and harmless vaccination AE, in order to prevent invasive diagnostics and confusion among parents and physicians. Retrospective analysis of 13children consulting pediatric dermatology between 2019 and 2023. Identification of diagnostic criteria and guidelines for action, based on the literature. In all, 13children (9boys, 4girls) with subcutaneous indolent but itching nodules at the vaccination sites (11 on the thighs, 2on the upper arms) with alatency of weeks to months were retrospectively evaluated. The children were vaccinated according to German STIKO ("Ständige Impfkommission") recommendations. Only inactivated vaccines contain aluminum. The documented occurrence of the first vaccination granulomas was between the 12thand 36thmonth of life. Regarding the STIKO vaccination calendar, the third immunization with the hexavalent inactivated vaccine coincides with the first administration of the live measles, mumps and rubella (MMR) vaccine (varicella(V)). This may incorrectly lead to the assumption that the live vaccine was the cause of granuloma development. Aluminum conjugation appears to be acentral trigger of the granulomas; further susceptibility factors are largely unknown. Diagnosis of sensitization to aluminum through epicutaneous testing has no practical impact and is, therefore, not routinely recommended. After weeks to years, granulomas spontaneously regress.

Seroprevalence of TORCH Viral Agents in Pregnant Women in Turkey: Systematic Review and Meta-Analysis.

Rubella Virus, Cytomegalovirus (CMV), Herpes Simplex Virus-2 (HSV-2), Hepatitis B (HBV) and Hepatitis C virus (HCV) can cause serious fetal disease. The seropositivity rates of these agents vary among countries and geographic regions. This study aimed to analyze the prevalence rates and diagnostic methods used in studies investigating the seroprevalence of viral pathogens in the TORCH group among pregnant women in Turkey between 2005 and 2024. A systematic search was conducted using electronic databases between January 2005 and January 2024. A total of 60 studies meeting the inclusion criteria were included. Data quality control was assessed using the Joanna Briggs Institute guideline prevalence studies checklist. Heterogeneity was measured using the I-squared (I2) statistic in the Comprehensive Meta Analysis (CMA) program. The average seropositivity rates for Rubella, CMV, HSV-2, HBV and HCV in Turkey were determined as 91.18%, 94.81%, 35.52%, 1.66% and 0.25%, respectively. When the diagnostic methods were examined, it was determined that ELISA and ECLIA methods were used most frequently. The seropositivity of the agents did not show statistically significant differences according to the year periods, geographical regions and age of the patients (p > 0.05). The highest prevalence rates of Rubella and HSV-2 in pregnant women were reported in the Mediterranean region, the highest prevalence rates of CMV and HCV in the Southeastern Anatolia region and the highest seroprevalence of Anti HBs in the Marmara region. The results of this study support the necessity of increasing public awareness in the control of fetal infection caused by TORCH viral agents, prenatal screening, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV. The results of this study highlight the need to increase public awareness on prenatal screening for the control of fetal infection caused by all TORCH viral agents, vaccination for Rubella and HBV and compliance with hygiene conditions for agents such as CMV, HSV-2 and HCV.

Immunisation schedule of the Pediatric Spanish Association: 2024 recommendations.

The AEP 2025 Vaccination and Immunization Schedule recommended for children, adolescents and pregnant women residing in Spain features the following novelties: Due to the increase in measles cases and outbreaks in recent years, we recommend advancing the second dose of measles, mumps and rubella (MMR) vaccine to 2 years of age. As a consequence of the above, since many autonomous communities (ACs) use the quadrivalent vaccine for the second dose of MMR and varicella vaccines, we recommend, for all ACs, advancing the second dose of varicella vaccine to 2 years of age. Due to the very significant increase in cases of pertussis since late 2023 and especially in 2024, we recommend advancing the dose of Tdap given in adolescence to 10-12 years of age. To complete protection against meningococcal disease in adolescence, we recommend vaccination against MenB at age 12 years. We believe that vaccination against seasonal influenza should be routine up to age 18 years, but given the disappointing coverage in children aged 6-59 months, we currently consider that improving this coverage should be prioritised, extending vaccination to children and adolescents aged 5-18 years once this objective has been achieved. Among other aspects, the routine immunization tables for healthy individuals and risk groups, the use of the new extended-valence conjugate vaccines against pneumococcal disease, routine vaccination at 4 months of age with MenACWY and vaccination against SARS-CoV-2 for individuals aged more than 6 months with risk factors remain unchanged with respect to the 2024 schedule.

Methicillin-resistant Staphylococcus Aureus Bacteraemia in a Young Boy following Mumps Infection: A Case Report

Mumps infection is regarded as one of the main vaccine-preventable diseases in the world. Although mumps is considered one of the most innocuous infections, it can also cause serious complications such as meningoencephalitis, pancreatitis, myocarditis, and long-term issues like deafness and multiple cranial nerve palsies. Due to its predominantly benign nature, it has long been a neglected infection. The Government of India includes the administration of the Measles and Rubella (MR) vaccine only (without the mumps vaccine) at 9 and 15 months of age for all children in the National Immunisation Schedule. In the present case, a nine-year-old boy was brought in with complaints of fever and bilateral swelling in the parotid region for three days, accompanied by pain during chewing. Clinically, patient was diagnosed with a mumps infection. The parotid swelling gradually decreased over the course of one week. However, the boy continued to experience persistent high-grade fever even after the parotitis improved. Complications of mumps, such as orchitis, pancreatitis, and meningoencephalitis, were ruled out. Laboratory investigations revealed the growth of Methicillin-resistant Staphylococcus Aureus (MRSA) in the blood, which was sensitive to the antibiotics doxycycline, ciprofloxacin and clindamycin. The boy was started on doxycycline, and the fever abated within 24 hours, leading to constitutional improvement. This unusual presentation of MRSA bacteraemia following a mumps infection underscores the importance of considering all possible differential diagnosis when a child does not follow the expected clinical course and continues to exhibit symptoms without improvement.

Assessment of Simplified Surveillance for Congenital Rubella Syndrome in Sudan, 2014-2017.

Congenital rubella syndrome (CRS) is a constellation of serious multi-organ birth defects following rubella virus infection during early pregnancy. Countries in which rubella vaccination has not yet been introduced can have a high burden of this disease. Data on CRS burden and epidemiology are needed to guide the introduction of a rubella vaccine and monitor progress for rubella elimination, but the multi-system nature of CRS manifestations and required specialized testing creates a challenge for conducting CRS surveillance in developing settings such as Sudan. To enhance data quality, we designed and tested a simplified approach for CRS surveillance in Sudan. Seven CRS surveillance sentinel sites were set up at general pediatric, eye, and cardiology hospitals in Sudan, using standard definitions for reporting and classifying infants with CRS clinical manifestations. Between 2014 and 2017, we evaluated the system using WHO CRS surveillance monitoring indicators, comparing simplified approaches against a comprehensive one. The simplified approaches included (1) an ophthalmic-focused approach; (2) a heart-focused approach; and (3) a cataract-only approach. Surveillance identified 179 infants with suspected CRS via the comprehensive approach, with 25 infants classified as laboratory-confirmed and 6 as clinically compatible. Surveillance sensitivity was highest for the simplified ophthalmic approach, while cataract-based surveillance had the highest proportion of confirmed cases. Simplified CRS surveillance, particularly focusing on detecting cataracts, can significantly contribute to monitoring the impact of rubella vaccine introduction. It could serve as an initial step towards comprehensive CRS surveillance, providing robust evidence to support rubella and CRS elimination efforts.

Rapid vaccination monitoring and its impact on vaccination coverage for high-quality catch-up campaigns in the Dominican Republic, 2023Monitoramento das estratégias de vacinação e impacto nas coberturas de vacinação para campanhas de seguimento de alta qualidade na República Dominicana, 2023

To assess the contribution of rapid vaccination monitoring to the achievement of vaccination coverage targets in catch-up vaccination campaigns. Data on catch-up vaccination were obtained from the database of the Directorate of Vaccine-Preventable Diseases. Data analysis was performed in Stata V.15®. Frequency and summary statistics were calculated; the p value was used to determine statistical significance. The change in mean coverage between interventions was assessed with Student's t-test. During the catch-up campaign, 815,482 children in 157 municipalities were immunized, and 2,431 rapid monitoring activities were carried out. Prior to rapid monitoring, measles and rubella (MR) vaccine coverage was 85.7%, while bivalent oral polio vaccine (bOPV) coverage was 89.9%; coverage was homogeneous in 78% of municipalities. After rapid monitoring, MR coverage rose to 98.7% and bOPV coverage to 100%. MR coverage increased by 14.6% and bOPV coverage by 11.7%; both changes were statistically significant (Student's t-test: 12.3 and 10.8, respectively; P = 0). Rapid monitoring is a useful strategy for validating coverage during catch-up vaccination campaigns and should be carried out by outside teams. The reported data can be used to improve the accuracy of coverage data. Rapid monitoring is an appropriate strategy from a cost-benefit standpoint, and we recommend its use to assess data quality during catch-up vaccination campaigns.

Inequalities in uptake of childhood vaccination in England, 2019-23: longitudinal study

ObjectiveTo quantify changes in inequalities in uptake of childhood vaccination during a period of steadily declining overall childhood vaccination rates in England.DesignLongitudinal study.SettingGeneral practice data for five vaccines administered to...

Live Attenuated Vaccine Administration in Children Treated With Methotrexate or Dupilumab.

A wholesale recommendation against use of live virus vaccines in patients treated with any medication classified as an immunosuppressant has been based on global theoretical concerns rather than clinical outcomes for specific drugs. A retrospective search of electronic medical records identified patients seen by the Allergy and/or Dermatology services between 2017 and 2023 at a pediatric tertiary center who received a live attenuated vaccine during the 6 week interval prior to the first prescription for methotrexate or dupilumab until 6 weeks after the last prescription for either medication. Individual charts of identified patients were manually reviewed for evidence of adverse events. The search identified 313 pediatric patients treated with dupilumab and/or methotrexate during the 7-year interval. Five of these patients received the combination measles, mumps, rubella, and varicella (MMRV) vaccine while on dupilumab and 4 while on methotrexate. Manual chart review was without evidence of adverse events for up to 6 months after immunization. This retrospective search identified a small number of pediatric patients immunized with the live attenuated MMRV vaccine during concomitant treatment with dupilumab or methotrexate. No associated adverse events were identified. Further investigation is needed to establish the safety and efficacy of live vaccines in patients treated with these immunomodulating agents.

Enablers to high vaccination uptake among a disadvantaged minority population: a qualitative study of the Arab population of Israel

BackgroundOver 1.9 million Arabs live in Israel and constitute 21% of the total population. Despite being a disadvantaged minority population with wide gaps in health indicators, Arabs have higher Human Papillomavirus (HPV) and Measles, Mumps, and Rubella (MMR) vaccination rates compared with the general Jewish population.MethodsIn-depth interviews with 21 health care providers, 16 Arab mothers, and 16 teenagers were conducted to collect information about health system enablers to HPV and MMR vaccination. All interviews were conducted in Arabic by an Arab researcher, audio-recorded, transcribed, and analysed using thematic analysis of the transcripts. Themes were mapped according to the WHO Health Systems Building Block Framework.ResultsWe identified several health system enablers. On the service delivery level, accessible and availability of vaccination services, delivery of vaccines through the school system and mother child clinics, and framing vaccinations as the norm were themes. Personable characteristics of the health workforce, the health care providers belonging to the same cultural group, and high levels of trust towards healthcare professionals were reported. Vaccination provided at no cost was also identified. On the leadership/governance level, the Arab community felt equal treatment and distribution of services, which was also an enabler reported. Despite high vaccine uptakes, parents and teenagers had limited knowledge regarding vaccination, particularly HPV.ConclusionsThis study highlights that a combination of good access and delivery to vaccination, delivered by a culturally competent, available, accessible respectful workforce can enable disadvantaged minorities to achieve high vaccine coverage, in particular in a cultural context where the population trusts and follows medical advice. Such evidence can serve as a basis for developing policies, interventions, and guidance to improve vaccine uptake among other underserved minority communities.

EE832 The Lifetime Return on Investment of Measles, Mumps, and Rubella Vaccination in Belgium and Poland

EE832 The Lifetime Return on Investment of Measles, Mumps, and Rubella Vaccination in Belgium and Poland

Immunization-related complex regional pain syndrome: A systematic review of case reports.

Vaccines have been shown to have the highest efficacy in preventing infectious diseases through their ability to induce immunological memory against pathogens. An adverse reaction to a vaccine is an unexpected medical occurrence following immunization. Complex regional pain syndrome (CRPS) is a disease that has undergone much controversy regarding its onset post-vaccination. This systematic review aims to evaluate cases of CRPS post-vaccination to better understand the manifestation of the disease and its potential association with vaccines. A systematic review of case reports was conducted employing the PRISMA 2020 guidelines. Outcomes of interest include type of vaccination, patient age, patient sex, time to symptom onset, and medical history including but not limited to previous autoimmune diseases, psychological illness, physical tissue trauma, and neurological disease. Initial querying of the five databases yielded 404 articles. Following a thorough review of articles, only 14 remained, comprising 18 cases. Studies included cases of CRPS development following tetanus, hepatitis B, hepatitis A, rubella, influenza, tetanus-diphtheria, human papillomavirus, and COVID-19 vaccine administration. The limitations of evidence used in this study highlight the need for a greater output of higher-level evidence in the form of controlled trials and retrospective studies to help further elucidate the connection between vaccine use and the development of CRPS in patients. Currently, vaccines continue to be safe for global public use.

Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi

Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (measles rubella vaccine (MRV), bivalent oral polio vaccine (OPV), and vitamin A Supplementation). The campaign sought to reach all children 9 months to younger than 14 years, representing more than 9 million individuals, and about half the country’s population. Following the campaign, TCV was incorporated into the routine immunization program for 9-month-old infants. We conducted a micro-costing study at 50 randomly selected health facilities, 10 districts, and at national level to retrospectively assess the financial and economic cost of the integrated campaign, as well as prospectively estimate the cost of delivering TCV in the routine immunization system. The financial and economic costs per dose for all interventions delivered in the campaign were $0.49 ($0.42;$0.57) and $0.84 ($0.67;$1.02), respectively. The main activities and cost types varied; human resources represented the main resource at health facility level, and per diem at district and national levels. The financial and economic cost to routinely deliver a dose of TCV were $0.44 ($0.17;$0.87), and $2.37 ($1.39;$3.53), respectively, with human resources as the main resource used by the routine program at all levels.The cost per dose delivered in the integrated campaign in Malawi was comparable with other integrated campaigns and was lower than the reported cost to deliver TCV in single antigen campaigns in India and Zimbabwe. Integrated campaigns may represent an opportunity to introduce new vaccines such as TCV to lower the cost per dose delivered. Attention should be given to challenges coming with integration, such as the burden for healthcare workers.Evidence produced by this study can be used in Malawi to inform financial sustainability of the TCV program and should inform decisions and strategies for implementation by other countries.

Structure-based design of glycoprotein subunit vaccines for mumps

Mumps virus (MuV) is a highly contagious paramyxovirus that is endemic in most regions of the world and continues to cause outbreaks even in highly immunized populations. Outbreaks of mumps in countries with high measles, mumps, and rubella vaccination coverage have been attributed to waning immunity and antigenic differences between the Jeryl Lynn vaccine strain (genotype A) and circulating wild-type viruses. To obtain a subunit vaccine, we used structure-based design to engineer the mumps fusion (F) glycoprotein stabilized in its prefusion conformation (Pre-F) as well as a chimeric immunogen comprising Pre-F linked to mumps hemagglutinin neuraminidase (HN); in mice, both Pre-F antigen and the chimeric antigen elicited potent cross-reactive plaque reducing neutralizing titers to genotypes A, G, and H mumps. A crystal structure of mumps Pre-F at 2.16 Å resolution validated the stabilization strategy, while a post-fusion form of F was engineered as a comparator. Monoclonal antibodies to mumps Pre-F and HN were isolated from immunized mice; 7 of 14 Pre-F-specific antibodies and 9 of 15 HN-specific antibodies were capable of neutralizing genotype G MuV with a range of potencies. Additionally, 7 of 14 Pre-F-specific antibodies neutralized genotype A mumps. Structural and binding analyses of Pre-F-specific antibodies revealed binding to four discrete neutralizing antigenic sites and binding analyses of HN-specific antibodies revealed binding to five discrete neutralizing antigenic sites. Overall, the PreF and the chimeric Pre-F/HN immunogens are promising candidates to boost MMR-elicited immunity to mumps or as a next-generation vaccine.

Anaphylactic Reaction With The Measles-Mumps-Rubella Vaccine In A Patient With Cow's Milk Allergy

The most common food allergy in children worldwide is cow's milk allergy. The most known allergens from cow's milk proteins are casein, alpha-lactalbumin, and beta-lactoglobulin. Lactalbumin hydrolysate is used as a stabilizer in the measles mumps rubella (MMR) vaccine originating in India. Different commercial forms of the MMR vaccine are available. While neomycin stabilizes, lactalbumin hydrolysate is used in the other form. We present a patient who was followed up for cow's milk allergy and developed anaphylaxis after the MMR vaccine originating from India. A 4-year-old girl with a history of anaphylaxis with cow's milk whose vaccinations were applied by the routine vaccination schedule in the family health center. Sneezing and urticaria started 1 minute after immunization. The patient presented to the emergency department (within 10 minutes after vaccination) with severe respiratory distress and intercostal retractions. The patient was administered three doses of intramuscular adrenaline, 5 minutes apart, intravenous pheniramine and methylprednisolone, and a nebulizer short-acting beta agonist. Symptoms regressed approximately 40 minutes after hospitalization. In our patient with a history of cow's milk anaphylaxis and lactalbumin-specific immunoglobulin E value of 61.3 kU/L, anaphylactic reaction with MMR vaccine seems to be related to the lactalbumin contained in the vaccine. Families and physicians should be meticulous about reading labels in the follow-up of patients with known food allergies.