Journal Article

Mutual interference on the immune response to yellow fever vaccine and a combined vaccine against measles, mumps and rubella

Maia, Maria de Lourdes S., Siqueira, Marilda M., Castro, Yvone P., Leal, Maria de Luz F., Camacho, Luiz Antonio B., Freire, Marcos de Silva, Nascimento Silva, Juliana Romualdo, Martins, Reinaldo M., Yamamura, Anna Maya Y.

2011

Overview

► Yellow fever vaccines (YFV) were given either simultaneously or 30 days after a combined measles-mumps-rubella vaccine (MMR) to compare their immunogenicity and reactogenicity in children. ► The immune response to YFV was substantially weaker when given simultaneously to MMR. ► The immune response to the rubella and mumps components of MMR was also weaker with simultaneous administration of YFV. ► Immune response to the measles component was strong regardless of time interval between vaccines. A randomized trial was conducted to assess the immunogenicity and reactogenicity of yellow fever vaccines (YFV) given either simultaneously in separate injections, or 30 days or more after a combined measles–mumps–rubella (MMR) vaccine. Volunteers were also randomized to YFV produced from 17DD and WHO-17D-213 substrains. The study group comprised 1769 healthy 12-month-old children brought to health care centers in Brasilia for routine vaccination. The reactogenicity was of the type and frequency expected for the vaccines and no severe adverse event was associated to either vaccine. Seroconversion and seropositivity 30 days or more after vaccination against yellow fever was similar across groups defined by YFV substrain. Subjects injected YFV and MMR simultaneously had lower seroconversion rates – 90% for rubella, 70% for yellow fever and 61% for mumps – compared with those vaccinated 30 days apart – 97% for rubella, 87% for yellow fever and 71% for mumps. Seroconversion rates for measles were higher than 98% in both comparison groups. Geometric mean titers for rubella and for yellow fever were approximately three times higher among those who got the vaccines 30 days apart. For measles and mumps antibodies GMTs were similar across groups. MMR's interference in immune response of YFV and YFV's interference in immune response of rubella and mumps components of MMR had never been reported before but are consistent with previous observations from other live vaccines. These results may affect the recommendations regarding primary vaccination with yellow fever vaccine and MMR.

• Publisher: Elsevier Ltd,Elsevier,Elsevier Limited
• Subject: Allergy and Immunology / antibodies / Antibodies, Viral / Applied microbiology / Arboviroses / Biological and medical sciences / Brazil / children / Children & youth / Combined vaccine against measles / Data Collection / Drug Antagonism / Drug Interactions / Female / Fever / Fundamental and applied biological sciences. Psychology / health services / Human viral diseases / Humans / Immune response / Immunogenicity / Infant / Infectious diseases / live vaccines / Male / Measles / Measles - immunology / Measles - prevention & control / Measles virus - immunology / Measles-Mumps-Rubella Vaccine - adverse effects / Measles-Mumps-Rubella Vaccine - antagonists & inhibitors / Measles-Mumps-Rubella Vaccine - immunology / Medical sciences / Microbiology / Mumps / Mumps - immunology / Mumps - prevention & control / Mumps virus - immunology / Reactogenicity / Rubella - immunology / Rubella - prevention & control / Rubella and mumps / Rubella virus - immunology / seroconversion / seroprevalence / Surveys and Questionnaires / Tropical viral diseases / vaccination / Vaccines / Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects) / Vaccines, Combined - adverse effects / Vaccines, Combined - immunology / Vector-borne diseases / Viral diseases / Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye / volunteers / Yellow fever / Yellow Fever - immunology / Yellow Fever - prevention & control / Yellow fever vaccine / Yellow Fever Vaccine - adverse effects / Yellow Fever Vaccine - antagonists & inhibitors / Yellow Fever Vaccine - immunology / Yellow fever virus / Yellow fever virus - immunology