Waning Antibody Levels and Avidity: Implications for MMR Vaccine-induced Protection

Background: The measles-mumps-rubella (MMR) vaccine is effective in eliciting a good antibody response. In addition to the amount of antibodies, the avidity of these antibodies might be important in protecting against disease.

Methods: The amount of circulating antibodies for measles, mumps, and rubella was measured with enzyme immunoassays, and the avidity of these antibodies was determined by urea dissociation. Three groups of twice-MMR-vaccinated individuals and 1 group of naturally infected individuals were studied. One vaccinated group (n = 71) was studied 6 months and 20 years after a second MMR vaccination.

Results: The antibody avidity indexes were high for measles and rubella but low for mumps. Twenty years after a second MMR vaccination, antibody levels for all 3 viruses waned. Also, the mean avidity index decreased by 8% for measles, 24% for mumps, and remained unchanged for rubella. Antibody avidity correlated with antibody concentration for measles. There was partial correlation for rubella and no correlation for mumps.

Conclusions: Measles and rubella induced high-avidity antibodies and mumps induced low-avidity antibodies after both vaccination and natural infection. Waning of both the concentration as well as the avidity of antibodies might contribute to measles and mumps infections in twice-MMR-vaccinated individuals.