Geographic variation in infant loss of maternal measles antibody and in prevalence of rubella antibody

Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Ministerio de Salud. Santiago, CL.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USAEscola Paulista de Medicina. São Paulo, SP, Brazil.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Supramedica Laboratory. Lados, NG.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.University of California. Department of Microbiology and Molecular Genetics. Irvine, CA.Secretaria de Saúde e Meio Ambiente. Porto Alegre, RS, Brazil.Ministério da Saúde. Fundação Serviços de Saúde Pública. Instituto Evandro Chagas. Belém, PA, Brasil.Pan American Health Organization. El Paso, TXChristian Medical College. Vellore, IN.Instituto Materno Infantil. Recife, PE, Brazil.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Yale University. School of Medicine. Departament of Epidemiology and Public Health. New Haven, CT, USA.Maternal and cord measles and rubella antibodies were compared in 15 populations from Brazil, Ecuador, Chile, India, Jordan, Nigeria, South Africa, Taiwan, and the United States. Review of the literature concerning these countries showed that a higher proportion of children 6-12 months of age responded immunologically to measles vaccine in areas with low per capita product than in wealthier populations. The authors show that this difference reflects differences in maternal antibody titer and differences in efficiency of transport of measles immunity across the placenta. No variation in the half-life of passive measles immunity in the infant was found in comparing three geographic areas. When these biologic factors are fully evaluated, it should be possible to predict the response to be expected from vaccination at any particular age without directly testing the vaccine in children below and above generally recommended ages for vaccination. With regard to rubella, high antibody prevalence rates were found in most of the developing countries, as well as in the United States, and these countries are therefore unlikely to encounter widespread problems with congenital rubella. However, Taiwan, and all of four areas of Brazil have prevalence rates which are no higher than those which pertained in the United States prior to establishment of the rubella immunization program. The authors believe that protection of the infants in these countries is a matter of high priority, but that, if approached hastily, it could exacerbate the problem