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Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines?
Vaccine. 2015 May 11; 33(20):2301-6.V

Abstract

BACKGROUND

The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days.

SUBJECTS AND METHODS

A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group).

RESULTS

Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination.

DISCUSSION

In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct.

CONCLUSION

In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries.

Authors+Show Affiliations

Institut Pasteur in Dakar, Dakar, Senegal; Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France; Ecole du Val-de-Grâce, Paris, France. Electronic address: r.michel4@wanadoo.fr.Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France; Institut Pasteur in French Guiana, Cayenne, France.Institut Pasteur in Dakar, Dakar, Senegal; Institut Pasteur de Madagascar, Madagascar.Institut Pasteur in French Guiana, Cayenne, France.Institut Pasteur in Dakar, Dakar, Senegal.Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802), Centre Hospitalier de Cayenne, Cayenne, French Guiana.Institut Pasteur de Madagascar, Madagascar.Institut Pasteur in French Guiana, Cayenne, France.Institut Pasteur in Dakar, Dakar, Senegal.Institut Pasteur in Dakar, Dakar, Senegal.Institut Pasteur in Dakar, Dakar, Senegal.Institut Pasteur in Dakar, Dakar, Senegal; Global Epidemiology, GSK Vaccines, Wavre, Belgium.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25843268

Citation

Michel, R, et al. "Observational Study On Immune Response to Yellow Fever and Measles Vaccines in 9 to 15-month Old Children. Is It Necessary to Wait 4 Weeks Between Two Live Attenuated Vaccines?" Vaccine, vol. 33, no. 20, 2015, pp. 2301-6.
Michel R, Berger F, Ravelonarivo J, et al. Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines? Vaccine. 2015;33(20):2301-6.
Michel, R., Berger, F., Ravelonarivo, J., Dussart, P., Dia, M., Nacher, M., Rogier, S., Moua, D., Sarr, F. D., Diop, O. M., Sall, A. A., & Baril, L. (2015). Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines? Vaccine, 33(20), 2301-6. https://doi.org/10.1016/j.vaccine.2015.03.069
Michel R, et al. Observational Study On Immune Response to Yellow Fever and Measles Vaccines in 9 to 15-month Old Children. Is It Necessary to Wait 4 Weeks Between Two Live Attenuated Vaccines. Vaccine. 2015 May 11;33(20):2301-6. PubMed PMID: 25843268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines? AU - Michel,R, AU - Berger,F, AU - Ravelonarivo,J, AU - Dussart,P, AU - Dia,M, AU - Nacher,M, AU - Rogier,S, AU - Moua,D, AU - Sarr,F D, AU - Diop,O M, AU - Sall,A A, AU - Baril,L, Y1 - 2015/04/02/ PY - 2014/10/18/received PY - 2015/03/20/revised PY - 2015/03/23/accepted PY - 2015/4/7/entrez PY - 2015/4/7/pubmed PY - 2016/1/19/medline KW - Active immune response KW - Live attenuated vaccine KW - Measles KW - Yellow fever SP - 2301 EP - 6 JF - Vaccine JO - Vaccine VL - 33 IS - 20 N2 - BACKGROUND: The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days. SUBJECTS AND METHODS: A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group). RESULTS: Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination. DISCUSSION: In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct. CONCLUSION: In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25843268/Observational_study_on_immune_response_to_yellow_fever_and_measles_vaccines_in_9_to_15_month_old_children__Is_it_necessary_to_wait_4_weeks_between_two_live_attenuated_vaccines L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00388-6 DB - PRIME DP - Unbound Medicine ER -