Intended for healthcare professionals

Rapid response to:


Measles: neither gone nor forgotten

BMJ 2018; 362 doi: (Published 25 September 2018) Cite this as: BMJ 2018;362:k3976

Rapid Response:

Universal measles vaccination - "well worth the risk of reduced transplacental immunity and increased vulnerability in adults..."?

I'm astonished by Allan S. Cunningham's comment "Universal measles vaccination has been lifesaving, and well worth the risk of reduced transplacental immunity and increased vulnerability in adults..."

I suggest reduced transplacental immunity is an extremely serious outcome of the measles vaccination intervention. We have no idea as yet what this means for future generations of children of vaccinated mothers, and the vulnerability of babies to disease at an earlier age.

In a measles outbreak in Australia in 2012 (168 notified cases) <1 year olds had the highest notification rate, with 10 cases aged <9 months. A paper discussing Australia's experience with declining measles antibodies states: "Continued close monitoring of cases occurring before 12 months of age (when MMR1 is due) will help to determine if vaccine schedule changes are required. This is particularly important in Australia as since July 2013 the second dose of MMR (given as MMR-Varicella) has been moved from 4 years to 18 months of age. As we have demonstrated that antibody levels begin to decline from 5 years of age (soon after children were due their MMR2 at 4 years), this change has the potential to lead to even lower antibody levels in young adults."[1]

The paper also states: "The clinical significance of declining anti-measles IgG antibody levels for protection against infection or disease is not clear..."

Do Allan S. Cunningham or others see anything to worry about here, including the reference to potential "vaccine schedule changes" and the ever-increasing load of vaccine products and revaccinations imposed upon babies and children?

This experience with measles vaccination also has implications for the implementation of other and new vaccine products and consequences for natural immunity. I suggest we have to think very carefully before implementing still experimental vaccine products, particularly for rare diseases such as invasive meningococcal B and others.

As I asked in my previous rapid response on this article, are any 'authorities' thinking about the big picture here?

Disclosure: I'm a 'measles survivor'. Born November 1959. Had measles around 18 months of age. Asked my mother about this event. She said doctor told her not to worry, they would just run their course (a rather more benign message than we receive nowadays...) My mother said the spots lasted about ten days and I did not seem to be too adversely affected. I had a serology test in 2012 - measles virus IgG antibody detected.

1. Heather F. Gidding et al. Declining measles antibody in the era of elimination: Australia's experience. Vaccine 36 (2018) 507-513.

Competing interests: No competing interests

11 November 2018
Elizabeth Hart
Adelaide, Australia