Intended for healthcare professionals

Rapid response to:


Measles: low uptake blamed on “incredulity and hostility” towards doctors

BMJ 2019; 365 doi: (Published 26 April 2019) Cite this as: BMJ 2019;365:l1932

Linked opinion

Rebuilding trust in immunisation is key to tackling vaccine hesitancy

Rapid Response:

Measles vaccination and antibody titre testing

In regards to vaccine hesitancy and the measles, mumps and rubella (MMR) vaccine, why are parents not being offered the opportunity to have an antibody titre test for their children after the first dose of live MMR vaccine, rather than being coerced to have what is likely to be an arbitrary second dose?

In regards to measles vaccination, the US Advisory Committee on Immunization Practices (ACIP) report on MMR vaccination (June 2013) admits that: “The second dose of measles-containing vaccine primarily was intended to induce immunity in the small percentage of persons who did not seroconvert after vaccination with the first dose of vaccine (primary vaccine failure).”[1]

According to this information from the US ACIP, it appears most children are being over-vaccinated with the second dose of MMR vaccine.

Many cautious parents who might be averse to unnecessarily over-vaccinating their children might be willing to pay for the option of antibody testing to check immunity after the first dose of this live vaccine combination, why are they being denied this evidence-based option?

It’s notable that in the state of New Jersey in the United States, the health department provides information on antibody titre testing. The Antibody Titer Law (Holly’s Law) allows parents to seek testing to determine a child’s immunity to measles, mumps and rubella before receiving the second dose of MMR vaccine:

The Antibody Titer Law was enacted in response to the death of five year old Holly Marie Stavola who died of encephalopathy which she developed seven days after receiving her second dose of MMR vaccine:

Why aren’t we all allowed to have the option of antibody titre testing?

Information on antibody titre testing generally continues to be withheld from parents and other individuals, citizens are not being properly informed about this option instead of an arbitrary second dose of MMR vaccine. This is a serious infringement of citizens’ right to ‘informed consent’ before this medical intervention.

1. Prevention of Measles, Rubella, Cogenital Rubella Syndrome, and Mumps, 2013. Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. Vol. 62, No. 4. June 14, 2013: (See page 3.)

Competing interests: No competing interests

21 May 2019
Elizabeth M Hart
Independent citizen investigating conflicts of interest in vaccination policy and the over-use of vaccine products
Adelaide, Australia