From the Research
Measles titers are recommended for children aged 12-15 months and 4-6 years, as well as for high-risk individuals such as healthcare workers, international travelers, and college students who lack documentation of immunity. For individuals born after 1957, two documented doses of MMR vaccine are generally considered sufficient evidence of immunity without the need for titer testing. However, healthcare workers should have documented immunity through either vaccination records or positive measles titers regardless of age. Measles titers measure the level of antibodies in the blood that protect against measles infection. Testing is particularly important for high-risk individuals who may have uncertain vaccination status or who work in settings where measles transmission could occur. If titers show inadequate immunity, vaccination with the MMR (measles, mumps, rubella) vaccine is recommended, as supported by the Advisory Committee on Immunization Practices (ACIP) recommendations 1.
Key Considerations
- The ACIP recommends 2 doses of MMR vaccine routinely for children with the first dose administered at age 12 through 15 months and the second dose administered at age 4 through 6 years before school entry 1.
- A study published in 2018 found that antibodies to measles, mumps, and rubella decline 3% per year on average, and have a high degree of individual variation 2.
- Another study published in 2012 found that the risk of measles in 2-dose recipients was significantly higher when vaccine was first administered at 12 months of age, compared with ≥15 months of age 3.
- Measles titers are an important tool for assessing immunity, particularly in high-risk individuals, and can help guide vaccination decisions, as noted in a study published in 1994 4.
Recommendations
- Healthcare workers should have documented immunity through either vaccination records or positive measles titers regardless of age.
- Individuals born after 1957 who have received two documented doses of MMR vaccine are generally considered to have sufficient evidence of immunity without the need for titer testing.
- High-risk individuals, such as international travelers and college students, who lack documentation of immunity should be tested for measles titers and vaccinated if necessary, as recommended by the ACIP 1.