From the Guidelines
Yes, measles immunoglobulin is available for post-exposure prophylaxis in certain high-risk individuals, and it should be administered within 6 days of exposure to prevent or modify the disease. The standard dose is 0.5 mL/kg of body weight given intramuscularly, with a maximum dose of 15 mL, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1. This treatment is primarily reserved for vulnerable individuals who cannot receive the MMR vaccine, including:
- Infants under 6 months
- Pregnant women
- Immunocompromised patients
- Those with severe immunodeficiency disorders Measles immunoglobulin works by providing passive immunity through ready-made antibodies that can immediately help the body fight the virus, though this protection is temporary, lasting only a few weeks to months 1. For long-term protection, eligible individuals should still receive the MMR vaccine once they are able to do so. It is essential to note that IG prophylaxis is not indicated for household contacts who have received a dose of measles vaccine on or after the first birthday, unless they are immunocompromised 1. Additionally, IG should not be used to control measles outbreaks 1. The effectiveness of IGIV in preventing measles is also discussed, with high-dose IGIV potentially being as effective as intramuscular IG 1.
From the Research
Availability of Measles Immunoglobulin
- Measles immunoglobulin is available for post-exposure prophylaxis, particularly for individuals at high risk of complications, such as infants under 6 months of age, immunocompromised patients, and pregnant women 2, 3.
- The concentration of measles antibodies in immunoglobulin products has declined due to the increased proportion of vaccinated donors, which may affect the efficacy of passive immunization 2, 3.
- Studies have shown that immunoglobulin products can still provide effective protection against measles, with estimates of effectiveness ranging from 76% to 100% 4, 5.
Administration and Dosage
- The recommended dosage and route of administration for measles immunoglobulin vary depending on the individual's age, weight, and health status 2, 3.
- For susceptible infants under 6 months of age, a single intravenous administration of immunoglobulins (400 mg/kg body weight) is recommended as soon as possible, preferably within 6 days after exposure to measles 2.
- For susceptible contacts who are pregnant or immunocompromised, intramuscular immunoglobulin (IMIg) or intravenous immunoglobulin (IVIg) can be provided, with the dosage and route of administration depending on the individual's specific needs and circumstances 3.
Effectiveness and Safety
- Studies have demonstrated the effectiveness and safety of measles immunoglobulin in preventing measles infection, with no serious adverse events reported 5.
- The effectiveness of measles immunoglobulin has been shown to be at least non-inferior to that of immunoglobulin preparations derived from donors before the global introduction of standard active immunization against measles 5.