From the Guidelines
To check for MMR (Measles, Mumps, and Rubella) titers, the specific labs ordered are IgG antibody tests for each of the three viruses: Measles IgG, Mumps IgG, and Rubella IgG. These blood tests measure the level of immunity a person has against these diseases by detecting the presence and quantity of specific antibodies in the bloodstream, as recommended by the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC) 1. A positive or "immune" result indicates adequate protection, while a negative or "non-immune" result suggests vulnerability to infection and may indicate the need for vaccination. The tests work by detecting immunoglobulin G antibodies that develop after either natural infection or successful vaccination. Results typically take 1-3 days and require a simple blood draw. No special preparation is needed before the test. Key points to consider when ordering these tests include:
- The patient's vaccination history and potential exposure to the diseases
- The presence of any symptoms or outbreaks in the community
- The need for confirmation of immunity in certain populations, such as healthcare workers or pregnant women, as outlined in the update on adult immunization recommendations of the Immunization Practices Advisory Committee (ACIP) 1. It is essential to note that laboratory evidence of immunity is a crucial factor in determining a person's immune status, especially in cases where vaccination records are unclear or unavailable.
From the Research
Labs Ordered for MMR Titers
The labs ordered for MMR titers include:
- Enzyme-linked immunosorbent assay (ELISA) for measuring Immunoglobulin G (IgG) against measles, mumps, and rubella viruses 2, 3, 4, 5
- In vitro plaque reduction neutralization (PRN) titers for measuring mumps antibody levels 2
- Multiplex flow immunoassay for detection of IgG-class antibodies to measles, mumps, rubella, and varicella-zoster viruses 4
- Immunofluorescence assays (IFAs) for detecting IgG-class antibodies to measles, mumps, and varicella-zoster viruses 4
- Multiplex bead immunoassay for detecting IgG-class antibodies to measles, mumps, rubella, and varicella-zoster virus 5
Measurement of MMR Antibody Levels
The measurement of MMR antibody levels can be done using various methods, including:
- ELISA for measuring IgG against whole mumps virus, hemagglutinin (HN), and nucleoprotein (NP) antigens 2
- PRN titers for measuring mumps antibody levels 2
- BioPlex 2200 MMRV IgG multiplex flow immunoassay for detecting IgG-class antibodies to measles, mumps, rubella, and varicella-zoster viruses 4
- AtheNA Multi-Lyte assay for detecting IgG-class antibodies to measles, mumps, rubella, and varicella-zoster virus 5
Interpretation of MMR Titer Results
The interpretation of MMR titer results can be complex and may require consideration of various factors, including: