From the Guidelines
Individuals who should be checked for measles antibody titers during the current measles outbreaks include healthcare workers, international travelers, college students, those planning pregnancy, and anyone unsure of their vaccination status or immunity, with priority given to those born between 1957-1989 who may have received only one MMR dose instead of the currently recommended two doses, and those without documentation of vaccination or previous measles infection. According to the most recent and highest quality study 1, healthcare workers, in particular, should be evaluated for presumptive evidence of measles immunity, and those without evidence of immunity should be offered the first dose of MMR vaccine and excluded from work from day 5–21 following exposure.
Key Groups to be Checked
- Healthcare workers
- International travelers
- College students
- Those planning pregnancy
- Anyone unsure of their vaccination status or immunity
Priority Groups
- Those born between 1957-1989 who may have received only one MMR dose instead of the currently recommended two doses
- Those without documentation of vaccination or previous measles infection Testing involves a simple blood test measuring IgG antibodies to measles virus, and if titers show inadequate immunity, vaccination with the MMR (measles, mumps, rubella) vaccine is recommended, typically given as two doses separated by at least 28 days for adults who have no previous doses, as suggested by 1 and 1. This recommendation is particularly important because measles is highly contagious, with one infected person capable of infecting 12-18 unprotected individuals, as noted in 1. The virus spreads through respiratory droplets and can remain airborne for up to two hours, making immunity crucial for both individual and community protection.
From the Research
Individuals Who Should Be Checked for Measles Titer
The following individuals should be checked for measles titer:
- HIV-infected children, as they are at increased risk of measles morbidity and mortality 2, 3, 4
- Children with HIV who have received antiretroviral therapy (ART) and have a CD4 count >15% 3
- Childhood cancer survivors who have received chemotherapy and two MMR vaccinations 5
- HIV-infected adults receiving HAART, as they may experience a rapid decline of measles antibodies despite their high CD4+ cell count 6
- Individuals who have been vaccinated against measles but may have lost immunity over time, such as those who received the MMR vaccine at a young age or have a weakened immune system 5, 6
Key Considerations
- The World Health Organization recommends revaccinating HIV-infected children against measles following immune reconstitution with combination antiretroviral therapy 2, 4
- Measles vaccine leads to an excellent seroconversion to measles component of vaccine in immune-reconstituted children with HIV 3
- HIV-infected adults may have a rapid decline of measles antibodies despite their high CD4+ cell count and sustained cellular proliferative response 6