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. 2014 Sep 29;32(43):5624-31.
doi: 10.1016/j.vaccine.2014.08.005. Epub 2014 Aug 17.

Humoral responses to independent vaccinations are correlated in healthy boosted adults

Lori Garman  1 , Amanda J Vineyard  2 , Sherry R Crowe  2 , John B Harley  3 , Christina E Spooner  4 , Limone C Collins  4 , Michael R Nelson  4 , Renata J M Engler  4 , Judith A James  5
Affiliations

Humoral responses to independent vaccinations are correlated in healthy boosted adults

Lori Garman et al. Vaccine. .

Abstract

Background: Roughly half of U.S. adults do not receive recommended booster vaccinations, but protective antibody levels are rarely measured in adults. Demographic factors, vaccination history, and responses to other vaccinations could help identify at-risk individuals. We sought to characterize rates of seroconversion and determine associations of humoral responses to multiple vaccinations in healthy adults.

Methods: Humoral responses toward measles, mumps, tetanus toxoid, pertussis, hepatitis B surface antigen, and anthrax protective antigen were measured by ELISA in post-immunization samples from 1465 healthy U.S. military members. We examined the effects of demographic and clinical factors on immunization responses, as well as assessed correlations between vaccination responses.

Results: Subsets of boosted adults did not have seroprotective levels of antibodies toward measles (10.4%), mumps (9.4%), pertussis (4.7%), hepatitis B (8.6%) or protective antigen (14.4%) detected. Half-lives of antibody responses were generally long (>30 years). Measles and mumps antibody levels were correlated (r=0.31, p<0.001), but not associated with select demographic features or vaccination history. Measles and mumps antibody levels also correlated with tetanus antibody response (r=0.11, p<0.001).

Conclusions: Vaccination responses are predominantly robust and vaccine specific. However, a small but significant portion of the vaccinated adult population may not have quantitative seroprotective antibody to common vaccine-preventable infections.

Keywords: Anthrax vaccine adsorbed; Hepatitis B; Measles; Mumps; Pertussis; Tetanus.

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Conflict of interest statement

Conflict of interest statement

S.R. Crowe is now affiliated with PharmAthene, Inc; however, her work with this study was only completed during her time at OMRF. All other authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1. Responder frequency of measles, mumps, and AVA vaccination
A cohort of 1465 individuals was tested for antibodies directed toward PA by ELISA. Of these, 1350 were tested for antibodies to measles virus, mumps virus, tetanus toxoid, and pertussis, and 931 were tested for antibodies to hepatitis B surface antigen (HBs) by ELISA. Shown is the percentage of individuals that were negative, positive, or equivocal for protective levels of antibody directed toward measles (A), mumps (B), pertussis (C), PA (D), PA (E), and HBs (F). Cutoffs for positive are 0.2 IU/mL for measles, 1.1 (Index Value) for mumps (0.9–1.1 = equivocal), 10 IU/mL for pertussis, 5.4 μg/mL for PA (5.4–97.3 μg/mL = equivocal), and 10 IU/L for HBs. All samples were considered fully protected by tetanus antibody level as defined by a cutoff IU/mL value of above 0.01.
Figure 2
Figure 2. Longevity of antibody response
Responses to multiple antigens were determined by ELISA and tested for associations with time since most recent vaccinations. Antibody responses to measles (A), mumps (B), and tetanus (C) were not correlated with time since most recent vaccination. Plasma antibody concentration specific for pertussis (D), PA (E), and HBs (F) were all negatively associated with time since last vaccination. Spearman correlation coefficients and p values are shown for each comparison. Regression models were estimated with log-transformed data then back-transformed for presentation of raw data.
Figure 3
Figure 3. Mumps, measles, and tetanus antibody responses are all positively correlated
Antibody responses to multiple antigens were tested for associations. Shown are comparisons between antibody levels specific for measles and mumps (A), measles and tetanus (B), mumps and tetanus (C), mumps and PA (D), pertussis and PA (E), and rubella and measles. Spearman correlation coefficients and p values are shown for each comparison, along with linear regression lines for ease of visualization. HBs antibody was not correlated with measles, mumps, or tetanus antibody levels (all Spearman r<0.06, all p>0.1). All variables are log10 transformed. Each symbol represents a single plasma sample.
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