The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Original article
Humoral immune response to measles and varicella vaccination in former very low birth weight preterm infants
Carolina Schlindwein Mariano Ferreira, Maria Cristina Abrão Aued Perin, Maria Isabel de Moraes-Pinto, Raquel Maria Simão-Gurge, Ana Lucia Goulart, Lily Yin Weckx, Amélia Miyashiro Nunes dos Santos,
Universidade Federal de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil
Received 25 November 2017, Accepted 19 December 2017
Abstract
Introduction

Immune response to vaccination in infants born prematurely may be lower than in infants born at full-term. Some clinical factors might be associated with humoral immune response.

Objectives

The objectives of this study were to compare the immune response to measles and varicella vaccination in infants born prematurely with those born at full-term and to analyze factors associated with measles and varicella antibody levels.

Methods

Prospective study including two groups of infants aged 12 months. One group of infants born prematurely with birth-weight <1500g and who were in follow-up at the outpatient clinic for preterm infants at the institution and other group of infants born at full-term. Infants with malformations, primary immunodeficiency diseases, born to HIV-positive mothers or who had received plasma or immunoglobulin transfusions five months before or three weeks after vaccination were excluded. Plasma antibodies were measured by ELISA and factors associated with antibody levels were assessed by linear regression.

Results

Sixty-five premature and 56 full-term infants were included. The percentage of immune individuals after vaccination against measles (100% vs. 100%) and varicella (92.5% vs. 93.2%) were similar in both groups, as well as the antibody levels against measles (2.393 vs. 2.412UI/mL; p=0.970) and varicella (0.551 vs. 0.399UI/mL; p=0.114). Use of antenatal corticosteroids decreased measles antibody levels whereas breastfeeding for more than six months increased varicella antibody levels.

Conclusions

Humoral responses to measles and varicella were similar between infants born prematurely and full-term infants. Measles antibody levels were negatively associated with antenatal corticosteroid use; varicella antibodies were positively associated with prolonged breastfeeding.

Keywords
Premature, Vaccination, Humoral immunity, Measles, Varicella