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Controlling Rubella: Problems and Perspectives

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▸Requests for reprints should be addressed to Dorothy M. Horstmann, M.D., M.A.C.P., Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven CT 06510.

New Haven, Connecticut

Ann Intern Med. 1975;83(3):412-417. doi:10.7326/0003-4819-83-3-412
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Long-term effectiveness of rubella vaccination in childhood is of particular importance because the ultimate goal of immunization is the prevention of infection during pregnancy. To determine how well vaccine-induced immunity persists in comparison to that acquired naturally, several hundred susceptible children who seroconverted after receiving HPV77DE5 vaccine were followed serologically over a 3-to-5-year period. The results indicate that vaccine-induced antibodies are less stable than those acquired through natural infection, and their persistence is closely related to the original response to immunization. Thus children who responded with a broad range of antibody types and who had brisk postvaccinal hemagglutination-inhibiting antibody titers of ≥ 1:64, maintained such levels without significant decline. In contrast, among the children who had feeble hemagglutination-inhibiting antibody responses initially and failed to develop complement-fixing or precipitating antibodies, a significant proportion lost detectable hemagglutination-inhibiting antibody levels after 3 to 5 years. The current and future immunity of such children is therefore in doubt, unless natural reinfection with wild rubella virus or revaccination with a more effective vaccine corrects their antibody deficiencies.







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