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II. Vaccine Comparisons and Evidence for Multiple Antibody Response

Albert B. Sabin, MD; Amador Flores Arechiga, MD; Jorge Fernández de Castro, MD; Paul Albrecht, MD; John L. Sever, MD, PhD; Isabel Shekarchi, PhD

JAMA. 1984;251(18):2363-2371.

Abstract
In 4- and 5-month-old infants in whom the undiluted chick embryo fibroblast (CEF) Schwarz strain measles vaccine had a poor immunogenic effect, there was an increase in immunogenicity when the high sugar concentration was diminished without reference to added albumin. The human diploid cell (HDC) measles vaccine was still superior in this age group even in a lower concentration of the Iki, Edmonston-Zagreb strain of virus. More aerosolized, HDC Iki strain virus was required for high seroconversion rates in 4- and 5-month-old infants who had higher titers of prevaccination plaque-neutralizing (PN) antibodies. Some of these infants had a delayed immune response that was absent at six weeks but present at three months after vaccination. The data provided evidence that the PN and enzyme-linked immunosorbent assay techniques measured different antibodies that develop and persist in different ways in 4- to 5-month-old infants. The HDC lyophilized measles vaccine yielded unexpectedly high seroconversion rates after subcutaneous injection of 5,000 plaque-forming units (PFUs) in 4-, 5-, and 6-month-old infants: 69% 89%, and 100%, respectively, at 14 weeks. In 12- to 23-month-old infants there was seroconversion of 92% and 100% at six weeks after inhalation of an estimated 175 PFUs of the CEF vaccine and 375 PFUs of the HDC vaccine, respectively. Within six weeks after vaccination, the PN antibody titers were significantly higher with the CEF vaccine (geometric mean titer of 2,275) than with the HDC vaccine (geometric mean titer of 343).

(JAMA 1984;251:2363-2371)

Author Affiliations
From the Sistema para El Desarrollo Integral de la Familia de Nuevo León, Universidad Autonoma de Nuevo León, Monterrey, Mexico (Dr Flores Arechiga); Dirrecion General de Epidemiologia, Secretaria de Salubridad y Asistencia, Mexico, DF (Dr Fernández de Castro); Division of Virology, Office of Biologics, Food and Drug Administration, Public Health Service (Dr Albrecht); and Infectious Diseases Branch, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health (Drs Sever and Shekarchi) Bethesda, Md.; Dr Sabin, an emeritus professor of the University of Cincinnati (1971) and of the Medical University of South Carolina (1982), is currently a visiting professor in the Department of Microbiology, Georgetown University School of Medicine and Dentistry, Washington, DC.; Dr Flores Arechiga is now with Secretaria de Salubridad y Asistencia, Servicios Coordinados de Salud Publica en el Estado de Nuevo León, Monterrey, Mexico.

Footnotes
Reprint requests to 3101 New Mexico Ave NW, Apt 1001, Washington, DC 20016 (Dr Sabin).

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