Dip in maternal antibodies in infants to resist measles: PGI study

Naina Mishra

Chandigarh, October 6

In a concerning revelation, a PGIMER study has shed light on the rapid decline of maternal anti-measles antibodies in infants, leaving them vulnerable to measles infection at an early age.

Points to grave implications

• A significant portion of Indian infants becoming susceptible to measles as early as three months of age, long before they are eligible for vaccination
• As per available data, in first two months of 2022, there was a staggering 79 per cent increase in measles cases in the country
• India contributed highest number of cases globally last year, with 12,773 cases reported by November

The study titled, “Maternally transmitted anti-measles antibodies, and susceptibility to disease among infants in Chandigarh: A prospective birth cohort study”, was conducted by the Paediatrics and Virology departments.

Prior to the age of measles vaccination, infants have traditionally relied on the passive transfer of maternal antibodies for protection. However, the study conducted in Chandigarh underscores the urgent need for intervention and increased awareness.

The study enrolled pregnant women and their newborn infants from 30 saganwadis in the city. The key finding that has raised alarms is the rapid decline in anti-measles IgG antibodies in infants. At birth, a significant 91.5 per cent of infants had protective antibody levels, but these levels plummeted to a mere 2.1 per cent by the time they reached 9 months of age.

It revealed that younger mothers, who likely had vaccine-derived measles immunity themselves, transferred lower levels of antibodies to their infants. This demographic trend added to the complexity of the issue.

The implications of this study are dire, as it suggests that a significant portion of Indian infants are becoming susceptible to measles as early as three months of age, long before they are eligible to receive measles vaccination. This situation poses a serious public health risk, especially considering the recent surge in measles cases.

Recent data shows in the first two months of 2022 alone, there was a staggering 79 per cent increase in measles cases compared to the previous year. India contributed the highest number of cases globally in 2022, with a record 12,773 cases reported by November.

While the current vaccination policy in India includes a dose of measles-rubella (MR) vaccine at 9 months, followed by the measles-mumps-rubella (MMR) vaccine at 12–15 months, the vulnerability of infants in the period between birth and eligibility for vaccination is evident.

The authors have recommended strengthening surveillance to monitor whether these susceptible infants develop clinical or subclinical measles.