#passive immunity

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LiveScience: DARPA Is Developing Human Bio-Factories to Brew Lifesaving Vaccines.

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I thought the only way an infant can get infected with measles is inutero and that the vaccination isn't provided until 9 mnths of age as to not cause interference with the maternal antibodies. So if the mother says that it will be her fault if her child gets measles it doesn't make sense. I mean I absolutely support the fact that she is encouraging vaccination but hw is she to blame if the child contracts measles prior 2 vaccination how will you answer the mothers who are going to question you?

Hi there!

I’m not quite sure that I fully understand the last part of your question. Are you asking how the mother is able to blame antivaxxers if her child contracts the measles because the baby should theoretically still be protected by maternal antibodies? (And that should the child come down with measles, the only way the baby could get it would be congenitally?) 

I wish the only way young infants could get measles was via in utero exposure. All we’d need to do is make sure every mom-to-be had her MMRs and then most babies with normal immune systems would have a relatively narrow window between age of maternal antibodies waning and typical age of immunization. However that just ain’t so.

Typically the measles vaccine is given between 12-15mo. since the infant’s immune system is mature enough at that point to sufficiently seroconvert (aka produce enough effective antibodies) and confer lasting immunity against the virus. During a measles outbreak, it is not uncommon to vaccinate infants as young as 6mo. old to at least boost their immune systems temporarily. I don’t think the aforementioned ages of vaccination have so much to do with interfering with maternal antibodies as much as they do with stimulating an adequately strong immune response in the infant. If an outbreak isn’t occurring and measles isn’t endemic in the area, it’s simply wasteful (and not to mention painful for baby) to vaccinate at younger ages when full immunity isn’t likely to be generated. 

As for measles being passed to babies in utero, I haven’t heard of many cases of that, and the only one to appear on my searches was this one isolated incident. By no means is it impossible, but I do believe it’s uncommon since pathogens that can cross the placenta are rare compared to the vast array of human infectious diseases; primarily the ones Ob/Gyn docs and pediatricians are concerned about are the TORCH pathogens (TOxoplasmosis, Rubella, CMV, HSV2) and a few others like chickenpox and certain STIs (HIV, chlamydia, and syphilis). Rubella, which is vaccinated against alongside measles in the MMR vaccine, is notorious for causing in utero infections and a horrific congenital syndrome. Perhaps that’s what you were thinking of? 

Unfortunately infants too young to be vaccinated—like the baby in the article—are still susceptible to measles despite the antibodies mom gave them through the placenta. By 6 months of age, the majority (99%) of the babies in the study born to vaccinated mothers possessed no antibodies to the measles virus, leaving them completely vulnerable. Fortunately for the mom in the article, if she was vaccinated for MMR and produced a sufficient immune response, and her 15-day-old baby was immunocompetent, he or she likely has sufficient antibodies to protect him or herself until about 2-3 months of age. However this is not necessarily the case because immune status can be highly variable (it’s uncommon to perform antibody titers on infants if there is no indication to do so) and relying solely on maternal passive immunity is a gamble this mother should not be forced to make. If the eligible individuals in her community were simply vaccinated against the measles, she could rely upon herd immunity as an extra and significantly more reliable layer of protection (prevents exposure and helps delay age of exposure) for her precious infant. 

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