Early measles vaccination in bone marrow transplant recipients

Summary: Measles vaccination has been recommended after the second year following bone marrow transplant (BMT) in patients not receiving immunosuppressive drugs. During a measles outbreak, we vaccinated all patients after the first year of transplant, and conducted a prospective trial to evaluate safety, effectiveness and sustained immunity after early vaccination. Patients received attenuated virus vaccine between 9 and 18 months after BMT. A total of 51 patients were evaluated and 27 of them (52.9%) were receiving immunosuppressive drugs. Only mild adverse reactions were noted. Nine patients (17.6%) were susceptible (IgGp100 mIU/ml) at vaccination, and all seroconverted. In those immune at vaccination, a four-fold increase in measles IgG titers was found in one of 34 patients (2.9%) with specific IgGX200 mIU/ml compared to 14 of 17 (82.3%) with IgGo200 mIU/ml (Po 0.0001). Sustained immunity after 24 months was more likely to occur in patients with specific IgG levelsp200 or X500 mIU/mL (83.4 and 100%, respectively) in comparison to patients with 200oIgGo499 mIU/ml at vaccination (50%; P ¼ 0.017). We conclude that even though early measles vaccination is safe, few patients are susceptible on day þ 365 and this strategy should be reserved for epidemic situations posing significant threat for the patients. Bone Marrow Transplantation (2005) 35, 787–791.