Audit of MMR vaccine response in HIV-infected children in a region with a recent measles outbreak

Abstract

Background: The recent increase of confirmed cases of measles in our region(111 in 2012 versus 21 in 2011) has made it very relevant that all HIV-infectedchildren attending our large regional centre have their measles immunitychecked. Furthermore all non immune children should be offered the MMRvaccine.

Aim: To assess the uptake of measles serology testing and MMR vaccination. To determine the immune response to the vaccine

Methods: A retrospective review of case notes and the trust’s laboratorydatabase was performed. The outcome data were compared using the Mann–Whitney U Test. (StatsDirect Version 2.3.3).

Results: Of 113 eligible patients, 19 were excluded as they were no longerunder our care. 94 patients remained and 80 had their measles serologychecked (85%). Of these 41.2% were measles immune and the remainder wereequivocal or non-immune. 87% of the latter received the MMR vaccine with aresponse rate of 57%, when they were not on antiretroviral treatment (ART)and 76% when they were. (not significant NS)

Conclusion: Children on ART responded better to MMR immunisationcompared to those who are not on ART, though this was not significant. Incomparison the VL and CD4 of these two groups were all significantly differentwith the exception of CD4 count in responders.As a consequence of this audit patients who missed their serology testing ortheir MMR vaccine have now been contacted, that this has been arranged.