What is the Prevalence of Adequate MMR Titers and are They Persisting in the Vaccinated Population?

measles   The measles vaccine was introduced in the USA around 1965. We know that those of us born before 1957, are considered immune to measles, mumps and rubella as these infections were a universal childhood experience back then. The CDC reports that the year before the vaccine was introduced, there were over 500,000 confirmed cases of measles, about 500 deaths and about 1000 cases of brain injury from measles encephalitis. (more on this can be found here… ) Since not all cases of measles would be reported, it is clear that virtually every child before the early 1960’s would get measles. This was a childhood right of passage. So what are the studies showing regarding how lasting the immunity is for those vaccinated?

In the recent article, “Measles, Mumps, and Rubella Titers in Air Force Recruits,” they found “among 32,502 recruits, seroprevalences for measles, mumps, and rubella antibodies were 81.6%, 80.3%, and 82.1%, respectively. Of the 22,878 recruits seropositive for both measles and rubella antibodies, 87.7% were also seropositive for mumps.” You can read this article here…  The study authors recommend “obtaining antibody titers from recruits for mumps in addition to the measles and rubella, and vaccinating all individuals susceptible to one or more of the viruses.”

One important question, is when to give the MMR? Are there benefits to waiting and giving the MMR later than the currently recommended 12-15 months of age? In the study, “A measles outbreak at a college with a prematriculation immunization requirement”, students vaccinated at 12-14 months of age were at increased risk compared to those vaccinated at greater than or equal to 15 months (RR = 3.1, 95% CI = 1.7, 5.7). Time since vaccination was not a risk factor for vaccine failure. Measles vaccine effectiveness was calculated to be 94% (95% CI = 86, 98) for vaccination at greater than or equal to 15 months.” You can read this study here…

It has been the policy at Integrative Pediatrics for the past 7 years, to give the MMR after age 3, and then a few years later to obtain titers and give a booster vaccine to anyone who was not showing adequate titers. Our data indicate a very high percentage (estimated at 95%) to have very high titers against measles, mumps, and rubella. Follow-up studies will be required in another 10 years to see if perhaps the procedure of giving the first MMR after age 3 (when the immune system is more mature than the current age of 12 – 15 months for the MMR) will result in better lasting immunity.

From the Air Force Recruit study, it appears that the current vaccine schedule is resulting in only 82% having adequate titers against measles. It is generally thought that we need 95% of the population protected to have adequate herd immunity (where enough of the population is immune to avoid epidemics). The lack of epidemics in the USA over the past decade however, would suggest that even this rate of 82% may be adequate for herd immunity.

In the study, “Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage,” (found here… ) 95% of the children had measles antibodies after vaccination, yet vaccine efficacy was not more than 68%.  In another study, 20% of those vaccinated against measles had no evidence of antibodies. Read more on this here…

In the study, “The 1992 measles epidemic in Cape Town–a changing epidemiological pattern,” (which you can find here… ) there were about 900 cases of measles. This study highlights a few things worth mention. Immunization coverage was 91%, there were more cases in the older children, suggesting the vaccination was not resulting in lasting immunity, and vaccine efficacy was 100% for the monovalent measles vaccine and 74% for the MMR. It is unfortunate that the USA has stopped production of the separated out monovalent measles vaccine as this could be used to boost the immunity of those who don’t have a lasting titer from their first MMR.

With vaccines, there are a few issues that can confuse the understanding of benefits and risks. Titers suggest immunity, but we know that many who have gotten ill with the measles during the past decade have had adequate titers, suggesting that titers alone does not guarantee protection, but usually does mean you will be protected. The study, “Measles outbreak in a fully immunized secondary-school population,” (read here… )gives details of a 1985 measles outbreak in Texas. The two high schools involved had 99% of the students vaccinated, 95% had detectable antibodies to measles. In this study 14 of the 74 students who lacked evidence of antibodies got measles and none of those with detectable antibodies got measles. In another study, “a total of 64 (82.1%) of the 78 patients had a history of adequate measles vaccination.” You can read that study here…

Many without titers can seem to be immune (avoid infection). What prevents infection is a healthy immune system. There is some evidence that over-vaccination actually damages the immune system. Vaccine induced immunity may not provide real world protection against the disease, although it appears giving a booster to older children who lack antibodies is helpful.  Natural immunity would appear to provide the best protection. I’m not advocating a return to the measles universal right of passage. We do, however, need to consider when to give the MMR, who needs a booster, and when.

In the last decade, where we have had fewer than 1000 cases of measles a year in the USA, one has to start wondering if the live virus vaccine, MMR, might actually be causing more measles cases now, much like the live polio vaccine was doing before we switched to the IPV killed polio vaccine. The study, “CASE OF VACCINE-ASSOCIATED MEASLES FIVE WEEKS POST-IMMUNIZATION, BRITISH COLUMBIA, CANADA, OCTOBER 2013,” (found here… ) showed “virus genotype was determined by the National Microbiology Laboratory in Winnipeg, Canada as vaccine strain, genotype A, MVs/British Columbia/39.13 [A] (VAC).” I find it troubling for example that the supposed measles death in Washington State this year (2015) where the virus was supposedly found at autopsy in a woman who never had measles symptoms was never put through the rigorous testing to determine the etiology of the measles they found. Perhaps it was actually vaccine strain measles she acquired from a vaccinated relative or other exposure. We have certainly reached a time in our country where this level of precision is indicated so we can track exactly what is going on with measles when and if we should have cases.


Safety of MMR vaccines

While safety studies are rarely long term, safety studies tend to focus on short term consequences. The study, “Vaccines for measles, mumps and rubella in children,” looked at 64 studies involving almost 15 million children.(read the study here… )

The most common side effect was aseptic meningitis observed with a relative risk ratio (RR) of 14.3-22.5. Imagine an increased risk of brain inflammation of 20 times! I wonder if there might be a link between these brain inflammations caused by the MMR and the brain inflammation that was universal in autism brains at autopsy. You can find more on that subject here…    There was also an increased risk of seizures. While they did not find an association with autism, it seems most of the studies would not have been long term enough to pick up that association.


What about the MMR and Autism link?

I’ve seen it with my own eyes a handful of times in my career since the early 2000’s through 2008 when I left my old practice, no longer willing to do vaccines as usual. I could no longer ignore what I both knew and had experienced with my own eyes. I was getting one new case of severe autism after the other, all after age one and after the MMR was given, sometimes soon after and sometimes months after. Year after year, a perfectly normal one year old would be destroyed and lose their language and social abilities, plunged into a world of pain and anxiety, some so extreme I didn’t see how the parents survived, let alone the poor child. If the MMR was shown to cause encephalitis, and autism seemed to be an encephalitis (brain inflammation), why was this possibility being dismissed? We now have the definitive Hannah Poling case, where the court ruled that her autism was vaccine induced.  The Italian Ministry of Health found the MMR vaccine caused Valentino Bocca’s autism when he was 15 months old. Sadly, tens of thousands if not a million children will not get their day in court. The study that needs to be done is that comparing unvaccinated children with a matched cohort of fully vaccinated children, or looking at rates of autism in selectively vaccinated children.

Dr Mumper published a small study with no new autism out of her approximately 300 patients. I have a similar experience in my practice of about 1500 patients where the autism rate is just X/1500 in the selectively vaccinated patients who refused the hepatitis B vaccine at birth, only gave one aluminum vaccine at a time, and waited until at least age 3 before giving the MMR.

While we await more definitive studies, it would seem prudent to wait on the MMR until at least age 3, and to skip it altogether if you have a family history of autism, if your child is homozygous for the MTHFR genetic enzyme defect, orif  there is a strong family history of autoimmune issues.

But vaccines have been proven safe and they have disproved the link between vaccines and autism, right? It will require a complete paradigm shift for us to move from the belief system that vaccines have been the greatest medical invention and savior from infectious diseases, to reach the understanding that perhaps some vaccines are too dangerous or too harmful for use today. Thanks to Galileo, we know the earth is not the center of the universe, from Semmelweiss we learned that hand washing can prevent the spread of infection. We know that antibiotics are wonderful, but excessive use of antibiotics can be harmful. Vaccines, likewise, have in some cases been wonderful, but that does not mean that more is better, or that all vaccines are great. Some antibiotics have been disastrous to our health and very high risk for side effects and complications.

I am not saying no one should get the MMR vaccine. I am saying we need to practice individualized medicine, determine who likely can safely get this vaccine and who should not. We can then work to develop herd immunity with minimal risk to those at highest risk for vaccine damage. WE can also move to giving the first MMR after age 3, and then checking titers perhaps at school age or even around the early teenage years then boost the immunity of those needing that. We need to bring back the single-dose separated measles, mumps, and rubella vaccines so that the booster can be given specific to the need of the child.



Dr. Paul





  • Joan

    Well written Dr. Paul. Thank you for breaking down this complex issue. We are HUGE fans of individualized medicine that you and your team practice.

  • Shyamala K

    Thank you Dr.Paul. More and more doctors should come forward and support for single dose vaccines and individualized medicine.

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