What is your approach to a patient with undetectable MMR titers checked prior to or during immunosuppression and a history of MMR vaccination in childhood?
Is there a role for booster vaccination and if so, how do you approach the timing when a patient is already on a biologic for immunosuppression?
Answer from: at Academic Institution
MMR titers are good correlates of protection.
If any titer is undetectable it could be one of these situations:
Primary failure. The components of the MMR have different efficacy. Two doses of appropriately given MMR will have 96+% against measles, but only 88% for mumps. Thus 1 in 10 appropriat...