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Antibody Response Following Customary Use of MMR Vaccine-Reply

Philip A. Brunell, MD
JAMA. 1984;251(24):3223-3224. doi:10.1001/jama.1984.03340480017013.
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In Reply.—  The "bottom line" in the evaluation of a vaccine is how it influences the disease it is intended to prevent; antibody determinations merely provide a rough guide as to what one might expect in this regard. The bottom line for rubella as well as measles and mumps vaccines looks very good. Indeed, we now talk of the "elimination" of measles and rubella.Serological assays for measuring response to immunization can be made more sensitive and, consequentlyly, increase the apparent effectiveness of the vaccine or vice versa. In our article, we tried to provide an "epidemiologic standardization" of the assays by adjusting their specificity and sensitivity using populations of known immune or susceptible persons. To suggest, however, that this could be used in lieu of the performance of the vaccine in preventing disease would be naive. The difference between our serological results and those of Dr Balfour was not


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