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Measles Vaccination Immunogenicity and Association with Caste in Chandigarh, India

Abram L. WagnerDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;

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Joseph L. MathewAdvanced Pediatrics Center, PGIMER, Chandigarh, India;

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Bradley F. CarlsonDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;

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Aparna G. KachoriaDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina;

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Bhavneet BhartiAdvanced Pediatrics Center, PGIMER, Chandigarh, India;

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Vanita SuriDepartment of Obstetrics & Gynecology, PGIMER Chandigarh, India;

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Matthew L. BoultonDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;
Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, Michigan

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ABSTRACT.

Measles affects those of lower socioeconomic status disproportionately. This study evaluated the impact of measles vaccination on antibody titers 3 months after vaccination across different socioeconomic groups, with a focus on caste. In total, 169 infants in Chandigarh, India, had serum samples collected immediately prior to vaccination at 9 months of age and 3 months later. Overall, 126 infants (76%) were seropositive (antibody titers > 12 mIU/mL), 26 (16%) were borderline (8–12 mIU/mL), and 14 (8%) were seronegative (< 8 mIU/mL). Seropositivity (versus borderline/seronegative infants) was 0.78 times as high among individuals from the historically marginalized scheduled castes/scheduled tribes compared with the others caste grouping (95% CI, 0.62–0.98). Antibody response was not tied to anthropometric measures but was attenuated among scheduled castes/scheduled tribes with higher incomes. This study provides observational evidence that social structures can be associated with individual immune responses.

Author Notes

Address correspondence to Abram L. Wagner, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109. E-mail: awag@umich.edu

Financial support: This work was funded by a gift to the University of Michigan from Ranvir Trehan and the Trehan Family Foundation to support public health research in India.

Authors’ addresses: Abram L. Wagner and Bradley F. Carlson, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, E-mails: awag@umich.edu and bcarlson@umich.edu. Joseph L. Mathew and Bhavneet Bharti, Advanced Pediatrics Center, PGIMER, Chandigarh, India, E-mails: dr.joseph.l.mathew@gmail.com and aimsmohali@gmail.com. Aparna G. Kachoria, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, E-mail: akachoria@unc.edu. Vanita Suri, Department of Obstetrics & Gynecology, PGIMER Chandigarh, India, E-mail: surivanita@yahoo.co.in. Matthew L. Boulton, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, and Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, MI, E-mail: mboulton@umich.edu.

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