{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:01:04Z","timestamp":1793196064827,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004752","name":"State Government of Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004752","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Measles infections cause significant morbidity and mortality in low- and middle-income countries (LMICs), especially in infants under 9 months of age. Measles seroprevalence data in infants too young to be vaccinated can identify immunity gaps to inform immunization strategies. Our systematic review and meta-analysis describes measles seroprevalence in infants &amp;lt;9 months in LMICs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We systematically searched journal articles and conference abstracts from 1 January 2018 to 25 December 2024 across 10 databases and registers (PROSPERO, CRD42023429586). We included observational studies presenting measles antibody seroprevalence data from infants &amp;lt;9 months in LMICs. Studies underwent dual reviewer screening and risk of bias was assessed using an adapted Joanna Briggs Institute tool. Seropositivity estimates were pooled using a random-effects inverse variance model. We performed subgroup analyses by country income level, measles vaccine coverage, and measles incidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1421 studies identified, 34 were included. Most studies were from middle-income countries (n = 30\/34) using hospital\/health-center data (n = 22\/34). Risk of bias was generally low or moderate (n = 33\/34). The meta-analysis included 20 studies (n = 8230 infants) with high interstudy heterogeneity. Pooled seropositivity was highest at birth (81%; 95% confidence interval [CI], 75%\u201388%), decreasing to 30% (95% CI, 24%\u201335%) by 4 months, and lowest at 7 months (18%; 95% CI, 0%\u201341%). Subgroup analyses showed minimal differences between categories.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Seventy percent of infants are seronegative by 4 months old and unprotected from measles before their first vaccine dose at 9\u201312 months. Early administration of measles-containing vaccines could provide sustained protection throughout infancy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf177","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T18:41:17Z","timestamp":1743705677000},"source":"Crossref","is-referenced-by-count":13,"title":["Measles Seroprevalence in Infants Under 9 Months of Age in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6409-1376","authenticated-orcid":false,"given":"Darren Suryawijaya","family":"Ong","sequence":"first","affiliation":[{"name":"Infection, Immunity & Global Health, Murdoch Children's Research Institute , Parkville, Victoria ,","place":["Australia"]},{"name":"Department of Paediatrics, The University of Melbourne , Parkville, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-1731","authenticated-orcid":false,"given":"Claire","family":"von Mollendorf","sequence":"additional","affiliation":[{"name":"Infection, Immunity & Global Health, Murdoch Children's Research Institute , Parkville, Victoria ,","place":["Australia"]},{"name":"Department of Paediatrics, The University of Melbourne , Parkville, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7947-680X","authenticated-orcid":false,"given":"Kim","family":"Mulholland","sequence":"additional","affiliation":[{"name":"Infection, Immunity & Global Health, Murdoch Children's Research Institute , Parkville, Victoria ,","place":["Australia"]},{"name":"Department of Paediatrics, The University of Melbourne , Parkville, Victoria ,","place":["Australia"]},{"name":"Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2401-8980","authenticated-orcid":false,"given":"Lien Anh Ha","family":"Do","sequence":"additional","affiliation":[{"name":"Infection, Immunity & Global Health, Murdoch Children's Research Institute , Parkville, Victoria ,","place":["Australia"]},{"name":"Department of Paediatrics, The University of Melbourne , Parkville, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"2025041815062154000_jiaf177-B1","author":"World Health Organization"},{"key":"2025041815062154000_jiaf177-B2","first-page":"205","article-title":"Measles vaccines: WHO position paper\u2014April 2017","volume":"92","author":"World Health Organization","year":"2017","journal-title":"Wkly Epidemiol Rec"},{"key":"2025041815062154000_jiaf177-B3","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.vaccine.2018.01.002","article-title":"Waning of measles maternal antibody in infants in measles elimination settings: a systematic literature review","volume":"36","author":"Guerra","year":"2018","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B4","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.15585\/mmwr.mm7345a4","article-title":"Progress toward measles elimination\u2014worldwide, 2000-2023","volume":"73","author":"Minta","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025041815062154000_jiaf177-B5","doi-asserted-by":"crossref","first-page":"e000761","DOI":"10.1136\/bmjopen-2011-000761","article-title":"The optimal age of measles immunisation in low-income countries: a secondary analysis of the assumptions underlying the current policy","volume":"2","author":"Aaby","year":"2012","journal-title":"BMJ Open"},{"key":"2025041815062154000_jiaf177-B6","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1126\/science.aaa3662","article-title":"Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality","volume":"348","author":"Mina","year":"2015","journal-title":"Science"},{"key":"2025041815062154000_jiaf177-B7","first-page":"9","article-title":"Efficacy of measles vaccination in women before pregnancy: changes in measles neutralizing antibodies in their children up to 9 months old in Ba Vi District, Hanoi City","volume":"32","author":"Dao","year":"2022","journal-title":"Med Prev"},{"key":"2025041815062154000_jiaf177-B8","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/S1473-3099(19)30396-2","article-title":"Effect of measles vaccination in infants younger than 9 months on the immune response to subsequent measles vaccine doses: a systematic review and meta-analysis","volume":"19","author":"Nic Lochlainn","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2025041815062154000_jiaf177-B9","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/tmi.13920","article-title":"Insufficient measles antibody protection in 6-month-old Malawian infants: reconsider vaccination schedule?","volume":"28","author":"Baroncelli","year":"2023","journal-title":"Trop Med Int Health"},{"key":"2025041815062154000_jiaf177-B10","doi-asserted-by":"crossref","first-page":"10217","DOI":"10.1038\/s41598-022-14493-3","article-title":"Leveraging a national biorepository in Zambia to assess measles and rubella immunity gaps across age and space","volume":"12","author":"Carcelen","year":"2022","journal-title":"Sci Rep"},{"key":"2025041815062154000_jiaf177-B11","doi-asserted-by":"crossref","first-page":"185","DOI":"10.7883\/yoken.JJID.2018.387","article-title":"Prevalence of protective measles virus antibody levels in umbilical cord blood samples and sera of mothers and transplacental transport ratio in Turkey","volume":"72","author":"Cetin Coban","year":"2019","journal-title":"Jpn J Infect Dis"},{"key":"2025041815062154000_jiaf177-B12","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.3390\/ijerph16234680","article-title":"Early waning of maternal measles antibodies in infants in Zhejiang Province, China: a comparison of two cross-sectional serosurveys","volume":"16","author":"Chong","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"2025041815062154000_jiaf177-B13","doi-asserted-by":"crossref","first-page":"2045854","DOI":"10.1080\/21645515.2022.2045854","article-title":"Waning of maternal antibody against measles virus in Shufu, China","volume":"18","author":"He","year":"2022","journal-title":"Hum Vaccin Immunother"},{"key":"2025041815062154000_jiaf177-B14","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3906\/sag-1809-54","article-title":"Evaluation of measles immunity in Turkey: is it still a threat?","volume":"49","author":"Karaayvaz","year":"2019","journal-title":"Turk J Med Sci"},{"key":"2025041815062154000_jiaf177-B15","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.3390\/pathogens10101316","article-title":"Waning of maternal antibodies against measles suggests a large window of susceptibility in infants in Lao People's Democratic Republic","volume":"10","author":"Khampanisong","year":"2021","journal-title":"Pathogens"},{"key":"2025041815062154000_jiaf177-B16","doi-asserted-by":"crossref","first-page":"3960","DOI":"10.1016\/j.vaccine.2020.03.056","article-title":"Seroprevalences of antibodies against pertussis, diphtheria, tetanus, measles, mumps and rubella: a cross-sectional study in children following vaccination procedure in Guangzhou, China","volume":"38","author":"Li","year":"2020","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B17","doi-asserted-by":"crossref","first-page":"2338505","DOI":"10.1080\/21645515.2024.2338505","article-title":"A real-world study on the changing characteristics of measles antibodies in premature infants in China","volume":"20","author":"Li","year":"2024","journal-title":"Hum Vaccin Immunother"},{"issue":"Suppl 2","key":"2025041815062154000_jiaf177-B18","first-page":"A63","article-title":"Rapid decline of anti-measles antibodies in a cohort of infants from birth to 12 months of age, calls for an urgent change in vaccination strategy in India","volume":"104","author":"Makam","year":"2019","journal-title":"Arch Dis Child"},{"key":"2025041815062154000_jiaf177-B19","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1016\/j.vaccine.2019.01.043","article-title":"Early disappearance of maternal anti-measles, mumps, rubella, and varicella antibodies in Indian infants","volume":"37","author":"Malshe","year":"2019","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B20","doi-asserted-by":"crossref","first-page":"e0287110","DOI":"10.1371\/journal.pone.0287110","article-title":"Maternally transmitted anti-measles antibodies, and susceptibility to disease among infants in Chandigarh, India: a prospective birth cohort study","volume":"18","author":"Mathew","year":"2023","journal-title":"PLoS One"},{"key":"2025041815062154000_jiaf177-B21","doi-asserted-by":"crossref","first-page":"13021","DOI":"10.1038\/s41598-018-31283-y","article-title":"Seroprevalence of maternal and cord antibodies specific for diphtheria, tetanus, pertussis, measles, mumps and rubella in Shunyi, Beijing","volume":"8","author":"Meng","year":"2018","journal-title":"Sci Rep"},{"key":"2025041815062154000_jiaf177-B22","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.4269\/ajtmh.17-0836","article-title":"Measles and rubella seroprevalence in mother-infant pairs in rural Nepal and the United States: pre- and post-elimination populations","volume":"99","author":"Murray","year":"2018","journal-title":"Am J Trop Med Hyg"},{"key":"2025041815062154000_jiaf177-B23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ijid.2021.04.002","article-title":"Dynamics of maternally transferred antibodies against measles, mumps, and rubella in infants in Sri Lanka","volume":"107","author":"Muthiah","year":"2021","journal-title":"Int J Infect Dis"},{"key":"2025041815062154000_jiaf177-B24","doi-asserted-by":"crossref","first-page":"404","DOI":"10.4103\/1995-7645.267583","article-title":"Association between measles antibodies in vaccinated and naturally infected mothers with protective antibodies and the occurrence of measles in their children: a cross-sectional study in the Bavi district of Hanoi","volume":"12","author":"Nguyen","year":"2019","journal-title":"Asian Pac J Trop Med"},{"key":"2025041815062154000_jiaf177-B25","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4269\/ajtmh.22-0055","article-title":"Measles serostatus in mothers and their newborns in Antioquia, Colombia: implications for measles elimination","volume":"108","author":"Santacruz-Sanmartin","year":"2023","journal-title":"Am J Trop Med Hyg"},{"issue":"Suppl 2","key":"2025041815062154000_jiaf177-B26","first-page":"S317","article-title":"Cord blood protective antibodies seroprevalence against diphtheria, pertussis, measles, mumps and rubella at birth among healthy term Indian neonates","volume":"9","author":"Verma","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2025041815062154000_jiaf177-B27","doi-asserted-by":"crossref","first-page":"4016","DOI":"10.1016\/j.vaccine.2020.04.013","article-title":"Antibodies to measles, mumps, and rubella virus in Thai children after two-dose vaccination at 9 months and 2.5 years: a longitudinal study","volume":"38","author":"Wanlapakorn","year":"2020","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B28","first-page":"388","article-title":"A study on measles and rubella antibody level in 319 pairs of mothers and infants in Songjiang District of Shanghai","volume":"53","author":"Zhu","year":"2019","journal-title":"Chi J Prev Med"},{"key":"2025041815062154000_jiaf177-B29","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1016\/j.vaccine.2019.09.047","article-title":"Measles antibody levels among vaccinated and unvaccinated children 6-59 months of age in the Democratic Republic of the Congo, 2013-2014","volume":"38","author":"Ashbaugh","year":"2020","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B30","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1097\/INF.0000000000002731","article-title":"Changes in measles seroprevalence in China after the launch of two provincial supplementary immunization activities during 2009 to 2013","volume":"39","author":"Chong","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"2025041815062154000_jiaf177-B31","first-page":"324","article-title":"Prevalence of maternal measles, rubella, mumps and varicella antibodies in the first six months of life","volume":"52","author":"Devecioglu","year":"2018","journal-title":"Mikrobiyol Bul"},{"key":"2025041815062154000_jiaf177-B32","doi-asserted-by":"crossref","first-page":"4829","DOI":"10.1016\/j.vaccine.2020.05.053","article-title":"Evaluating the population measles susceptibility in Tianjin, China","volume":"38","author":"Ding","year":"2020","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B33","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.vaccine.2022.01.012","article-title":"Measles susceptibility in maternal-infant dyads-Bamako, Mali","volume":"40","author":"Dixon","year":"2022","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B34","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1186\/s12879-019-4167-0","article-title":"Seroprevalence of transplacentally acquired measles antibodies in unvaccinated infants at nine months of age and its relation to the feeding practices","volume":"19","author":"Javed","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2025041815062154000_jiaf177-B35","doi-asserted-by":"crossref","first-page":"125","DOI":"10.21101\/cejph.a7981","article-title":"Increase in measles cases in a city hospital, Istanbul, Turkey","volume":"32","author":"Karabey","year":"2024","journal-title":"Cent Eur J Public Health"},{"key":"2025041815062154000_jiaf177-B36","doi-asserted-by":"crossref","first-page":"126243","DOI":"10.1016\/j.vaccine.2024.126243","article-title":"Measles immunity status in Iranian infants and children and outbreak concerns: time for reconsidering the vaccination schedule?","volume":"42","author":"Pourakbari","year":"2024","journal-title":"Vaccine"},{"key":"2025041815062154000_jiaf177-B37","first-page":"e140365","article-title":"Seroprevalence of measles and rubella IgG antibodies in children and pregnant women in Iran","volume":"12","author":"Tabatabaei","year":"2024","journal-title":"Arch Pediatr Infect Dis"},{"key":"2025041815062154000_jiaf177-B38","doi-asserted-by":"crossref","first-page":"4203","DOI":"10.1080\/21645515.2021.1924522","article-title":"One single-center serological survey on measles, rubella and mumps antibody levels of people in Youyang, China","volume":"17","author":"Wang","year":"2021","journal-title":"Hum Vaccin Immunother"},{"key":"2025041815062154000_jiaf177-B39","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1038\/s41467-023-37407-x","article-title":"Long-term measles antibody profiles following different vaccine schedules in China, a longitudinal study","volume":"14","author":"Wang","year":"2023","journal-title":"Nat Commun"},{"key":"2025041815062154000_jiaf177-B40","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1017\/S0950268818000948","article-title":"Serum anti-tetanus and measles antibody titres in Ugandan children aged 4 months to 6 years: implications for vaccine programme","volume":"146","author":"Warrener","year":"2018","journal-title":"Epidemiol Infect"},{"key":"2025041815062154000_jiaf177-B41","first-page":"276","article-title":"Surveillance of measles, rubella and mumps antibody levels in healthy population in Baoshan District, Shanghai","volume":"31","author":"Yang","year":"2018","journal-title":"Chi J Biologicals"},{"key":"2025041815062154000_jiaf177-B42","first-page":"1095","article-title":"Antibody levels of measles, rubella and mumps viruses in healthy population in Shanghai from 2010 to 2020","volume":"56","author":"Yang","year":"2022","journal-title":"Chi J Prev Med"},{"key":"2025041815062154000_jiaf177-B43","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1186\/s12879-024-09816-w","article-title":"Hospital-acquired infections and unvaccinated children due to chronic diseases: an investigation of the 2017-2019 measles outbreak in the northern region of Vietnam","volume":"24","author":"Tran","year":"2024","journal-title":"BMC Infect Dis"},{"key":"2025041815062154000_jiaf177-B44","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s12889-019-6511-0","article-title":"Epidemiological characteristics and trends of a nationwide measles outbreak in Mongolia, 2015-2016","volume":"19","author":"Orsoo","year":"2019","journal-title":"BMC Public Health"},{"key":"2025041815062154000_jiaf177-B45","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1086\/313926","article-title":"Factors determining prevalence of maternal antibody to measles virus throughout infancy: a review","volume":"31","author":"Caceres","year":"2000","journal-title":"Clin Infect Dis"},{"key":"2025041815062154000_jiaf177-B46","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/infdis\/jit143","article-title":"Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage","volume":"208","author":"Waaijenborg","year":"2013","journal-title":"J Infect Dis"},{"key":"2025041815062154000_jiaf177-B47","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae537","article-title":"Long-term dynamics of measles virus-specific neutralizing antibodies in children vaccinated before 12 months of age [published online ahead of print 4 November 2024]","author":"van der Staak","journal-title":"Clin Infect Dis"},{"key":"2025041815062154000_jiaf177-B48","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/EDE.0000000000000841","article-title":"The reduction of measles transmission during school vacations","volume":"29","author":"Klinkenberg","year":"2018","journal-title":"Epidemiol"},{"key":"2025041815062154000_jiaf177-B49","doi-asserted-by":"crossref","first-page":"i5170","DOI":"10.1136\/bmj.i5170","article-title":"Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review","volume":"355","author":"Higgins","year":"2016","journal-title":"BMJ"},{"key":"2025041815062154000_jiaf177-B50","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2991\/jegh.k.191117.001","article-title":"Resurgence of measles in Europe: a systematic review on parental attitudes and beliefs of measles vaccine","volume":"10","author":"Wilder-Smith","year":"2020","journal-title":"J Epidemiol Glob Health"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaf177\/62857141\/jiaf177.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaf177\/62857141\/jiaf177.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T19:06:45Z","timestamp":1745003205000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/advance-article\/doi\/10.1093\/infdis\/jiaf177\/8105657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":50,"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaf177","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"article-number":"jiaf177"}}