{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:38:02Z","timestamp":1765546682958,"version":"3.37.3"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Safety of live vaccines in patients treated with immunosuppressive therapies is not well known, resulting in contradictory vaccination recommendations. We describe here the first case of vaccine-associated measles in a patient on natalizumab treatment.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A young female patient with relapsing-remitting multiple sclerosis on natalizumab treatment received the live attenuated measles, mumps, and rubella vaccine in preparation for a change in her treatment in favour of fingolimod, with established immunosuppressive qualities. Seven days after receiving the vaccine, our patient experienced diffuse muscle pain, fatigue, and thereafter developed a fever and then an erythematous maculopapular rash, compatible with vaccine associated measles. This was later confirmed by a positive measles RT-PCR throat swab. The patient\u2019s symptoms resolved without any sequelae.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In this case report we review the immunosuppressive qualities of natalizumab and the evidence in favour and against live vaccines in patients on this treatment. Our findings reveal the insufficient understanding of the immunosuppressive effects of new immunomodulators, and thus of the safety of live vaccines in patients on such medications. While this case triggers precaution, there is insufficient evidence to conclude that natalizumab treatment could favor the onset of vaccine-associated measles.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-05475-9","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T10:03:51Z","timestamp":1602669831000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Vaccine-associated measles in a patient treated with natalizumab: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1849-8874","authenticated-orcid":false,"given":"Alix","family":"Miauton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasiliki","family":"Pantazou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renaud","family":"Du Pasquier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blaise","family":"Genton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"issue":"3","key":"5475_CR1","doi-asserted-by":"publisher","first-page":"e44","DOI":"10.1093\/cid\/cit684","volume":"58","author":"LG Rubin","year":"2014","unstructured":"Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):e44\u2013100.","journal-title":"Clin Infect Dis"},{"issue":"605","key":"5475_CR2","first-page":"922","volume":"14","author":"G Eperon","year":"2018","unstructured":"Eperon G, Buhler S, Enriquez N, Vaudaux B. The immunosuppressed traveler: vaccination guidelines. Rev Med Suisse. 2018;14(605):922\u201333.","journal-title":"Rev Med Suisse"},{"issue":"6","key":"5475_CR3","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1017\/cjn.2015.296","volume":"42","author":"PW O'Connor","year":"2015","unstructured":"O'Connor PW, Kremenchutzky M. Use of Natalizumab in patients with multiple sclerosis: 2015 update. Can J Neurol Sci Le J Canadien des Sciences Neurologiques. 2015;42(6):372\u201380.","journal-title":"Can J Neurol Sci Le J Canadien des Sciences Neurologiques"},{"key":"5475_CR4","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.msard.2019.04.004","volume":"31","author":"C Lebrun","year":"2019","unstructured":"Lebrun C, Vukusic S, French Group for Recommendations in Multiple Sclerosis. Immunization and multiple sclerosis: recommendations from the French multiple sclerosis society. Mult Scler Relat Disord. 2019;31:173\u201388.","journal-title":"Mult Scler Relat Disord"},{"issue":"3","key":"5475_CR5","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/nrneurol.2012.8","volume":"8","author":"M Loebermann","year":"2012","unstructured":"Loebermann M, Winkelmann A, Hartung HP, Hengel H, Reisinger EC, Zettl UK. Vaccination against infection in patients with multiple sclerosis. Nat Rev Neurol. 2012;8(3):143\u201351.","journal-title":"Nat Rev Neurol"},{"issue":"8","key":"5475_CR6","doi-asserted-by":"publisher","first-page":"ofy174","DOI":"10.1093\/ofid\/ofy174","volume":"5","author":"DJ Epstein","year":"2018","unstructured":"Epstein DJ, Dunn J, Deresinski S. Infectious complications of multiple sclerosis therapies: implications for screening, prophylaxis, and management. Open Forum Infect Dis. 2018;5(8):ofy174.","journal-title":"Open Forum Infect Dis"},{"key":"5475_CR7","unstructured":"The Centralized information system for infectious diseases (CISID). http:\/\/data.euro.who.int\/cisid\/. Accessed 26 May 2020."},{"key":"5475_CR8","unstructured":"Centers for Disease Control and Prevention Newsroom Releases. https:\/\/www.cdc.gov\/media\/releases\/2019\/p0530-us-measles-2019.html. Accessed 26 May 2020."},{"key":"5475_CR9","unstructured":"Organisation WH. The immunological Basis for Immunization Series. Module 7: Measles. Update 2009."},{"issue":"RR-04","key":"5475_CR10","first-page":"1","volume":"62","author":"HQ McLean","year":"2013","unstructured":"McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS, Centers for Disease Control and Prevention. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep. 2013;62(RR-04):1\u201334.","journal-title":"MMWR Recomm Rep"},{"issue":"11","key":"5475_CR11","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1002\/ccr3.1174","volume":"5","author":"SB Sood","year":"2017","unstructured":"Sood SB, Suthar K, Martin K, Mather K. Vaccine-associated measles in an immunocompetent child. Clin Case Rep. 2017;5(11):1765\u20137.","journal-title":"Clin Case Rep"},{"issue":"4","key":"5475_CR12","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1016\/j.amjmed.2013.10.015","volume":"127","author":"T Kurata","year":"2014","unstructured":"Kurata T, Kanbayashi D, Kinoshita H, Arai S, Matsui Y, Fukumura K, et al. Late onset of vaccine-associated measles in an adult with severe clinical symptoms: a case report. Am J Med. 2014;127(4):e3\u20134.","journal-title":"Am J Med"},{"issue":"2","key":"5475_CR13","doi-asserted-by":"publisher","first-page":"104","DOI":"10.7326\/0003-4819-129-2-199807150-00007","volume":"129","author":"JB Angel","year":"1998","unstructured":"Angel JB, Walpita P, Lerch RA, Sidhu MS, Masurekar M, DeLellis RA, et al. Vaccine-associated measles pneumonitis in an adult with AIDS. Ann Intern Med. 1998;129(2):104\u20136.","journal-title":"Ann Intern Med"},{"issue":"2","key":"5475_CR14","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/S0022-3476(94)70318-3","volume":"124","author":"WJ Monafo","year":"1994","unstructured":"Monafo WJ, Haslam DB, Roberts RL, Zaki SR, Bellini WJ, Coffin CM. Disseminated measles infection after vaccination in a child with a congenital immunodeficiency. J Pediatr. 1994;124(2):273\u20136.","journal-title":"J Pediatr"},{"issue":"4","key":"5475_CR15","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1086\/520449","volume":"29","author":"A Bitnun","year":"1999","unstructured":"Bitnun A, Shannon P, Durward A, Rota PA, Bellini WJ, Graham C, et al. Measles inclusion-body encephalitis caused by the vaccine strain of measles virus. Clin Infect Dis. 1999;29(4):855\u201361.","journal-title":"Clin Infect Dis"},{"issue":"4","key":"5475_CR16","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1056\/NEJMcp1905181","volume":"381","author":"PM Strebel","year":"2019","unstructured":"Strebel PM, Orenstein WA. Measles. N Engl J Med. 2019;381(4):349\u201357.","journal-title":"N Engl J Med"},{"issue":"12","key":"5475_CR17","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1212\/WNL.59.12.1837","volume":"59","author":"OT Rutschmann","year":"2002","unstructured":"Rutschmann OT, McCrory DC, Matchar DB, Immunization Panel of the Multiple Sclerosis Council for Clinical Practice G. Immunization and MS: a summary of published evidence and recommendations. Neurology. 2002;59(12):1837\u201343.","journal-title":"Neurology."},{"issue":"3","key":"5475_CR18","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s40263-015-0226-2","volume":"29","author":"EM Williamson","year":"2015","unstructured":"Williamson EM, Berger JR. Infection risk in patients on multiple sclerosis therapeutics. CNS Drugs. 2015;29(3):229\u201344.","journal-title":"CNS Drugs"},{"issue":"6","key":"5475_CR19","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1007\/s00415-016-8263-4","volume":"264","author":"MT Mailand","year":"2017","unstructured":"Mailand MT, Frederiksen JL. Vaccines and multiple sclerosis: a systematic review. J Neurol. 2017;264(6):1035\u201350.","journal-title":"J Neurol"},{"key":"5475_CR20","first-page":"894","volume-title":"Adverse effects of vaccines: evidence and causality","author":"Medicine Io","year":"2012","unstructured":"Medicine Io. In: Stratton K, Ford A, Rusch E, Clayton EW, editors. Adverse effects of vaccines: evidence and causality. Washington, DC: The National Academies Press; 2012. p. 894."},{"key":"5475_CR21","volume-title":"New research demonstrate Biogen's continued commitment to improve care of patients with multiple sclerosis across treatment spectrum","author":"Biogen","year":"2019","unstructured":"Biogen. New research demonstrate Biogen's continued commitment to improve care of patients with multiple sclerosis across treatment spectrum; 2019. https:\/\/investors.biogen.com\/news-releases\/news-release-details\/new-research-demonstrate-biogens-continued-commitment-improve. Accessed 20 Aug 2020."},{"issue":"9","key":"5475_CR22","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1056\/NEJMoa044397","volume":"354","author":"CH Polman","year":"2006","unstructured":"Polman CH, O'Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH, et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354(9):899\u2013910.","journal-title":"N Engl J Med"},{"issue":"4","key":"5475_CR23","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/S1474-4422(17)30007-8","volume":"16","author":"T Kalincik","year":"2017","unstructured":"Kalincik T, Brown JWL, Robertson N, Willis M, Scolding N, Rice CM, et al. Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study. Lancet Neurol. 2017;16(4):271\u201381.","journal-title":"Lancet Neurol"},{"issue":"9","key":"5475_CR24","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1056\/NEJMoa044396","volume":"354","author":"RA Rudick","year":"2006","unstructured":"Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue E-W, et al. Natalizumab plus interferon Beta-1a for relapsing multiple sclerosis. N Engl J Med. 2006;354(9):911\u201323.","journal-title":"N Engl J Med"},{"issue":"2","key":"5475_CR25","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1038\/nrd1637","volume":"4","author":"JH Noseworthy","year":"2005","unstructured":"Noseworthy JH, Kirkpatrick P. Natalizumab. Nat Rev Drug Discov. 2005;4(2):101\u20132.","journal-title":"Nat Rev Drug Discov"},{"issue":"10","key":"5475_CR26","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1001\/archneur.63.10.1383","volume":"63","author":"O Stuve","year":"2006","unstructured":"Stuve O, Marra CM, Bar-Or A, Niino M, Cravens PD, Cepok S, et al. Altered CD4+\/CD8+ T-cell ratios in cerebrospinal fluid of natalizumab-treated patients with multiple sclerosis. Arch Neurol. 2006;63(10):1383\u20137.","journal-title":"Arch Neurol"},{"issue":"20","key":"5475_CR27","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1056\/NEJMoa1107829","volume":"366","author":"G Bloomgren","year":"2012","unstructured":"Bloomgren G, Richman S, Hotermans C, Subramanyam M, Goelz S, Natarajan A, et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N Engl J Med. 2012;366(20):1870\u201380.","journal-title":"N Engl J Med"},{"issue":"4","key":"5475_CR28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002028","volume":"3","author":"K Yao","year":"2008","unstructured":"Yao K, Gagnon S, Akhyani N, Williams E, Fotheringham J, Frohman E, et al. Reactivation of human herpesvirus-6 in natalizumab treated multiple sclerosis patients. PLoS One. 2008;3(4):e2028.","journal-title":"PLoS One"},{"issue":"8","key":"5475_CR29","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1177\/1352458514556296","volume":"21","author":"C Warnke","year":"2015","unstructured":"Warnke C, Stettner M, Lehmensiek V, Dehmel T, Mausberg AK, von Geldern G, et al. Natalizumab exerts a suppressive effect on surrogates of B cell function in blood and CSF. Mult Scler. 2015;21(8):1036\u201344.","journal-title":"Mult Scler"},{"issue":"2","key":"5475_CR30","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1001\/jamaneurol.2019.3365","volume":"77","author":"G Luna","year":"2019","unstructured":"Luna G, Alping P, Burman J, Fink K, Fogdell-Hahn A, Gunnarsson M, et al. Infection risks among patients with multiple sclerosis treated with Fingolimod, Natalizumab, rituximab, and injectable therapies. JAMA Neurol. 2019;77(2):184\u201391.","journal-title":"JAMA Neurol"},{"issue":"4","key":"5475_CR31","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s11910-016-0637-6","volume":"16","author":"EM Williamson","year":"2016","unstructured":"Williamson EM, Chahin S, Berger JR. Vaccines in multiple sclerosis. Curr Neurol Neurosci Rep. 2016;16(4):36.","journal-title":"Curr Neurol Neurosci Rep"},{"key":"5475_CR32","doi-asserted-by":"crossref","unstructured":"Huber F, Ehrensperger B, Hatz C, Chappuis F, Buhler S, Eperon G. Safety of live vaccines on immunosuppressive or immunomodulatory therapy-a retrospective study in three Swiss travel clinics. J Travel Med. 2018;25(1).","DOI":"10.1093\/jtm\/tax082"},{"issue":"23","key":"5475_CR33","doi-asserted-by":"publisher","first-page":"2449","DOI":"10.1001\/jama.2013.6768","volume":"309","author":"MW Heijstek","year":"2013","unstructured":"Heijstek MW, Kamphuis S, Armbrust W, Swart J, Gorter S, de Vries LD, et al. Effects of the live attenuated measles-mumps-rubella booster vaccination on disease activity in patients with juvenile idiopathic arthritis: a randomized trial. JAMA. 2013;309(23):2449\u201356.","journal-title":"JAMA."},{"issue":"5","key":"5475_CR34","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/j.vaccine.2014.11.052","volume":"33","author":"M Shinjoh","year":"2015","unstructured":"Shinjoh M, Hoshino K, Takahashi T, Nakayama T. Updated data on effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation. Vaccine. 2015;33(5):701\u20137.","journal-title":"Vaccine."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-05475-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-020-05475-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-05475-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T23:33:58Z","timestamp":1634168038000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-020-05475-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,14]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["5475"],"URL":"https:\/\/doi.org\/10.1186\/s12879-020-05475-9","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2020,10,14]]},"assertion":[{"value":"29 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The ethic committee of the Canton de Vaud (CER-VD) has been consulted and does not consider any submissions of case reports including less than 5 cases.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided written informed consent for the publication of her case.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare the following competing interests: R. d. P. has served on scientific advisory boards for Biogen, Celgene, Janssen, Merck, Novartis, Roche, and Sanofi-Genzyme; has received funding for travel or speaker honoraria from Abbvie, Biogen Idec, Celgene, Merck, Roche, and Sanofi-Genzyme. The rest of the authors declare that there have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"753"}}