{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:54:42Z","timestamp":1786359282049,"version":"build-2736575974"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vaccination schedules, as well as their effectiveness and contraindications, need to be evaluated regularly, especially in specific situations. Congenital Zika Syndrome (CZS) is a severe condition that results in extensive functional and neurological impairment of fetuses and newborns due to Zika virus tropism for fetal neural progenitor cells. Down Syndrome (DS) is the leading genetic cause of intellectual disability. The immune impairment in DS has already been described, but little is known about the immune response of CZS children. Thus, CZS and DS are specific conditions that can be considered for a reassessment of the available immunizations. Here, we carried out serological analyses of attenuated vaccines-induced antibodies for measles, rubella, and yellow fever viruses in children aged 2\u20137, grouped into asymptomatic controls, DS children, and CZS children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma samples were taken, and vaccination records were compiled during clinical follow-up. Enzymatic immunoassays for quantifying anti-measles and anti-rubella IgG were performed to assess the response to the Measles, Mumps, and Rubella (MMR) vaccine. Plaque Reduction Neutralization Test (PRNT) was performed to investigate neutralizing antibodies in response to the Brazilian vaccine strain of yellow fever (YF-17DD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We highlight similar levels of anti-measles IgG and neutralizing antibodies for YF-17DD among CZS, DS, and asymptomatic children, although low positivity of measles data was seen in the three groups. In DS children, the 2\u20134-year-old group had an increased level of anti-measles IgG compared to the older group of children aged five to seven years. Lower anti-rubella IgG levels were observed in CZS and DS children compared to asymptomatic children. For anti-rubella IgG, the good performance of vaccination in asymptomatic children is due to younger ones rather than older ones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There were no reports of adverse events after the use of the MMR and YF-17DD indicating that CZS and DS could continue to receive these vaccines, but our data draws attention to the necessity of monitoring the vaccination response in CZS and DS children over time and the possible need to adhere to national measles vaccination campaigns. Scientific research needs to continue to help develop appropriate CZS and DS health guidelines.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1250059","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T17:27:06Z","timestamp":1702574826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Serological investigation of vaccine-induced antibodies for measles, rubella, and yellow fever viruses in children vertically exposed to Zika virus or with down syndrome"],"prefix":"10.3389","volume":"11","author":[{"given":"D\u00e9bora","family":"Familiar-Macedo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helver Gon\u00e7alves","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana Rabe","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Pauvolid-Corr\u00eaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayara Neto","family":"da Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Cavalcante de","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita de C\u00e1ssia Ferreira","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Artimos de Oliveira","family":"Vianna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudete Aparecida Araujo","family":"Cardoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel Tavares","family":"Boy da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Paula","family":"Baumblatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzia Maria","family":"de-Oliveira-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1007\/s12098-017-2555-2","article-title":"Vaccinations in primary care","volume":"85","author":"Shukla","year":"2018","journal-title":"Indian J Pediatr"},{"key":"B2","first-page":"241","article-title":"Ten great public health achievements\u2014United States, 1900\u20131999","volume":"48","year":"1999","journal-title":"Morb Mortal Wkly Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e521","DOI":"10.1016\/S2214-109X(14)70280-3","article-title":"National, regional, and global sex ratios of infant, child, and under-5 mortality and identification of countries with outlying ratios: a systematic assessment","volume":"2","author":"Alkema","year":"2014","journal-title":"Lancet Glob Health"},{"key":"B4","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0242367","article-title":"Congenital Zika syndrome: a systematic review","volume":"15","author":"Freitas","year":"2020","journal-title":"PLoS One"},{"key":"B6","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.ejogrb.2021.07.012","article-title":"Zika virus infection in pregnant women and their children: a review","volume":"265","author":"Marb\u00e1n-Castro","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"100769","DOI":"10.1016\/j.spen.2019.08.005","article-title":"Viral infections and the neonatal brain","volume":"32","author":"de Vries","year":"2019","journal-title":"Semin Pediatr Neurol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1590\/0004-282X20200020","article-title":"Clinical characteristics of children with congenital Zika syndrome: a case series","volume":"78","author":"Massetti","year":"2020","journal-title":"Arq Neuropsiquiatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fimmu.2021.610456","article-title":"Differential longevity of memory CD4 and CD8 T cells in a cohort of the mothers with a history of ZIKV infection and their children","volume":"12","author":"Badolato-Corr\u00eaa","year":"2021","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/v14020250","article-title":"Involvement of Th1Th17 cell subpopulations in the immune responses of mothers who gave birth to children with congenital Zika syndrome (CZS)","volume":"14","author":"Paiva","year":"2022","journal-title":"Viruses"},{"key":"B11","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s00430-022-00746-5","article-title":"Immunological imbalance in microcephalic children with congenital Zika virus syndrome","volume":"211","author":"Salmeron","year":"2022","journal-title":"Med Microbiol Immunol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1365-2249.2011.04335.x","article-title":"Infections and immunodeficiency in down syndrome","volume":"164","author":"Ram","year":"2011","journal-title":"Clin Exp Immunol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41572-019-0143-7","article-title":"Down syndrome","volume":"6","author":"Antonarakis","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B14","doi-asserted-by":"publisher","first-page":"L892","DOI":"10.1152\/ajplung.00434.2020","article-title":"Lung disease manifestations in down syndrome","volume":"321","author":"Danopoulos","year":"2021","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/S1081-1206(10)60516-9","article-title":"Follow-up study of immune defects in patients with dysmorphic disorders","volume":"102","author":"Cruz","year":"2009","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"5040","DOI":"10.1016\/j.vaccine.2011.04.060","article-title":"Immune evaluation and vaccine responses in down syndrome: evidence of immunodeficiency?","volume":"29","author":"Joshi","year":"2011","journal-title":"Vaccine"},{"key":"B17","year":"2019"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fped.2020.00073","article-title":"Immune dysregulation in children with down syndrome","volume":"8","author":"Huggard","year":"2020","journal-title":"Front Pediatr"},{"key":"B19","year":"2022"},{"key":"B20","year":"2022"},{"key":"B21","year":""},{"key":"B22","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.biologicals.2012.09.005","article-title":"Evaluation of accuracy and reliability of the plaque reduction neutralization test (micro-PRNT) in detection of yellow fever virus antibodies","volume":"40","author":"Sim\u00f5es","year":"2012","journal-title":"Biologicals"},{"key":"B23","doi-asserted-by":"publisher","first-page":"52065","DOI":"10.3791\/52065","article-title":"Viral concentration determination through plaque assays: using traditional and novel overlay systems","volume":"93","author":"Baer","year":"2014","journal-title":"J Vis Exp"},{"key":"B24","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1056\/NEJMoa2101195","article-title":"Congenital Zika syndrome: a nationwide cohort study in Brazil, 2015\u20132018","volume":"386","author":"Paixao","year":"2022","journal-title":"N Engl J Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1097\/INF.0b013e3181ff85a8","article-title":"Impaired avidity maturation after tetanus toxoid booster in children with down syndrome","volume":"30","author":"Kusters","year":"2011","journal-title":"Pediatr Infect Dis J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1097\/INF.0b013e3182737410","article-title":"Influenza A\/H1N1 vaccination response is inadequate in down syndrome children when the latest cut-off values are used","volume":"31","author":"Kusters","year":"2012","journal-title":"Pediatr Infect Dis J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1002\/jmv.24813","article-title":"Declining antibody levels after hepatitis B vaccination in down syndrome: a need for booster vaccination?","volume":"89","author":"Eijsvoogel","year":"2017","journal-title":"J Med Virol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"6689","DOI":"10.1016\/j.vaccine.2015.10.083","article-title":"Generation of switched memory B cells in response to vaccination in down syndrome children and their siblings","volume":"33","author":"Valentini","year":"2015","journal-title":"Vaccine"},{"key":"B29","year":""},{"key":"B30","doi-asserted-by":"publisher","first-page":"19071","DOI":"10.1073\/pnas.1905570116","article-title":"Decreased humoral immunity to mumps in young adults immunized with MMR vaccine in childhood","volume":"116","author":"Rasheed","year":"2019","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e0002027","DOI":"10.1371\/journal.pgph.0002027","article-title":"Municipality-level measles, mumps, and rubella (MMR) vaccine coverage and deprivation in Brazil: a nationwide ecological study, 2006 to 2020","volume":"3","author":"Godin","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"B32","volume-title":"Epidemiological update: Measles","year":"2020"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.3390\/vaccines10101570","article-title":"Reduced prevalence of measles antibodies in a cohort of Brazilian children under 15 years of age","volume":"10","author":"Estofolete","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ofid\/ofv006","article-title":"Seroprevalence of measles, mumps, rubella and varicella antibodies in the United States population, 2009\u20132010","volume":"2","author":"Lebo","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2643","DOI":"10.1016\/j.vaccine.2021.03.085","article-title":"Ten-year follow-up on efficacy, immunogenicity and safety of two doses of a combined measles-mumps-rubella-varicella vaccine or one dose of monovalent varicella vaccine: results from five East European countries","volume":"39","author":"Prymula","year":"2021","journal-title":"Vaccine"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-62151-3","article-title":"Prevalence of measles antibodies in S\u00e3o Jos\u00e9 do Rio Preto, S\u00e3o Paulo, Brazil: a serological survey model","volume":"10","author":"Estofolete","year":"2020","journal-title":"Sci Rep"},{"key":"B37","doi-asserted-by":"publisher","first-page":"17488","DOI":"10.1038\/s41598-020-73618-8","article-title":"Seroprevalence of measles antibodies and factors associated with susceptibility: a national survey in Mexico using a plaque reduction neutralization test","volume":"10","author":"D\u00edaz-Ortega","year":"2020","journal-title":"Sci Rep"},{"key":"B38","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1093\/ajcp\/106.2.170","article-title":"Rubella immunity. Defining the level of protective antibody","volume":"106","author":"Skendzel","year":"1996","journal-title":"Am J Clin Pathol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/0264-410x(94)00086-3","article-title":"Antibodies to measles, mumps and rubella in UK children 4 years after vaccination with different MMR vaccines","volume":"13","author":"Miller","year":"1995","journal-title":"Vaccine"},{"key":"B40","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1056\/nejmoa1710430","article-title":"Immunogenicity of fractional-dose vaccine during a yellow fever outbreak\u2014final report","volume":"381","author":"Casey","year":"2018","journal-title":"N Engl J Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.3389\/fimmu.2019.01211","article-title":"Duration of humoral and cellular immunity 8 years after administration of reduced doses of the 17DD-yellow fever vaccine","volume":"10","author":"Da Costa-Rocha","year":"2019","journal-title":"Front Immunol"},{"key":"B42","first-page":"269","article-title":"Vaccines and vaccination against yellow fever. WHO position paper\u2014june 2013","volume":"88","year":"2013","journal-title":"Wkly Epidemiol Rec"},{"key":"B43","doi-asserted-by":"publisher","first-page":"7147","DOI":"10.1016\/j.vaccine.2019.09.051","article-title":"Duration of post-vaccination humoral immunity against yellow fever in children","volume":"37","author":"de Noronha","year":"2019","journal-title":"Vaccine"},{"key":"B44","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.vaccine.2021.12.029","article-title":"Exploratory study of humoral and cellular immunity to 17DD yellow fever vaccination in children and adults residents of areas without circulation of yellow fever virus","volume":"40","author":"Reis","year":"2022","journal-title":"Vaccine"},{"key":"B45","year":""},{"key":"B46","doi-asserted-by":"publisher","first-page":"287","DOI":"10.5830\/CVJA-2016-019","article-title":"Congenital heart disease and down syndrome: various aspects of a confirmed association","volume":"27","author":"Benhaourech","year":"2016","journal-title":"Cardiovasc J Afr"},{"key":"B47","doi-asserted-by":"publisher","first-page":"258","DOI":"10.5114\/kitp.2017.72231","article-title":"The significance of neonatal thymectomy for shaping the immune system in children with congenital heart defects","volume":"14","author":"Stosio","year":"2017","journal-title":"Kardiochir Torakochirurgia Pol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"870","DOI":"10.15585\/mmwr.mm6533e2","article-title":"Update: interim guidance for the evaluation and management of infants with possible congenital Zika virus infection\u2014united States, August 2016","volume":"65","author":"Russell","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"B49","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1001\/jamapediatrics.2016.0429","article-title":"What pediatricians and other clinicians should know about Zika virus","volume":"170","author":"Kline","year":"2016","journal-title":"JAMA Pediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1250059\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T17:27:09Z","timestamp":1702574829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1250059\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,14]]},"references-count":49,"alternative-id":["10.3389\/fped.2023.1250059"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1250059","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,14]]},"article-number":"1250059"}}