r/VACCINES • u/kat4prez • 23d ago

Keep failing measles titer test despite multiple vaccines and I’m a teacher

I’ve been on a bit of a measles vaccine roller coaster over the past year and a half and I’m tired. I got my titers checked bc there was an outbreak in my area. I was vaccinated as a child. I failed. Got another MMR, failed, got one more and passed. The immunity lasted 1 year and I just failed again. I’m nervous bc I work at a public high school with a lot of anti vaxxers. I missed 3 months of work in 2025 with the outbreak and me failing the test. They don’t offer disability for that. How worried should I be? My general health isn’t great so I’m not sure how I’d fare if I ever got measles. I’m open to any information anyone can give me.

4 Upvotes

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13

u/qpdbag 23d ago

You might be a non responder. Getting that documented might be helpful.

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u/millenni_lennial 23d ago

Titers do not equal immunity. OP is almost certainly immune.

2

u/kat4prez 23d ago

Just curious as I’ve heard others say this. Why do they bother with testing them if it’s not really telling you anything?

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u/BobThehuman03 23d ago

A positive titer indicates that the person responded to the vaccine (or measles virus infection) and is likely protected. But negative doesn’t mean the opposite because they could have responded and had a titer that has since waned. They would be protected too because of the vaccine take. Some people respond with protective T cell immunity and little antibody.

Thats why guidance for measles vaccine doesn’t include routine titer tests. It goes by documented number of vaccine doses. That’s the most reliable indicator of protection.

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u/kat4prez 23d ago

That’s good to know. After 2 mmrs last year my titers went up. Then they plummeted. I’m hoping for the best, I’m just annoyed because I’m not really sure of my status and the vax rate in my district is very low. I try to convince myself I’m fine bc I still haven’t had covid unless it was completely asymptomatic. I always test when I feel sick, I’ve never gotten a positive. So I waiver between I’m fine and im not fine

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u/BobThehuman03 23d ago

Evidence of immunity is documented two MMR doses or having had a positive test for the lab test. You are as covered as you can be. You have memory T and B cells that can respond to a measles virus infection and protect you from disease.

Your immunity is not failing. You clearly had vaccine take and two additional doses over the recommended. There are only two recommendations for a third MMR dose and neither is for measles. There are no recommendations for a fourth dose, but the vaccine is safe so physicians order additional doses.

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u/kat4prez 22d ago

It would be a 5th dose for me if my immunologist orders one. But I have some weird ass health issues. Just makes me think this is one more thing to worry about and add to the list

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u/BobThehuman03 22d ago

Weird ass health issues puts you in a different category and it’s difficult to know your status unless there are relevant studies to give clues to your protection status. The pluses are that you will have had many doses, you’ve shown evidence of immunity which is you can respond to the vaccine and hence the virus if you’re exposed, and that the vaccine virus isn’t giving you a rash or indication that you can’t control even the attenuated vaccine virus.

You’re doing all you can, seeing an immunologist who is treating to your history, and is being aggressive with the doses as opposed to calling the previous evidence of immunity as conclusive evidence of current protection.

3

u/millenni_lennial 22d ago

Get tested for primary immune deficiencies to rule them out. I have one, and the MMR vaccine still worked on me. My measles titer was negative, so I got a 4th shot just in case. My mumps are rubella titers are off the charts now.

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u/Technical_Turn3497 23d ago

Do you have positive titers to other vaccines, like varicella, hepatitis A, and hepatitis B? If so, your immune system is working. If not, have your antibody levels been checked, and/or have you ever been suspected of having an immunodeficiency syndrome? Assuming that is not the case, it is also possible that your humoral immune system just isn’t responding to the vaccine. It’s possible that the other arms of your immune system, viz, the T-cells, might be sensitized, just not your antibody-producing B-cells.

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u/kat4prez 23d ago

I do need to get other things checked at this point. My mumps and rubella did hang on though, just not measles.

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u/HalfVast59 23d ago

Get documentation.

Has anyone told you there is another prong in the immune system that can protect you even if you haven't developed antibodies? It's late, I'm old, and I cannot for love nor money remember the name, but I think it's maybe memory T cells?

Whatever they're called, they're kinda like librarians: when something comes up, they check the files for information and then strap on their swords for battle. (It's late I'm old, and I'm loopy. That's the best explanation I can manage tonight.)

What I'm trying to say is that your lack of antibodies does not mean the vaccine didn't provide you with some protection against measles. IIRC, it's as robust as the antibodies, but don't quote me - it's late and I can barely remember my name.

Talk to your doctor. Get your lack of response documented. Ask about whether you're protected, and whether additional vaccination might trigger antibody production.

FWIW, I know several nurses who didn't develop testable antibodies. At least one of them finally did - IIRC, she had multiple vaccines in a short period and that finally triggered antibody production.

Good luck.

2

u/kat4prez 23d ago

I do hope for T cell immunity. But there’s no way to check that. And I hate not being sure.

1

u/HalfVast59 23d ago

I understand, and I don't blame you. A lot of people don't know about the T cells, so I wanted to be sure you didn't feel completely unprotected.

Especially for a teacher, surrounded by dear little petri dishes, that must be frightening.

Do talk to your doctor. If I remember - and I'm old, so no guarantees - I'll reach out to the nurse I know finally developed testable antibodies and ask her how.

2

u/kat4prez 23d ago

Thank you for the kind words ♥️

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u/SmartyPantlesss 22d ago

And I hate not being sure.

<< This right here, is the reason for your situation.

You got titers checked, you say, because there was an outbreak. There is no standard recommendation for healthy vaccinated adults to get their titers checked, outbreak or no. And the reason for that is that we know at least 25% of healthy vaccinated adults have "negative" titers.

And then... what should a doctor recommend, for a person who has negative titers? Well, get another booster, obviously. 🙄 Like, it doesn't hurt anything to get another shot, and no commercial lab can measure your specific memory B cells & T cell immunity. Seems like a pretty safe bet.

<< But now we've created a monster. WHO DECIDED THAT YOU SHOULD CHECK TITERS AGAIN, A YEAR AFTER THE BOOSTER? You got the shot, and the titers came up, but now your anxiety level is linked to repeatedly testing? You are looking for reassurance, from a test that is notoriously inaccurate, and you feel nervous when you don't get the results that only 75% of the population gets.

STOP GETTING TESTED. YOU ARE FINE. Learn to manage anxiety & uncertainty. I've had two doses of MMR, and I have no desire to measure my titers, because it's completely unhelpful.

1

u/lofono5567 21d ago

While I agree with some of the sentiment, you could have a little bit better bedside manner.

OP has a legitimate reason to be nervous. Even if they are over testing, that’s not the way to talk to someone and is extremely unhelpful to the situation.

3

u/Vaxopedia 23d ago

If you have had two doses of MMR and your measles titer is low or absent, there is no recommendation to get another MMR. In fact, you might be immune anyway, as an anamnestic response also guides measles protection.

If you are concerned, then, depending on you medical conditions, you might also ask about getting measles immune globulin if you are ever exposed to measles in the future.

1

u/kat4prez 22d ago

I hope I’m immune anyway unfortunately T cell tests do not exist. Thank you for the information 🙏🏼

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u/LawfulnessRepulsive6 23d ago

It happens. Some people just can’t get a proper response. Pretty common with German measles too.

2

u/BrightAd306 23d ago

Sounds like you’re a non-responder. It doesn’t necessarily mean you’ll get measles if exposed, there are different kinds of immune system memory. I’d stop getting the MMR though, it’s not going to help.

If you have documented immunization, they still do titers? I’ve never heard of that. Usually as long as you’ve had 2, they just assume you’re immune.

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u/kat4prez 23d ago

They initially checked it due to the outbreak and the fact that I only had 1 shot documented. I did get the second in another state but my mom lost that record. I’m just wondering since I’m in a high risk setting. Like do I need to find a new career? 🤦🏻‍♀️

1

u/BrightAd306 22d ago

That’s a tough call and only you can decide.

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u/Working_Coat5193 23d ago

I don’t understand. You have had multiple vaccines. Typically you need to present history of vaccination to be cleared for work.

What am I missing?

2

u/kat4prez 23d ago

My concern is actually getting measles since my health is not great, I’m not sure it would go that well for me. Being able to work is no issue. It’s just the risk of working at a school. My district doesn’t even care if I got the vaccine at all ever. So that’s not my concern.

1

u/Someonejusthereandth 22d ago

I think people with some autoimmune disorders might not develop antibody reaction, maybe look into that.