Table 2.

Interrupted Time Series Analysis of Measles Antibody Concentrations

CharacteristicsSample SizeMedian Concentration (Q1, Q3)Adjustedβ (95% CI)Adjusted Geometric Mean Ratio (95% CI)P Value
Intercept-6.853 (6.312, 7.393)946.282 (551.121, 1624.781)<.001
Birth period
 Prevaccine (1925–1964)209942.2 (560.2, 1678.8)
 Birth cohort-specific Ab trend-−0.002 (−0.018, 0.014)0.998 (0.982, 1.014).783
 Pre-EPI (1965–1977)141637.6 (370.1, 1341.0)
 Ab-level change postvaccine introduction (1965)-−0.179 (−0.557, 0.200)0.836 (0.573, 1.221).354
 Birth cohort-specific Ab trend change (1966–1977)-−0.040 (−0.086, 0.006)0.961 (0.917, 1.006).089
 EPI and SIAs (1978–2009)386334.8 (160.9, 633.8)
 Ab-level change post EPI introduction (1978)-0.015 (−0.415, 0.444)1.015 (0.660, 1.559).947
 Birth cohort–specific Ab trend change (1979–2009)-0.018 (−0.030, 0.066)1.018 (0.970, 1.068).462
 Ab-level change post-SIAs introduction (1995–2009)-0.147 (−0.201, 0.495)1.158 (0.818, 1.640).408
 Post-SIAs (2010–2021)279415.5 (237.6, 812.9)
 Ab-level change without boosting from SIAs (2010)-−0.236 (−0.821, 0.349)0.790 (0.440, 1.417).428
 Birth cohort-specific Ab trend change (2011–2021)-0.200 (0.150, 0.250)1.221 (1.162, 1.284)<0.001
Sex
 Male401514.1 (247.5, 974.8)ReferenceReference-
 Female614465.3 (254.1, 968.0)0.048 (−0.071, 0.167)1.049 (0.931, 1.181).432
Any underlying disease
 Yes233748.0 (369.4, 1463.1)−0.054 (−0.221, 0.113)0.947 (0.802, 1.119).525
 No762440.7 (222.2, 869.6)ReferenceReference-
 Unknown20232.2 (132.1, 328.6)−0.427 (−0.840, −0.013)0.653 (0.432, 0.987).043
Socioeconomic status
 Low329414.3 (240.2, 757.2)ReferenceReference-
 Middle406581.7 (311.1, 1262.1)0.090 (−0.188, 0.368)1.094 (0.828, 1.445).527
 High250422.0 (183.4, 896.1)0.112 (−0.180, 0.403)1.118 (0.835, 1.497).452
 Missing30508.5 (319.5, 1477.1)0.249 (−0.176, 0.675)1.283 (0.838, 1.964).250
CharacteristicsSample SizeMedian Concentration (Q1, Q3)Adjustedβ (95% CI)Adjusted Geometric Mean Ratio (95% CI)P Value
Intercept-6.853 (6.312, 7.393)946.282 (551.121, 1624.781)<.001
Birth period
 Prevaccine (1925–1964)209942.2 (560.2, 1678.8)
 Birth cohort-specific Ab trend-−0.002 (−0.018, 0.014)0.998 (0.982, 1.014).783
 Pre-EPI (1965–1977)141637.6 (370.1, 1341.0)
 Ab-level change postvaccine introduction (1965)-−0.179 (−0.557, 0.200)0.836 (0.573, 1.221).354
 Birth cohort-specific Ab trend change (1966–1977)-−0.040 (−0.086, 0.006)0.961 (0.917, 1.006).089
 EPI and SIAs (1978–2009)386334.8 (160.9, 633.8)
 Ab-level change post EPI introduction (1978)-0.015 (−0.415, 0.444)1.015 (0.660, 1.559).947
 Birth cohort–specific Ab trend change (1979–2009)-0.018 (−0.030, 0.066)1.018 (0.970, 1.068).462
 Ab-level change post-SIAs introduction (1995–2009)-0.147 (−0.201, 0.495)1.158 (0.818, 1.640).408
 Post-SIAs (2010–2021)279415.5 (237.6, 812.9)
 Ab-level change without boosting from SIAs (2010)-−0.236 (−0.821, 0.349)0.790 (0.440, 1.417).428
 Birth cohort-specific Ab trend change (2011–2021)-0.200 (0.150, 0.250)1.221 (1.162, 1.284)<0.001
Sex
 Male401514.1 (247.5, 974.8)ReferenceReference-
 Female614465.3 (254.1, 968.0)0.048 (−0.071, 0.167)1.049 (0.931, 1.181).432
Any underlying disease
 Yes233748.0 (369.4, 1463.1)−0.054 (−0.221, 0.113)0.947 (0.802, 1.119).525
 No762440.7 (222.2, 869.6)ReferenceReference-
 Unknown20232.2 (132.1, 328.6)−0.427 (−0.840, −0.013)0.653 (0.432, 0.987).043
Socioeconomic status
 Low329414.3 (240.2, 757.2)ReferenceReference-
 Middle406581.7 (311.1, 1262.1)0.090 (−0.188, 0.368)1.094 (0.828, 1.445).527
 High250422.0 (183.4, 896.1)0.112 (−0.180, 0.403)1.118 (0.835, 1.497).452
 Missing30508.5 (319.5, 1477.1)0.249 (−0.176, 0.675)1.283 (0.838, 1.964).250

Abbreviations: Ab, antibody; CI, confidence interval; EPI, National Expanded Program on Immunization; Q, quartile; SIA, supplementary immunization activity.

Table 2.

Interrupted Time Series Analysis of Measles Antibody Concentrations

CharacteristicsSample SizeMedian Concentration (Q1, Q3)Adjustedβ (95% CI)Adjusted Geometric Mean Ratio (95% CI)P Value
Intercept-6.853 (6.312, 7.393)946.282 (551.121, 1624.781)<.001
Birth period
 Prevaccine (1925–1964)209942.2 (560.2, 1678.8)
 Birth cohort-specific Ab trend-−0.002 (−0.018, 0.014)0.998 (0.982, 1.014).783
 Pre-EPI (1965–1977)141637.6 (370.1, 1341.0)
 Ab-level change postvaccine introduction (1965)-−0.179 (−0.557, 0.200)0.836 (0.573, 1.221).354
 Birth cohort-specific Ab trend change (1966–1977)-−0.040 (−0.086, 0.006)0.961 (0.917, 1.006).089
 EPI and SIAs (1978–2009)386334.8 (160.9, 633.8)
 Ab-level change post EPI introduction (1978)-0.015 (−0.415, 0.444)1.015 (0.660, 1.559).947
 Birth cohort–specific Ab trend change (1979–2009)-0.018 (−0.030, 0.066)1.018 (0.970, 1.068).462
 Ab-level change post-SIAs introduction (1995–2009)-0.147 (−0.201, 0.495)1.158 (0.818, 1.640).408
 Post-SIAs (2010–2021)279415.5 (237.6, 812.9)
 Ab-level change without boosting from SIAs (2010)-−0.236 (−0.821, 0.349)0.790 (0.440, 1.417).428
 Birth cohort-specific Ab trend change (2011–2021)-0.200 (0.150, 0.250)1.221 (1.162, 1.284)<0.001
Sex
 Male401514.1 (247.5, 974.8)ReferenceReference-
 Female614465.3 (254.1, 968.0)0.048 (−0.071, 0.167)1.049 (0.931, 1.181).432
Any underlying disease
 Yes233748.0 (369.4, 1463.1)−0.054 (−0.221, 0.113)0.947 (0.802, 1.119).525
 No762440.7 (222.2, 869.6)ReferenceReference-
 Unknown20232.2 (132.1, 328.6)−0.427 (−0.840, −0.013)0.653 (0.432, 0.987).043
Socioeconomic status
 Low329414.3 (240.2, 757.2)ReferenceReference-
 Middle406581.7 (311.1, 1262.1)0.090 (−0.188, 0.368)1.094 (0.828, 1.445).527
 High250422.0 (183.4, 896.1)0.112 (−0.180, 0.403)1.118 (0.835, 1.497).452
 Missing30508.5 (319.5, 1477.1)0.249 (−0.176, 0.675)1.283 (0.838, 1.964).250
CharacteristicsSample SizeMedian Concentration (Q1, Q3)Adjustedβ (95% CI)Adjusted Geometric Mean Ratio (95% CI)P Value
Intercept-6.853 (6.312, 7.393)946.282 (551.121, 1624.781)<.001
Birth period
 Prevaccine (1925–1964)209942.2 (560.2, 1678.8)
 Birth cohort-specific Ab trend-−0.002 (−0.018, 0.014)0.998 (0.982, 1.014).783
 Pre-EPI (1965–1977)141637.6 (370.1, 1341.0)
 Ab-level change postvaccine introduction (1965)-−0.179 (−0.557, 0.200)0.836 (0.573, 1.221).354
 Birth cohort-specific Ab trend change (1966–1977)-−0.040 (−0.086, 0.006)0.961 (0.917, 1.006).089
 EPI and SIAs (1978–2009)386334.8 (160.9, 633.8)
 Ab-level change post EPI introduction (1978)-0.015 (−0.415, 0.444)1.015 (0.660, 1.559).947
 Birth cohort–specific Ab trend change (1979–2009)-0.018 (−0.030, 0.066)1.018 (0.970, 1.068).462
 Ab-level change post-SIAs introduction (1995–2009)-0.147 (−0.201, 0.495)1.158 (0.818, 1.640).408
 Post-SIAs (2010–2021)279415.5 (237.6, 812.9)
 Ab-level change without boosting from SIAs (2010)-−0.236 (−0.821, 0.349)0.790 (0.440, 1.417).428
 Birth cohort-specific Ab trend change (2011–2021)-0.200 (0.150, 0.250)1.221 (1.162, 1.284)<0.001
Sex
 Male401514.1 (247.5, 974.8)ReferenceReference-
 Female614465.3 (254.1, 968.0)0.048 (−0.071, 0.167)1.049 (0.931, 1.181).432
Any underlying disease
 Yes233748.0 (369.4, 1463.1)−0.054 (−0.221, 0.113)0.947 (0.802, 1.119).525
 No762440.7 (222.2, 869.6)ReferenceReference-
 Unknown20232.2 (132.1, 328.6)−0.427 (−0.840, −0.013)0.653 (0.432, 0.987).043
Socioeconomic status
 Low329414.3 (240.2, 757.2)ReferenceReference-
 Middle406581.7 (311.1, 1262.1)0.090 (−0.188, 0.368)1.094 (0.828, 1.445).527
 High250422.0 (183.4, 896.1)0.112 (−0.180, 0.403)1.118 (0.835, 1.497).452
 Missing30508.5 (319.5, 1477.1)0.249 (−0.176, 0.675)1.283 (0.838, 1.964).250

Abbreviations: Ab, antibody; CI, confidence interval; EPI, National Expanded Program on Immunization; Q, quartile; SIA, supplementary immunization activity.

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