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Yes, even if the titers are fine, say in a 5 year old who had one MMR at 10 months and one at 4 year, I would give a 3rd MMR to be within CDC guidelines because, even though young children may have a bump in titers they may not be high enough to give life long protection if the shots are not given properly. So , just for example, the 5 year old who was improperly vaccinated may have a titer of 10 while the properly vaccinated child may have a titer of 50. Both technically have normal titers when the lab reports anything above 5 as normal because not just infants get titers checked...adults do too and their levels are much lower. But since immunity wanes over time, the properly vaccinated child is far more protected than the improperly vaccinated one. The child who starts at 50 might be at 10 when he is 60 and still immune...but where will the child who starts at 10 be?
In all honesty the practice of providing so many booster shots for kids does protect against this to a large degree, and this is why there is now a recommendation for a second MMR (and a second chickenpox vaccine). It is also the reason the pertussis component was added back into the adult tetanus shot. Immunity does decrease over time, so you want to make sure your kids start with as high a level as possible when they are little, because we all know they are going to grow up and live very long and healthy lives!
But really it is the harrassment from every daycare, school and college that really convinces most parents to repeat the immunization...they really don't leave you alone!
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Amy
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