Prenatal ExposuretoPoly- andPerfluoroalkylSubstances(2009-2014) andVaccine Antibody TitersofMeasles, Mumps, Rubella, andVaricellainChildrenFourto Eight YearsOldfromtheHealthyStartCohort

BACKGROUND: Prenatal exposurestocertainpoly- andperfluoroalkyl substances(PFAS) areassociatedwithreducedhumoralresponsestosome childhood immunizations. OBJECTIVE: We estimatedassociationsbetweenprenatalPFASexposureandchildantibodytitersformeasles, mumps, rubella(MMR), andvaricella after immunization. METHODS: We measuredserumantibodytitersof145children(4-8 yold) enrolledintheHealthyStartcohortinColorado, whosemothershad PFAS quantified mid-pregnancy(2009-2014). Weusedlinearandlogisticregressionmodelstoassesstherelationshipbetween five PFASdetectedin >65% of mothersandcontinuousornon-high-censored ("low") antibodytitersandquantileg-computationtoevaluatetheoveralleffect ofthePFAS mixture. RESULTS: Median concentrationsofindividualPFASwereatorbelowthemedianreportedamongfemalesintheUnitedStates. Afterreceivingtwo vaccine doses, seropositivelevelsofantibodiesweredetectedamongmost(93%-100%) children. Eachlog-unitincreaseinperfluorononanoate was associated with2.09[95% confidence interval(CI): 1.13,3.87] timeshigheroddsofalowmeaslestiter, andeachlog-unitincreaseinperfluorooctanoate wasassociatedwith2.46(95% CI: 1.28,4.75) timeshigheroddsofalowmumpstiter. OddsratiosforallotherPFASwereelevated, butCIs included thenull. EachquartileincreaseinthePFASmixturewasassociatedwith1.35(95% CI: 0.80,2.26) timeshigheroddsofalowmeaslestiter and 1.44(95% CI: 0.78,2.64) timeshigheroddsofalowmumpstiter. Nosignificant associationswereobservedbetweenPFASandvaricellaor rubella antibodies. Instratified analyses, associationswerenegativeamongfemalechildren, exceptforperfluorohexane sulfonateandvaricella, whereas theywerepositiveamongmales. DISCUSSION: Some prenatalPFASwereassociatedwithlowerantibodytitersamongfullyimmunizedchildren. Thepotentialforimmunotoxiceffects of PFASrequiresfurtherinvestigationinalargerstudy, becauseexposureisubiquitousglobally. https://doi.org/10.1289/EHP12863