To investigate the humoral immune response to measles, rubella, and varicella-zoster virus (VZV) vaccines in biliary atresia (BA) children before liver transplantation, we conducted the cross-sectional designed study. Fifty BA children (age, 3.6+/-0.2 years; 24 girls) who had not yet received liver transplantation, and another 150 healthy controls (age, 4.0+/-0.1 years; 78 girls) were recruited into this study to evaluate their primary humoral immune response to measles, rubella, and VZV vaccines. All of these BA children (n=50) and controls (n=150) received one dose of measles, one dose of measles-mumps-rubella (MMR), and one dose of VZV vaccine before our assessment. Serum samples were collected at least 1 month after the vaccination and serum immunoglobulin G (IgG) antibody to measles, rubella, and VZV were then determined by qualitative enzyme-linked immune-sorbent assay. The prevalence of seropositive rate of measles IgG antibody (84% vs. 96.7%; P=0.002), rubella (82.0% vs. 98.7%; P<0.001), and VZV (74% vs. 95.3%; P<0.001) were significantly different between BA children and the controls after regular measles, MMR, and VZV vaccination before 2 years of age. In those BA children with seronegative VZV antibody after vaccination, two had VZV infection after the liver transplantation. This study indicated that humoral immunity to rubella, measles and VZV vaccines are significantly lower in BA children than the normal population by standard vaccine schedule.