IgG antibody prevalence suggests high immunization needs in newcomers to Luxembourg, 2012

Vaccine coverage of the general population in Luxembourg is high, but refugees or asylum seekers may be incompletely vaccinated and susceptible to vaccine-preventable diseases.In order to assess protection rates, serum and oral fluid samples were collected from 406 newcomers aged between 13 and 70 years arriving between May and September 2012. Sera were screened for IgG antibodies against measles, rubella, mumps, hepatitis B, tetanus, diphtheria and pertussis. Oral fluid samples were screened for antibodies against measles, mumps and rubella virus to investigate their suitability for antibody prevalence studies.More than 90% of the participants had IgG antibodies against rubella, 73% against measles and 56% against mumps. Less than 19% had anti-HBs antibodies. Nearly 84% of the participants had an adequate protection against tetanus, 73% against diphtheria and 40% had pertussis antibodies. 93%, 95% and 78% of the measles, rubella and mumps test results obtained with serum and oral fluid were concordant.The majority of the participants lacked antibodies against at least one of the measles/mumps/rubella (58%) and diphtheria/tetanus/pertussis (72%) vaccine components and against hepatitis B virus (82%) and might thus profit from vaccination. Oral fluid is a suitable alternative and non-invasive specimen for measles/rubella antibody prevalence studies.     

上海市麻疹、流行性腮腺炎、风疹抗体水平调查分析

[目的 ]　了解本市健康人群麻疹、腮腺炎、风疹的抗体水平。　 [方法 ]　采集 0～ 5 0岁健康人群血标本 5 43份 ,检测麻疹、腮腺炎、风疹抗体。　 [结果 ]　小于 8月龄组麻疹抗体GMT最低 ,接种麻疹疫苗后抗体GMT显著升高 (P<0 .0 0 1) ;小于 8月龄组及 8月龄组风疹抗体水平最低 ,1岁接种疫苗后风疹抗体显著升高 (P <0 .0 0 1) ,但随着年龄的增长抗体水平有所下降 ,抗体阳性率维持在 85 %以上 ;小于 8月龄组及 8月龄组流行性腮腺炎抗体水平最低 ,1岁以上各年龄组抗体水平显著上升 (P <0 .0 0 1)。　 [结论 ]　上海市现阶段实行麻疹疫苗、MMR疫苗的接种程序比较合理和有效 ,但应该进一步开展上海市育龄期妇女风疹抗体水平调查和MMR疫苗免疫持久性观察 ,研究预防未及龄儿童麻疹疫苗免疫策略、育龄期妇女接种风疹疫苗免疫策略 ,预防先天性风疹综合征     

Antibody persistence in children aged 6–7 years one year following booster immunization with two MMR vaccines applied by aerosol or by injection

ImportanceIn a previous study on booster vaccination, we reported that two aerosolized MMR vaccines were as safe and immunogenic as injectable vaccines containing the same antigens. We now present results of antibody persistence one year after immunization.ObjectiveTo assess the antibody persistence for measles, mumps, and rubella one year following booster immunization.MethodsWe performed clinical and serological follow-up of participants in a previous study of Mexican children aged 6–7 years, in which participants were randomized to four groups receiving, by aerosolized or by injection, the MMR SII vaccine (Serum Institute of India), or the MMR II (Merck Sharp & Dhome). We evaluated the antibody persistence by PRN test for measles and by ELISA for rubella and mumps. The occurrence of clinical events was evaluated via periodic visits of a nurse team to children’s schools and homes.ResultsOf the 260 initial participants, 241 completed one-year follow-up. There were only statistically significant differences in baseline seropositivity for mumps. One year after immunization, seropositivity in all groups was 100% for measles and rubella. The seropositivity rank for mumps was from 90.3% for the injected vaccine MMR II to 96.6% for vaccine MMR SII applied by aerosol; these differences were not statistically significant. With exception of the aerosolized vaccine MMR SII for the geometric mean titer (GMT) for measles, all study groups presented declination of GMT for the three viruses. The difference between the aerosolized vaccines MMR SII and MMR RII was statistically significant for mumps antibodies. Only mild clinical events were identified.ConclusionUnder conditions of no endemic transmission for measles and rubella, and of low circulation of mumps virus, school-aged children remained seropositive to the three viruses one year following booster immunization.The study was registered under CMN 2010-005 number at COFEPRIS (National Regulatory Authority).     

Vaccine-induced measles virus antibodies after two doses of combined measles, mumps and rubella vaccine: a 12-year follow-up in two cohorts

In Finland, a two-dose vaccination programme against measles, mumps and rubella (MMR) was begun in 1982. The programme with high coverage (97–98%) has eliminated these three diseases from Finland. The aim of the present study was to follow up the kinetics of measles virus antibodies in MMR vaccinated cohorts. We have followed the kinetics of measles virus antibody levels induced by vaccination in the same individuals immunized with their first MMR vaccine in 1982. After 12 years 80% of the original children remained available for sampling. Antibodies to measles virus were measured by haemagglutination inhibition (HI) and plaque reduction neutralization (NT) techniques. The primary dose induced 99.4% seroconversion for measles with a geometric mean HI antibody titre (GMT) of 1/269 (±219), equivalent to 4304 mIU (milli-International Units) ml⁻¹ in group A. The 12-year follow-up specimens showed a measles seropositivity rate of 100% as assayed with the HI and NT tests with a mean HI antibody titre of 1/39 (±54), equivalent to 624 mIU ml⁻¹. The vaccination-induced measles virus antibodies decline in the absence of natural booster infections. It is important to follow how long the protection achieved by the present vaccine programme will last after elimination of indigenous measles.     

4~6岁儿童接种麻疹-流行性腮腺炎-风疹联合减毒活疫苗加强免疫的免疫原性与安全性研究

目的:探讨4~6岁儿童接种麻疹-流行性腮腺炎-风疹联合减毒活疫苗（MMR）后的加强免疫原性与安全性。方法:分别在山西省、内蒙古自治区以及北京市招募曾有8月龄和18月龄接种过1剂麻疹-风疹联合减毒活疫苗和MMR疫苗免疫史的4~6岁儿童作为研究对象,分为4、5、6岁组,进行MMR疫苗加强免疫研究。接种MMR疫苗前与接种后3...     

Antibodies to measles,mumps, and rubella virus in Thai children after two-dose vaccination at 9 months and 2.5 years: A longitudinal study

IntroductionThailand changed the schedule of childhood measles–mumps–rubella (MMR) vaccination in 2014, moving the second dose from the age of 6 years to 2.5 years. There are currently no data on antibody responses to the MMR vaccine since this recommendation.Material and methodsWe investigated antibody responses in a cohort of children who received two doses of MMR vaccine at the ages of 9 months and 2.5 years that was originally established to evaluate antibody levels to Bordetella pertussis antigens (ClinicalTrials.gov no. NCT02408926). Infants were born to mothers who previously received tetanus–diphtheria–acellular pertussis vaccine at 27–36 weeks of gestation. Anti-measles, -mumps, and -rubella virus IgG levels were measured at birth (cord blood) and the ages of 2 and 7 months (before the first MMR vaccination); 18 and 24 months (9 and 15 months, respectively, after the first dose); and 36 months (6 months after the second dose) using commercially available enzyme-linked immunosorbent assay kits.ResultsAt 7 months of age, 96.2%, 99.6%, and 98.8% of infants had no protection against measles, mumps, and rubella, respectively. Levels of antibody against all three antigens increased significantly after the first but not the second dose. At 6 months after two-dose vaccination, 97.4%, 84.8%, and 78.7% of children remained seroprotected against measles, mumps, and rubella, respectively.ConclusionsMaternally derived antibodies to measles, mumps, and rubella virus disappeared by the age of 7 months in Thai children. Two-dose MMR vaccination at 9 months and 2.5 years of age induced robust immune responses against these viruses.     

Antibody titers against measles, rubella, mumps and varicella-zoster viruses in medical students]

It is important to identify and immunize susceptible students who have clinical practice to prevent and control hospital infections. The antibody titers to measles, rubella, mumps and varicella viruses were measured in 1,139 students(417 men, 722 women, average age 21.3+/-2.7 yr old)including 510 medical students, 442 nursing students and 187 students of the School of Medical Technology in Kurume University. Antibodies against measles virus were detected by particle agglutination assay(PA), those against rubella virus by hemagglutination inhibition assay(HI), and those against mumps and varicella viruses by enzyme-linked immunosorbent assay(EIA). The serological susceptibilities to measles, rubella, mumps and varicella viruses were 112(9.8%), 112(9.8%), 163(14.3%)and 73(6.4%), respectively. The serological susceptibilities to measles, rubella and mumps viruses in male students were not different from those in female students. The susceptibility to varicella virus in female students was significantly higher than that in male students. After susceptible students were recommended to have vaccinations against each virus, the vaccination rate of the students without antibody was 99.1%. The history of infection and vaccination against the viruses were examined by self-recorded questionnaires in 406 students from all disciplines. The serological susceptibility of students with positive vaccination history was 11.1% for measles, 6.8% for rubella, 18.3% for mumps, and 4.9% for varicella. The serological susceptibility of students with a positive infection history was 5.7% for measles, 3.4% for rubella, 2.9% for mumps, and 4.9% for varicella. In the self-recorded questionnaire, the rate of unknown infection and vaccination histories were 57.5% and 71.6% for measles, 52.5% and 68.4% for rubella, 34.3% and 75.6% for mumps, and 27.1% and 80.5% for varicella, respectively. In conclusion, these data confirm that it is essential to assess immune status against measles, rubella, mumps and varicella in students who have clinical practice in hospital regardless of infection or vaccination history. Accordingly, susceptible students should be vaccinated to prevent those viral infections in hospital.     

Duration of the immune response to MMR vaccine in children of two age-different groups

A combined vaccine against measles, mumps and rubella (MMR) was administered to both a group of children aged 10–12 months simultaneously with booster doses of compulsory diphtheriatetanus toxoids and oral poliovirus vaccine and a group of children aged 15–24 months who had previously received booster doses of the compulsory vaccines.Apart from one subject belonging to the second group who was non responder and one from the same group who did not seroconvert against the mumps virus alone, 5 to 6 weeks after MMR vaccine administration we found protective levels of antibodies against measles, mumps and rubella viruses in all children. The follow up of both groups at 3 years did not reveal difference between the two groups. Protective levels of serum antibodies against measles and mumps were found in the two groups, altough a significant decline of rubella antibodies was shown (p < 0.05).Since the immunogenicity of the vaccines in the two groups did not differ, we recommend that the scientific community reconsider the vaccination schedule until now recommended. In our opinion the MMR vaccine should be administered simultaneously with booster doses of diphtheria-tetanus toxoids and oral poliovirus vaccine at 10–12 months of age because this policy improves parents' compliance, markedly reduces community costs and simplifies routine immunization schedule.     

Epidemiology of measles,mumps and rubella in Italy

A serosurvey for measles, mumps and rubella was conducted in Italy; incidence based on statutory notifications over the last three decades was also calculated. In Italy the diseases followed an endemic-epidemic pattern, with an incidence peak every 2-4 years, and had a limited reduction of incidence attributable to childhood immunization. Lower notification rates were observed in the Southern regions. This is possibly related to greater under notification in the South and is confirmed by our seroprevalence data. Incidence of measles and rubella and proportion of cases among young adults increased significantly in the three decades considered, but not for mumps. Serological data confirmed that these infections are still very frequent in Italy, without significant geographic variation in the country. In the age groups 2-4 and 5-9 years the percentage of individuals still susceptible to each virus was higher than 30%. The proportion of susceptible subjects older than 15 years was similar for the three infections (6.1, 11.7 and 8.8% for measles, mumps and rubella, respectively). The low vaccine coverage for rubella and measles in Italy has so far only partially affected the occurrence of the diseases. No impact of mumps vaccination is visible. The average number of deaths, for each disease, has decreased during the three study periods. Today the priority in Italy is to halt the progressive increase of the mean age of acquisition of the three infections, to eliminate differences in coverage among regions and to conform to European standards. This will be achieved through a combination of increasing MMR vaccine coverage before 2 years of age, implementing vaccination campaigns for low seroprevalence age groups, and/or introducing a second dose of MMR, depending on the level of current MMR coverage.     

A randomised single blind trial of a combined mumps measles rubella vaccine to evaluate serological response and reactions in the UK population

Four hundred and twenty children were randomly assigned to receive either mumps measles rubella (MMR) vaccine (207) or measles vaccine (213) in a single blind study, to investigate the reactogenicity and serology of the MMR vaccine. There was no significant difference between the number of children developing symptoms after MMR vaccination to those developing symptoms after measles vaccination. Both vaccines are associated with a rash, temperature and restlessness five to thirteen days after vaccination. The serological response to measles vaccine was similar in both groups with 92-6% seroconverting with MMR, and 96-8% with measles. Seroconvertion against mumps and rubella with the MMR vaccine was 88% and 96% respectively. This study confirms the safety and efficacy of the MMR vaccine in a UK population.     

A population-based case–control study on viral infections and vaccinations and subsequent multiple sclerosis risk

Viral infections are probably involved in the pathogenesis of multiple sclerosis (MS). A recent cohort study in the Gothenburg population revealed no change in MS incidence associated with the introduction of the Swedish measles, mumps and rubella vaccination programmes. The aim of the present study was to clarify whether these infections or vaccinations, and two other infections, varicella and infectious mononucleosis, influence MS risk. We performed a population-based case–control study in Gothenburg that included 509 MS cases and 2,067 controls, born 1959–1986. Data on infections and vaccinations were obtained from questionnaires and from child health and school health records. We found no significant associations between measles, mumps, rubella or varicella and MS risk. These results were consistent between the two source materials. Infectious mononucleosis was associated with significantly higher MS risk (odds ratio 2.03, 95% CI 1.52–2.73). Overall, there was no significant association between measles-mumps-rubella (MMR) vaccination and MS risk, while those MMR vaccinated before age ten only were at significantly higher MS risk (odds ratio 4.92, 95% CI 1.97–12.20). Those MMR vaccinated both before and after age ten had intermediate MS risk. Infection with measles, mumps, rubella and varicella did not influence MS risk in contrast to infectious mononucleosis which conferred doubled MS risk. The association with ‘early’ MMR vaccination only was an isolated finding, limited by a small number of subjects and multiple testing. Most likely this was a chance finding. Future studies could investigate it on an a priori basis.     

Age-stratified seroprevalence of measles, mumps and rubella (MMR) virus infections in Switzerland after the introduction of MMR mass vaccination

We have performed age-stratified seroprevalence studies for MMR to evaluate these vaccinations. Serum samples submitted for diagnostic testing were randomly selected for unlinked anonymous panels. IgG antibodies were tested by ELISA and indirect immunofluorescence. In the vaccination cohort (age 1.5 to 6.5 years), seroprevalence attained 80%. For measles and mumps it continued to increase to 95%, while for rubella it declined transiently to 60% between 7 and 12 years of age. We observed no differences according to gender in any age group in 1991--1992. (Semi)quantitative values of the IgG antibodies against all three viruses increased during adolescence, suggesting wild virus circulation. In 1992, MMR vaccination has reached < 80% of the children during their second year of age. Due to previous monovalent measles and mumps vaccinations in pre-school children and due to endemic and epidemic activity, particularly of mumps virus, a trough of the seroprevalence in adolescents was evident only for rubella. MMR vaccination campaigns performed at school since 1987 have increased seroprevalence in this population segment and have probably over-compensated for the expected shift to the right of the seroprevalence curves. A more compulsive implementation of the recommended childhood vaccination schedule and continued efforts at catchup vaccinations during school age especially for rubella are necessary to avoid the accumulation of susceptible young adults during the forthcoming decades.     

Seroprevalence of Antibodies to Measles, Mumps, and Rubella among Thai Population: Evaluation of Measles/MMR Immunization Programme

Stored serum specimens, from four regions of Thailand, of healthy children attending well baby clinics and of healthy people with acute illnesses visiting outpatient clinics were randomly sampled and tested for IgG antibody to measles, mumps, and rubella (MMR). The immunity patterns of rubella and mumps fitted well with the history of rubella and MMR vaccination, seroprotective rates being over 85% among those aged over seven years. A high proportion of younger children acquired the infection before the age of vaccination. MMR vaccination should preferably be given to children at an earlier age. For measles, 73% seroprotective rates among children, aged 8-14 years, who should have received two doses of measles/MMR vaccine, were lower than expected. This finding was consistent with the age-group reported in outbreaks of measles in Thailand. The apparent ineffectiveness (in relation to measles) of MMR immunization of 1^st grade students warrants further studies.Key words: Antibodies, Immunization, Measles, Measles vaccine, Mumps, MMR vaccine, Rubella, Seroepidemiologic studies, Seroprevalence, Vaccination, Thailand     

Antibody persistence in young adults 1 year after MMR immunization by aerosol or by subcutaneous route

Information on antibody persistence after aerosol revaccination with MMR components is limited. Thus, antibody titers were determined in 283 adult participants in a MMR vaccine trial 12 months after revaccination. One group had received aerosolized Triviraten vaccine while two other groups received either injected Triviraten or MMR II vaccine. Both MMR vaccines contained the same rubella strain, but different measles and mumps strains. Seropositivity to measles persisted in 98% of aerosolized vaccine recipients, 92% of injected Triviraten, and 95% of injected MMR II. All participants in the three groups retained seropositivity to rubella, while less than 50% remained seropositive to mumps.     

麻疹-流行性腮腺炎-风疹联合减毒活疫苗流行性腮腺炎组份免疫效果观察

目的对麻疹-流行性腮腺炎（流腮）-风疹联合减毒活疫苗（Measles,Mumps and Rubella Combined Atteruated Live Vaccine,MMR）中,流腮组份的免疫效果进行观察评价。方法对接种MMR后,流腮组份免疫学效果进行分析评价,并追踪观察记录2年内受种人群及本地人群中流腮发病情况。结果接种MMR前,流腮抗体几何平均滴度（Geometric Mean Titer,GMT）为1∶6.87,免疫后GMT为1∶26.35,免疫后GMT是免疫前GMT的3.8倍,免疫前、后GMT差异有统计学意义（Z=-6.22,P〈0.001）。免疫前、后流腮抗体阳性率分别为64.63%、95.12%,差异有统计学意义（χ2=23.71,P〈0.001）。免疫前、后流腮抗体阴性者与阳性者GMT和免疫前相比差异均有统计学意义（Z=-4.40,P〈0.001;Z=-4.84,P〈0.001）。免疫前流腮抗体阴性者与阳性者接种MMR后,免疫成功率分别为86.21%、54.72%,差异有统计学意义（χ2=8.266,P=0.004）。对受种人群及本地人群进行为期2年的流腮发病追踪观察,在受种人群中未发现流腮病例报告。结论在3-6岁儿童中接种MMR,对于预防流腮效果良好,产生的保护效果至少能维持2年。     

Antikörper gegen impfpräventable Erkrankungen bei Schwangeren und deren Neugeborenen

In the eastern part of Germany, the age of primigravid women has clearly increased since 1990. This may change the protection provided by antibodies in pregnant women as well as their newborns. The objective of the present study was to assess antibodies against vaccine-preventable viral infectious diseases in pregnant women and their offspring to draw conclusions about their protection. Maternal and cord blood samples of 290 women from the eastern part of Germany with a mean age of 28 years were analyzed for antibodies against measles, mumps, rubella, poliomyelitis, and varicella. The study showed that the pregnant women had detectable levels of antibodies against measles virus in 79%, against mumps virus in 96%, against rubella virus in 87%, against polioviruses types 1-3 in 62-64%, and against varicella-zoster virus (VZV) in 97% of the cases. The seroprevalence of the antibodies in the newborns were not significantly different from those of their mothers. When antibody titers of mothers and newborns were compared, significantly higher titers to VZV could be detected in the cord blood sera of newborns. It is suggested that the prevalence of antibodies against measles and poliomyelitis is insufficient to protect the newborns efficiently. An immunity gap of 13% against rubella in mothers results in a potential risk for a congenital rubella syndrome in newborns. Despite the high seroprevalence of rubella and chickenpox, there is considerable potential for infections during pregnancy and neonatal period.     

Mutual interference on the immune response to yellow fever vaccine and a combined vaccine against measles, mumps and rubella

A randomized trial was conducted to assess the immunogenicity and reactogenicity of yellow fever vaccines (YFV) given either simultaneously in separate injections, or 30 days or more after a combined measles-mumps-rubella (MMR) vaccine. Volunteers were also randomized to YFV produced from 17DD and WHO-17D-213 substrains. The study group comprised 1769 healthy 12-month-old children brought to health care centers in Brasilia for routine vaccination. The reactogenicity was of the type and frequency expected for the vaccines and no severe adverse event was associated to either vaccine. Seroconversion and seropositivity 30 days or more after vaccination against yellow fever was similar across groups defined by YFV substrain. Subjects injected YFV and MMR simultaneously had lower seroconversion rates - 90% for rubella, 70% for yellow fever and 61% for mumps - compared with those vaccinated 30 days apart - 97% for rubella, 87% for yellow fever and 71% for mumps. Seroconversion rates for measles were higher than 98% in both comparison groups. Geometric mean titers for rubella and for yellow fever were approximately three times higher among those who got the vaccines 30 days apart. For measles and mumps antibodies GMTs were similar across groups. MMR's interference in immune response of YFV and YFV's interference in immune response of rubella and mumps components of MMR had never been reported before but are consistent with previous observations from other live vaccines. These results may affect the recommendations regarding primary vaccination with yellow fever vaccine and MMR.     

An evaluation of measles, mumps and rubella vaccine in a population of Yorkshire infants

In October 1988 combined measles, mumps and rubella (MMR) vaccination replaced monocomponent measles as part of the routine childhood vaccination programme in the United Kingdom. Prior to this policy change a study was undertaken in 335 children aged 15 months, to evaluate the clinical reactions and immunogenicity of the new combined MMR vaccine (Trimovax, Immravax, Merieux), in comparison with an established monocomponent measles vaccine (Rouvax, Merieux). Parents were asked to select whether their child should receive MMR vaccine or measles monocomponent; over 95% chose MMR. Children who were given the MMR vaccine had seroconversion rates of 96% for measles, 97% for mumps and 100% for rubella, whilst those who received monocomponent measles vaccine had a seroconversion rate of 100%. The number of side effects reported was similar with both vaccines; all were mild and self-limiting. The results from this study confirm the efficacy and low reactogenicity of MMR vaccine and support its use as part of the routine childhood immunisation programme in the United Kingdom.     

日照市健康人群麻疹、风疹和流行性腮腺炎抗体水平调查

目的了解日照市健康人群麻疹、风疹、流行性腮腺炎(腮腺炎)抗体水平和自然感染情况。方法 2009年采集日照市开发区1～≥20岁健康人群血清标本245份,采用酶联免疫吸附试验检测麻疹、风疹和腮腺炎抗体。结果麻疹、风疹和腮腺炎抗体分别检测血清245份。麻疹抗体阳性率98.78%,几何平均滴度(GMT)1:1722.13;风疹抗体阳性率60.82%,抗体含量均值为35.30U/ml;腮腺炎抗体阳性率为84.49%,抗体含量均值为62.94U/ml。结论麻疹抗体阳性率显著高于风疹和腮腺炎抗体阳性率,风疹抗体阳性率普遍较低,3～6岁儿童的腮腺炎抗体阳性率显著低于其他健康人群。应加强儿童风疹和腮腺炎疫苗接种,提高接种率。定期开展育龄期妇女风疹疫苗接种工作。