Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella

In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were immunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested by the haemolysis in gel method. After a neutralisation test against measles as well all children showed immunity to the disease. A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986. An outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.     

Optimal age for measles and mumps vaccination in Australia

Trivalent measles-mumps-rubella vaccine has recently replaced measles-mumps vaccine in Australia and is recommended as a single dose at the age of 12 to 15 months, with the exception of Aboriginal children in central Australia who are vaccinated at 9 months. The timing of measles vaccination has been controversial not only in Australia but also in the United States, where measles outbreaks continue to occur. This study aimed to determine seroconversion rates for measles-mumps vaccine in children aged 12 to 18 months and to make a recommendation for the timing of vaccination based on seroconversion rates and attack rates. The parents of 425 children aged 12 to 18 months gave consent for their children to have serum collected at the time of measles-mumps vaccination and three months later. The mean age at vaccination of the children who had two serum samples for measles and mumps antibody estimations was 13.9 months (mode, 13.1). The seroconversion rate for measles was 95% (314/329) (95% confidence interval (CI), 92.5% to 97.3%) and for mumps 97% (309/320) (95% CI, 93.8% to 98.1%). There were no statistically significant differences in the rates of seroconversion for measles or mumps related to age in months at the time of vaccination or in post-vaccination measles antibody titres related to age at vaccination. Post-vaccination mumps antibody titres tended to be lower in older vaccinees. None of the children who presented for vaccination had serological evidence of prior measles infection but five had evidence suggestive of prior mumps. As the seroconversion rates for measles and mumps vaccines were very high in these children it was concluded that no advantage resulted from delaying vaccination until 15 months and that the current National Health and Medical Research Council recommendations for vaccination at age 12 to 15 months should remain.     

Measles,mumps, and rubella: A cross-sectional study of susceptibility to vaccine-preventable diseases among young people in India

BackgroundGlobal elimination of vaccine preventable diseases, such as measles, mumps and rubella is a priority. Many countries have reported diminishing of antibody titres against these diseases among young population as immunization coverage of adolescents and adults in not monitored. The objective of this study was to determine the susceptibility against measles, mumps and rubella among young adults.MethodsIn this cross-sectional study serological evidence of susceptibility to measles, mumps and rubella was determined by qualitative detection of IgG antibody titres by commercially available enzyme linked florescence assay (VIDAS, bioMerieux) in serum samples young adults.ResultsA total of 335 young individuals (mean age: 20.54 ± 1.37 years) participated voluntarily between May 2017 to September 2018, of which 183 (54.63%) were males. Seroprotection against measles, mumps and rubella were 87.16%, 82.69% and 79.10% respectively.ConclusionSerological surveillance is important to monitor immune status in population. Susceptibility of young adults to measles, mumps, and rubella indicates need for booster vaccination. With the recent launch of measles-rubella vaccination campaign in India, country specific data will be required to plan periodicity of such campaign, which in turn would be based on accumulation of susceptible individuals in a community. Lastly, inclusion of mumps vaccine in the national universal immunization program needs consideration.     

合肥市 2011 年健康人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的研究人群麻疹、风疹、流行性腮腺炎免疫状况,为制定免疫对策提供科学依据。方法随机抽取1422名0～30岁健康人员及部分育龄期女性,用酶联免疫吸附试验检测麻疹、风疹、流行性腮腺炎IgG抗体水平,并进行分析。结果1422名健康人员麻疹抗体阳性1071人,抗体阳性率为75．3％;风疹抗体阳性1149人,抗体阳性率为80．8％;流腮抗体阳性1097人,抗体阳性率为77．1％。结论合肥市麻疹有出现散发和小范围流行的可能,风疹和流行性腮腺炎学龄组出现暴发的可能性较高。在认真完成麻疹疫苗的常规接种的前提下,对大年龄组儿童进行MMR疫苗的强化免疫或查漏补种是消除麻疹和控制风疹及流行性腮腺炎的有效方法和途径。     

成人发热出疹性疾病的临床研究

目的 探讨成人发热出疹性疾病的临床特点。方法 回顾性分析我院近5年来420例成人发热出疹性疾病的临床特点、并发症和预后。结果 成人发热出疹性疾病大多数均有典型的临床表现;并发症主要以肝脏、肺脏为主;预后良好。麻疹IgM抗体阳性率为65%,风疹IgM抗体阳性率为15%,麻疹IgM抗体、风疹IgM抗体均为阴性者占20%。结论 血清学诊断是鉴别成人发热出疹性疾病的重要手段,为控制麻疹的发病率,除坚持疫苗接种、对特定人群（成人）强化免疫及对流动人口进行应急接种或加强新疫苗的研制外,还应继续推行风疹疫苗的接种。     

Antibody response following measles-mumps-rubella vaccine under conditions of customary use

A study of 301 children who had been immunized two to 19 months previously with measles, mumps, and rubella (MMR) vaccine at 36 different sites in San Antonio, Tex, including physicians' offices and clinics, revealed that 99.7% had antibody against rubella and 98.3% had antibody against measles and mumps. None of the 49 infants who were tested prior to receipt of MMR vaccine had antibody against any of these viruses, indicating that the antibody found after immunization was unlikely to be due to false-positive results. The lack of antibody in these infants confirmed that there had not been a significant number of cases of these diseases that could contribute to the high frequency of antibody found after immunization. A single dose of MMR vaccine administered under customary conditions appears to be an effective method of conferring immunity against these diseases.     

郑州市2004～2005年几种急性传染病流行特征分析

目的 分析郑州市2004-2005年麻疹、流行性腮腺炎、风疹几种急性传染病的流行特征和趋势，为修订防治措施提供依据。方法 对郑州市2004-2005年麻疹、流行性腮腺炎、风疹的流行情况和预防控制措施的实施效果进行调查分析。结果 郑州市2004与2005年麻疹、流行性腮腺炎及风疹的发病率分别为6．28％/10万、34．19/10万和4．38/10万与22，17/10万、16．86/10万和2．07/10万。流行性腮腺炎、风疹发病总体呈下降趋势，但局部地区和个别年龄段发病显著上升。结论 提高常规免疫接种率，及时对适龄儿童进行麻疹疫苗复种，并有计划的开展麻疹疫苗强化免疫，加强流动人口管理，消除免疫空白，以达到迅速控制麻疹，是控制麻疹需要解决的问题。     

Measles, mumps, and rubella: the need for a change in immunisation policy

There is growing evidence that the present policy of childhood immunisation in the United Kingdom is inadequate. It is unlikely ever to achieve complete eradication of the congenital rubella syndrome and measles, and the problem of mumps has not even begun to be addressed. After a coordinated campaign to increase uptake of immunisation in Fife the uptake of rubella immunisation in teenage girls increased from 75% in 1981 to 94% in 1985 and the uptake of measles vaccination in preschool children from 55% in 1981 to 81% in 1985. There are a few girls each year who do not accept rubella immunisation, whose immune state is unknown, and who are consequently at risk of rubella during future pregnancies. Despite the increased uptake of measles vaccine over the past four years there is currently an epidemic of measles in Fife, with 544 notified cases in the first quarter of 1986. In 1984, 19 Fife residents were admitted to hospital because of complications of mumps. The time is ripe for a complete reassessment of the national immunisation policy.     

银川市0~7岁流动儿童8种传染病血清抗体水平监测分析

目的：了解银川市0~7岁流动儿童的免疫水平,评价疫苗免疫效果,为制定银川市免疫规划策略和措施提供科学依据。方法于2013年采用分层随机抽样调查方法对银川市195名0~6岁儿童进行HBsAg、HbsAb、脊髓灰质炎、麻疹、白喉、百日咳、破伤风、风疹及腮腺炎IgG抗体8种血清抗体水平检测,并进行统计学分析。结果195名儿童中,HbsAg和HbsAb阳性率分别为0和69.7%,8种血清抗体阳性率最高为脊髓灰质炎,占97.4%,最低为百日咳,占15.4%;不同地区间,0~7岁儿童白喉和破伤风抗体阳性率比较差异具有统计学意义(P<0.05);不同年龄组间0~7岁儿童HbsAb、风疹和麻疹抗体阳性率比较差异有统计学意义(P<0.05);不同性别间0~7岁流动儿童8种血清学抗体阳性率比较差异无统计学意义(P>0.05);不同民族间0~6岁流动儿童麻疹和腮腺炎抗体阳性率回族高于汉族,差异有统计学意义(P<0.05)。结论银川市0~7岁流动儿童免疫状况良好,但部分种类疫苗抗体水平较低,存在薄弱地区与人群,应加强重点地区、重点疫苗种类及重点年龄段儿童的预防接种技术规范化管理,并根据监测结果,必要时开展强化免疫。     

Immunization policies in Canadian medical schools.

OBJECTIVE: To determine the policies of Canadian medical schools concerning immunization of students and the methods used to promote these policies. DESIGN: Mail survey with the use of a 12-item, self-administered questionnaire; telephone follow-up to ensure response. SETTING: All 16 medical schools in Canada. PARTICIPANTS: Deans of Canada's 16 medical schools or their designates. All of them responded to the questionnaire. MAIN OUTCOME MEASURES: Policies on vaccination of students against diphtheria, hepatitis B, influenza, measles, mumps, poliomyelitis, rubella, tetanus and typhoid fever; recommended or required timing of such vaccination; methods for making students aware of immunization policies and for making vaccinations available to students; responsibility for payment for vaccination; compliance rates; methods used to monitor compliance; problems associated with noncompliance; policies for compensating students infected with hepatitis B or other vaccine-preventable diseases; and future plans for vaccination of medical students. RESULTS: Vaccination against rubella was required in 11 (69%) of the 16 medical schools, and vaccination against tetanus, diphtheria and hepatitis B was required in 10 (63%). Nine schools (56%) required vaccination against measles and poliomyelitis, and eight (50%) required mumps vaccination. Only three schools (19%) required or recommended influenza vaccination, and only one recommended vaccination against typhoid fever. The authors identified various methods used to promote student awareness of immunization policies, make vaccinations available, pay for vaccinations and monitor compliance. CONCLUSIONS: Each medical school has a unique set of requirements and recommendations for the vaccination of medical students. National guidelines on immunization for medical students and a comprehensive and nationally coordinated vaccination program would help to ensure that students receive proper protection from disease.     

Immunisation before school entry: should there be a law?

An epidemiologist questions whether laws mandating vaccination of children before school entry are necessary in Britain to reduce the incidence of diseases such as measles, mumps, and rubella. Using vaccination against measles as his example, Noah compares the coverage rate in the United States, where 46 states have school immunization laws, with coverage rates in Norway, the Netherlands, Sweden, Finland, and England and Wales, where immunization before school entry is not required. The United States has achieved a high vaccination rate for school age children, as have the Scandinavian countries and the Netherlands without enforcement laws. Noah concludes that better organization of health services and increased promotion of vaccination among health personnel and the public may be sufficient to raise Britain's overall immunization rate without legislation.     

2005～2011年广西浦北县流行性腮腺炎流行病学特征分析

目的：了解广西山区人口密度较大的浦北县近几年流行性腮腺炎的流行病学特征,为今后制定防治措施提供科学依据。方法：收集该县2005～2011年报告的流行性腮腺炎病例及儿童麻疹-腮腺炎-风疹疫苗（MMR）的接种资料,采用Excel软件进行统计分析。结果-该县过去的7年中共发现流行性腮腺炎364例,尽管全县腮腺炎年均人群发病率为6．04／10万,但2～14岁少儿发病率在（58．20～358．03）／10万,超过广西的腮腺炎人群平均发病率41．20／10万。男女之比为2．03：1。该县腮腺炎病例全年均有出现,高峰期分别在3—5月和11～12月,5个月的病例占总病例数的65．93％。全县除一个镇无腮腺炎病例报道外,其它15个镇均有病例报道。腮腺炎病例中有29．40％曾经接种过MMR疫苗。结论：该县需进一步加强人学前后儿童MMR的接种及补种工作并提高疫苗接种的质量。     

河源市2004—2017年麻疹流行特征及消除进展

目的 分析河源市2004—2017年麻疹流行病学和消除进展特点,为本地区麻疹消除工作提供参考。方法 通过麻疹监测信息报告管理系统,收集河源市2004—2017年麻疹病例信息,结合历年强化免疫活动,采用描述流行病学方法分析病例发病特征。结果 发病基本维持每5~6年一个流行周期,其中2015—2017年年均发病率为0.39/10万;发病县区占比下降;发病呈明显的季节性规律,发病季节与年龄出现位移;流动人口发病比重不高,但发病前7~2d前往过医院就诊者占28.43%;免疫史不详者和无免疫史者共占88.03%;8月龄病例1剂次接种仅占8.70%;发病人群主要为散居儿童、学生和幼托儿童。结论 河源市麻疹消除仍存在薄弱环节,另二胎政策开放,易感人群累积提速。为深入推进麻疹消除进程,仍须持续深度践行《2006—2012年全国消除麻疹行动计划》和《全国麻疹监测方案》;针对年龄双相移位现象,尽早开展对适龄儿童以外人群免疫策略研制。     

五华县2009～2012年麻疹和风疹病例监测结果分析

目的 分析五华县2009～ 2012年发热出疹病例实验室监测结果,了解五华县麻疹和风疹发病情况.方法 使用酶联免疫吸附捕获法(ELISA)检测发热出疹病例的血清标本中麻疹、风疹IgM抗体,结合流行病学资料进行统计分析.结果 2009～2012年共检测发热出疹病例血清标本27例,麻疹IgM抗体阳性1例,阳性率为3.70％o,风疹IgM抗体阳性10例,阳性率为37.04％,发热出疹病例发病高峰在每年3～6月份,仅2011年有1例麻疹实验室确诊病例,发病率为0～0.08/10万.结论 五华县2009～2012年发热出疹病例以风疹为主,麻疹发病率达到1/100万以下的消除麻疹目标,但仍需加强对发热出疹病例进行监测,为消除麻疹、预防控制风疹提供及时、准确的实验室数据.     

城乡结合部社区学龄前儿童基础免疫状况调查

目的了解北京市城乡结合部社区学龄前儿童免疫规划疫苗基础免疫情况,为查漏补种、传染病防控提供依据。方法采用普查的方法对北京市某城乡结合部社区学龄前儿童进行调查。自行设计问卷,通过入户调查填写调查表,了解儿童基本信息;免疫接种信息由《儿童预防接种信息管理系统》导出。结果 1 315例本社区管理儿童的卡介苗(BCG)、乙肝疫苗(HepB)、脊髓灰质炎疫苗(OPV)、百白破疫苗(DPT)及麻疹疫苗基础免疫的合格率分别为99.0%、97.0%、95.4%、96.8%和93.5%,及时率分别为90.3%、90.4%、83.4%、79.4%和79.7%。"五苗"全程接种合格率为87.2%,及时率为57.9%。A群流脑疫苗(A-MCV)、甲肝疫苗(HepA)、乙脑疫苗(JEV)、风疹疫苗、流行性腮腺炎疫苗基础免疫合格率分别为93.7%,88.4%,92.7%、92.1%和92.4%。本市户籍儿童的麻疹疫苗、A-MCV、HepA、JEV、风疹疫苗及流行性腮腺炎疫苗的基础免疫合格率明显高于外地户籍儿童(P<0.05);不同年龄组的儿童接种率总体上无显著差异。结论北京市城乡结合部社区学龄前儿童基础免疫状况存在一定问题,应加大管理力度。     

Sero-response to measles vaccination at 12 months of age in Saudi infants in Qassim Province

OBJECTIVE: To evaluate the sero-response to measles component of the first measles, mumps and rubella MMR dose given at 12 months by measuring measles antibody before and one month after the vaccination. METHODS: A follow-up study where, 57 children at the age of 12 months were recruited randomly from the Primary Health Care Centers in Qassim, Saudi Arabia using a multistage sampling techniques. Fieldwork was conducted from October until December 2006. Blood samples were collected to measure measles IgG antibody before, and one month after giving MMR using enzyme linked immunosorbent assay. Data were compared before and after vaccination using geometric mean titer GMT and seroconversion. RESULTS: In the 57 infants, positivity rate increased significantly from 3.5% (2/57) pre-vaccination to 100% one month after p=0.0001, and with a sero-conversion of 96.5% (55/57). Also, GMT increased significantly from 0.014-2.172 IU/ML, after vaccination p=0.0001. CONCLUSION: Sero conversion and GMT are significantly high after the first MMR given at 12 months and this is supported by the surveillance data in Qassim.     

营山县2014年健康人群麻疹、风疹、腮腺炎抗体水平监测结果分析

目的:了解营山县健康人群麻疹、风疹、腮腺炎抗体水平,评价疫苗接种效果和人群免疫状况,为制定免疫规划策略和相应传染病防制措施提供依据。方法:按照分层随机抽样的原则,分<1岁、1岁~、3岁~、5岁~、7岁~、15岁~、≥20岁7个年龄组,每个年龄组随机抽取30人作为监测对象,共210人,采用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)法检测麻疹IgG、风疹IgG、腮腺炎IgG。结果:共检测210份血清标本,麻疹IgG阳性率为86.19%,风疹IgG阳性率为80.48%,腮腺炎IgG阳性率为63.81%。结论:营山县健康人群麻疹IgG抗体水平1岁以上年龄组人群均达到《预防接种规范》要求的85%免疫成功率指标,建立了有效免疫屏障。风疹IgG抗体和腮腺炎IgG抗体水平较低,不足以达到有效免疫屏障,提示我们要加强风疹、腮腺炎接种率和接种质量。     

Antibody response in school children to live rubella vaccine (Cendehill strain)

The efficacy of an attenuated rubella virus vaccine, Cendevax, was tested on 65 school children. Forty-nine of them (75%) had pre-existing antibodies and in these there was no increase in the HAI antibody titres after administration of the vaccine. Sixteen children (25%) had no demonstrable rubella HAI antibody prior to vaccination. From the latter group, postvaccination serum samples were available from only 11, and 10 of these seronegative children showed seroconversion after vaccination. The geometric mean HAI titre was 1:180. Seven of the 10 postvaccination serum samples had complement-fixing antibodies and specific IgM antibodies were detected by the immunofluorescence test in 8. No correlation was observed between the CF and the IgM antibodies.     

南宁市麻疹、风疹流行病学监测

目的对2007～2008年南宁市麻疹、风疹疑似病例进行IgM抗体检测,分析其流行特征,探讨适合南宁市的控制策略。方法采用酶联免疫吸附法（ELISA）对日常监测到的麻疹、风疹疑似病例血清标本进行IgM抗体检测,结果用SPSS13.0进行统计学分析。结果 2007～2008年检测的813份疑似麻疹病例样本中,麻疹抗体阳性率为31.49%,风疹为14.76%。麻疹、风疹发病时间仍在2～8月份之间。城区麻疹发病率比县份高,风疹以个别县份居高。8月龄～2岁仍是麻疹主要发病年龄,但2008年麻疹出现＂双向位移＂的现象。麻疹主要在散居儿童中高发,占62.2%,风疹则集中在学生中多发,占79%。有明确麻疹和风疹免疫史的分别为14.6%和2.8%。出疹后4～7d采血检测麻疹IgM抗体阳性率最高,为61.39%。结论本地发热出疹性疾病以麻疹为主;发病年龄分布提示疫情控制欠佳;采血时间与检出率密切相关;发病人口免疫率低。     

2005—2012年大化瑶族自治县流行性腮腺炎流行病学特征分析

目的 了解广西山区大化瑶族自治县近几年流行性腮腺炎的流行病学特征,为今后制定防治措施提供科学依据,、方法收集该县2005—2012年报告的流行性腮腺炎病例及儿童麻疹一腮腺炎一风疹疫苗（measles,mumps,an—drubella,MMR）的接种资料,采用Excel2003、SPSS11．5软件进行统计分析。结果该县过去的8年中共发现流行性腮腺炎病例535例,腮腺炎年均人群发病率为15．99／10厅,健康人群MMR接种率平均为2．78％,而腮腺炎病例均未进行过MMR接种。该县腮腺炎病例全年均有出现,高峰期分别在初夏和冬季;4～7岁学龄前儿童发病率占44．86／10万;伞县病例男女之比为1．82：1;全县16个乡镇均有病例报告,病例数最多的大化镇,年均人群发病率为39．90／10月,占总病例数的49．72％。结论尽管该县人群腮腺炎疫苗接种逐年增多,但近两年腮腺炎病例呈现增多趋势,需进一步加强对重点乡镇及重点人群特别是入学前后儿童MMR的接种及补种工作并提高疫苗接种的质量。