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     

Immunity against infectious diseases: predictive value of self-reported history of vaccination and disease.

OBJECTIVE: To determine whether self-reported history of disease and/or vaccination is predictive of immunity against hepatitis B, varicella, rubella, mumps, and measles. DESIGN: The seroprevalence of viral antibodies and the predictive value of a self-report questionnaire were determined for 616 paramedical students who matriculated into Padua Medical School (Padua, Italy) during 2003-2005. RESULTS: The majority of subjects (86.9%) remembered being vaccinated against hepatitis B but had no recollection of disease. Among vaccinees, 1.5% showed markers of previous infection, 6.7% tested negative for anti-hepatitis B virus surface antigen (anti-HBsAg) antibodies, and 91.8% tested positive for anti-HBsAg. Self-reported vaccination history had a positive predictive value of 93.2% for test results positive for immunity against hepatitis B. Immunity against varicella (93.7% of subjects) and rubella (95.5%) was high, compared with immunity against mumps (79.9%) and measles (83.1%). In addition, results of tests for detection of immunity against mumps and measles were equivocal for more than 7% of subjects, probably because their vaccination regimen was not completed. Self-reported histories of varicella disease and rubella disease and vaccination had high positive predictive values (greater than 98% each) for testing positive for antiviral antibodies, compared with self-reported histories of mumps disease and vaccination and measles disease and vaccination; however, high positive predictive values were observed for self-reported histories of mumps only (92.0%) and measles only (94.7%). CONCLUSIONS: The self-report questionnaire used in this study did not accurately predict immunity against 5 transmittable but vaccine-preventable diseases. A complete serological evaluation of healthcare workers, followed by vaccination of those with negative or equivocal results of serological tests, is an appropriate measure to decrease the risk of infection in this population.     

Prevalence of measles, rubella, mumps, and varicella antibodies among healthcare workers in Japan.

OBJECTIVES: To evaluate the immune status of healthcare workers (HCWs) against measles, rubella, mumps, and varicella in Japan, and to promote an adequate vaccination program among HCWs. SETTING: University of Tokyo Hospital. PARTICIPANTS: Eight hundred seventy-seven HCWs. DESIGN: Serologic screening for measles, rubella, mumps, and varicella was performed on HCWs. Antibodies against measles, rubella, and mumps were detected using hemagglutination inhibition (HI) assay ($4.20 per test). If serum was negative by HI assay, enzyme-linked immunosorbent assay (EIA) was performed ($12.60 per test). Anti-varicella antibodies were detected by EIA only. RESULTS: Among tested HCWs, 98.5%, 90.4%, 85.8%, and 97.2% had immunity to measles, rubella, mumps, and varicella, respectively. All those born before 1970 were seropositive for measles. However, individuals susceptible to rubella, mumps, and varicella were present in all age groups. The sensitivities and negative predictive values of HI assay compared with EIA were 86.6% and 11.3% for measles, 99.1% and 92.2% for rubella, and 47.8% and 24.1% for mumps, respectively. For measles and mumps, prevaccination screening by HI assay in combination with EIA led to significant savings compared with EIA only. In contrast, it was estimated that prevaccination screening using only HI assay would be more economical for rubella. CONCLUSIONS: Aggressive screening and vaccination of susceptible HCWs was essential regardless of age. Prevaccination serologic screening using a combination of HI assay and EIA was more economical for measles and mumps.     

上海市浦东新区2012年麻疹疑似病例IgM抗体检测结果分析

目的对2012年上海市浦东新区麻疹疑似病例进行IgM抗体检测,分析麻疹流行病学特征,为进一步制订麻疹防治策略提供科学依据。方法应用酶联免疫吸附试验（ELISA）对疑似麻疹病例血清标本同时检测麻疹、风疹IgM抗体。结果 2012年该区共检测麻疹疑似病例241例。检出麻疹IgM抗体阳性111例,阳性率为46.06%;风疹IgM抗体阳性38例,阳性率为15.77%;其中有4例麻疹、风疹IgM抗体均为阳性。麻疹阳性年龄主要分布于20-30岁年龄和8个月-10岁以下年龄,其次是8个月以下婴儿。流行高峰后移至5-9月份。风疹阳性年龄20-30岁组最高,其次为30-40岁组。流行高峰在3-6月份。麻疹、风疹IgM抗体阳性率与血清采集时间有密切关系。出疹4天后采集的血清标本IgM抗体阳性率（麻疹49.75%、风疹18.27%）明显高于3天内（麻疹为29.55%、风疹为4.55%）。麻疹、风疹病例中无免疫史或免疫不详者占88.29%和92.11%。结论建议对重点人群进行麻疹强化免疫,提高免疫接种率,开展查漏补,麻疹初免年龄应适当提早。提高疑似麻疹病例的血清标本采集率。同时也需要加强风疹的监测和预防接种工作,控制风疹疫情的蔓延,并进一步加强麻疹、风疹及其他出疹性疾病的监测。     

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.     

Effektivität, Populationseffekte und Gesundheitsökonomie der Impfungen gegen Masern und Röteln

Vaccination against measles and rubella has been included in national immunization programs worldwide for several decades. In this article, we present the evidence related to the effectiveness of measles and rubella vaccination based on published systematic reviews, and we describe the epidemiological and health economic effects of vaccination at a population level. Several observational studies demonstrate the high effectiveness (>?90?%) of both measles and rubella vaccination. The global measles mortality reduction and the dramatic decrease in rubella and measles incidences after introduction of routine immunization contribute to the very high quality of evidence. The countries of the Americas have proved that it is feasible to eliminate measles and rubella by strengthening infant immunization through routine vaccination services and by conducting supplemental immunization activities in other childhood age groups so as to close immunity gaps. An economic evaluation of measles and rubella vaccination specifically for the healthcare system in Germany does not exist. However, we conducted a systematic review and identified 11 health-economic studies from other industrialized countries and one for a hypothetical industrialized country. Results indicate that vaccination against measles and rubella had either a cost-effective or even a cost-saving potential, which could be assumed with some limitations also for the German setting. In conclusion, there is compelling evidence that the available vaccines are very effective and that measles and rubella elimination is feasible if adequate vaccination strategies are implemented. In Germany, catch-up vaccination programs are urgently needed for children, adolescents, and young adults specifically in the western federal states.     

深圳市发热出疹性疾病血清流行病学分析

为了解发热出疹性疾病(RFIs)血清流行病学特征,对深圳市1998～1999年发热出疹性病例同时检测麻疹、风疹IgM抗体,进行流行病学分析.共检测RFIs 328例,麻疹IgM抗体阳性率为54.88%,风疹IgM抗体阳性率为9.45%.RFIs病例中麻疹和风疹发病高峰季节为春、夏季.麻疹发病以少年儿童为主,而风疹主要发病对象则出现两个非连续年龄高峰期,分别为儿童高峰期和青少年高峰期.180例麻疹IgM抗体阳性病例中,免疫史不详和无免疫史占83.89%.结果显示,RFIs病例中以麻疹、风疹为主,其分布也与麻疹、风疹流行特征相似.有必要将RFIs病例血清学监测列入计划免疫常规监测.     

Waning antibodies in measles and rubella vaccinees--a longitudinal study

The evolution of measles- and rubella-specific serum IgG was followed in a longitudinal study in 224 young adolescent vaccinees, with or without boost vaccination before or during the 6.8-year observation period. Antibody titres were monitored by enzyme immuno assay (Enzygnost, Dade-Behring). After revaccination (second dose) rubella seropositivity rate increased from 92.1 to 100%, whereas measles seroprevalence (about 90%) did not significantly change between the paired sera. Significantly higher IgG (> three-fold) in the second serum of 5.2% (measles) and 7.8% (rubella) of participants with low antibodies (measles: < 1500 mIU; rubella < 40 IU) in first serum, suggest a secondary immune response (SIR) during the study period, only partially explained by revaccination. Excluding individuals with SIR, minimal annual antibody decay rates of -2.9% (confidence interval, CI: -0.7 to -4.8%) for rubella and -1.6% (CI: -0.1 to -3%) for measles were determined in participants with single dose vaccination. Thus, two-dose vaccination was adequate to protect women from rubella infection at least during childbearing age. Similarly only few individuals may become seronegative for measles again after successful vaccination due to minimal waning of low antibody levels (< 1500 mIU). However, as a result of a more rapid decay of high-titre (> 1500 mIU) antibodies (-2.4%/year), many vaccinees may eventually become susceptible to vaccine-modified measles (VMM) and consequently complicate measles control strategies.     

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35~42 d各采集血标本3 ml。在研究期间,主动监测疫苗接种后30 min、1 d、2 d、3 d、4~12 d,以及13~42 d的不良事件。血清采用酶标法检测麻疹、流行性腮腺炎和风疹的IgG抗体。采用方差分析或非参数检验比较研究组间麻疹、腮腺炎和风疹抗体几何平均浓度（GMC）,采用χ²检验或Fisher确切概率法比较组间阳性率和不良事件发生率。结果 共500名完成免后采血儿童纳入免疫原性分析,535名儿童纳入安全性分析。总体不良事件发生率为20.37%,轻度不良事件最多。局部与全身不良事件发生率分别为0.37%和20.00%。局部不良事件的症状以接种部位发红为主,全身不良事件以发热症状为主,其次为咳嗽、皮疹、流涕等。在4~6岁进行1剂MMR疫苗加强免疫后,麻疹抗体、腮腺炎抗体与风疹抗体阳性率均在99%以上,3组间阳性率差异无统计学意义。3组间仅腮腺炎抗体GMC差异有统计学意义（P=0.042）,麻疹与风疹抗体相关结果均无差异。免前阴性者的麻疹、腮腺炎及风疹抗体GMC均低于免前阳性者。结论 在4~6岁儿童中进行MMR疫苗的加强免疫,具有良好的免疫原性与安全性,在4~6岁之间的加强免疫效果相近。     

Evaluation of the measles,mumps and rubella immunisation programme in Spain by using a sero-epidemiological survey

In Spain, measles, mumps and rubella vaccination was introduced in 1981, with one dose at the age of 15 months and another at the age of 11 years being administered since 1995. Reported disease incidence was less than one case per 100,000 people for measles and rubella, and 23 cases per 100,000 people for mumps. A seroepidemiological survey was undertaken to estimate the frequency of susceptible individuals by age and environment; and vaccination coverage and efficacy of the vaccines administered. A population-based cross-sectional study was then conducted, covering the population aged 2–39 years, residing in Spain (excluding Catalonia). The sample was stratified by age and rural/urban environment and informed consent obtained to take blood specimens from subjects attending blood-extraction centres. The final sample totalled 3932 persons. IgG antibodies were detected by an enzyme-linked immunosorbent assay. Estimated vaccination coverage was 96% for children aged 2–5 years; vaccine efficacies were 96.7% for measles, 97.2% for rubella and 79.3% for mumps. Immunity was the lowest in the 6–9 year age group for measles (90.8%) and in males aged between 15 and 24 years for rubella (86 and 89.8%, respectively). In the case of mumps, this proved the lowest in the 2–5 year age group (76.7%) and in those autonomous regions in which only the Rubini strain had been administered. The incidence of measles has enabled the National Measles Elimination Plan to be implemented by which the elimination of congenital rubella syndrome could now be initiated. A possible explanation for the higher susceptibility observed for mumps might lie in the Rubini strain's low efficacy.     

Persistence of antibodies in 4-8 year old Austrian children after vaccination with hexavalent DTaP-HBV-IPV/Hib and MMR vaccines

To determine the proficiency of the Austrian childhood vaccination schedule to induce long lasting seroprotection against vaccine preventable diseases a seroepidemiological study in 348 children between four and eight years of age was conducted. Antibodies against diphtheria, tetanus, pertussis, hepatitis B, measles, mumps and rubella antigens were assessed in children, who had been vaccinated with hexavalent DTaP-HBV-IPV/Hib vaccines at three, four, five months and in the second year of life and/or MMR vaccines in the second year of life at least once, but mostly twice.High seroprotection rates (SPRs) were detected for tetanus (96%) and measles (90%). SPRs regarding diphtheria and mumps were 81% and 72%, respectively. Rubella-SPRs were 68% in females and 58% in males. Hepatitis B-antibody levels ≥10 mIU/mL were present in 52%; antibodies against pertussis were detected in 27% of the children. SPRs for measles and rubella depended on the interval since last vaccination; mumps-antibodies were significantly lower after one MMR-vaccination only. Antibodies against diphtheria, tetanus and pertussis depended on the interval since last vaccination while HBs-antibodies did not. The low levels of antibodies 1-7 years after vaccination against pertussis, rubella and mumps after only one vaccination should be considered when recommending new vaccination schedules.     

天津市麻疹风疹及流行性腮腺炎抗体水平分析

目的了解天津市健康人群麻疹、风疹、流行性腮腺炎抗体水平,评价疫苗接种需求。方法2007年3月采集0~57岁健康人群608人份血样品,用ELISA方法定量检测麻疹、风疹、流行性腮腺炎IgG抗体水平。运用直线相关分析抗体阳性率,保护率GMC与疾病发病率之间的关系,P0.05为差异有统计学意义。结果麻疹、风疹和流行性腮腺炎疫苗接种率分别为70.39%、16.78%和12.34%;抗体阳性率分别为91.78%,65.79%和73.52%;抗体几何平均浓度(GMC)分别为2 488.10 IU/L、200.4 IU/ml和759.91 U/ml。麻疹抗体阳性率,保护率与发病率存在明显相关关系(P0.01),而GMC与麻疹发病率没有显著性相关;风疹和流行性腮腺炎抗体阳性率、GMC与发病率无相关关系。结论本次调查显示2007年天津市麻疹人群抗体GMC总体保持在较高水平。风疹、流行性腮腺炎疫苗接种率和抗体水平较低,2剂次的麻腮风疫苗(MMR)纳入免疫规划既有助于消除麻疹,也有利于控制风疹和流行性腮腺炎。     

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.     

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.     

Prevalence of childhood exanthematic disease antibodies in paramedical students: need of vaccination

The immunity to common childhood exanthematic diseases such as varicella, rubella, mumps and measles was evaluated in 1024 students of the degree courses of health professions at Padua University Medical School. Subjects were subdivided according to gender and age (25 years old or less, and older than 25 years). Results showed that the prevalence of positive antibodies (IgG) to varicella and rubella (94.1 and 94.5%, respectively) was significantly higher (p<0.001) than mumps (78.6%) and measles (86.3%). In addition, measles showed a significant higher prevalence than mumps (p<0.001). Prevalence of positive antibodies to rubella in females (97.4%) was significantly higher (p<0.001) than males (87.5%), but only if aged 25 years or less. Furthermore, males older than 25 years were significantly more immune (p<0.001) to measles (93.0%) than younger ones (84.3%). A vaccination strategy was applied but compliance was less than 50%; in addition, about 40.0% of vaccinated subjects eluded control after vaccination. Seroconversion after vaccine appeared high for rubella, mumps and measles (92.3, 88.9 and 88.1%, respectively), but low for varicella (43.8%).     

Natural immunity to measles, rubella and mumps among Spanish children in the pre-vaccination era

Prior to the start of mass vaccination campaigns against measles, rubella and mumps, a prevalence study of natural immunity to these diseases was undertaken in a sample of 1700 unvaccinated Spanish children. They were representative of the 3-7 year-old population in terms of age, regional distribution and urban or rural environment. Measles infection prevalence was significantly higher than that for rubella and mumps from 3 (48.3%, 14.2%, 25.5%, respectively) through 7 years of age, (64%, 40.9%, 39%). As a function of age, naturally-acquired immunity increased according to parabolic progressions. In the 3-5 year-old group, rural environment, low socioeconomic status, no school attendance and lack of brothers were associated with statistically lower levels of measles, rubella, or mumps infection. In the 6-7 year-old group, only 12% of the children showed antibodies against the three diseases and 18.7% exhibited triple susceptibility.     

梧州市331例麻疹疑似患者血清检测结果分析

目的 了解梧州市2005～2010年麻疹疫情的流行特征,排除临床麻疹疑似病例中的风疹患者等其他出疹性疾病,为制定预防控制麻疹提供科学依据.方法 采用酶联免疫捕获法对疑似麻疹患者血清进行麻疹IgM抗体检测,同时检测风疹IgM抗体.结果 采2005～2010年共收检梧州各市县送检疑似麻疹患者血清331份,麻疹IgM抗体阳性...     

Changes of the immunological patterns against measles, mumps and rubella. A vaccination programme studied 3 to 7 years after the introduction of a two-dose schedule

A two-dose vaccination programme using a combined measles, mumps and rubella vaccine (MMR) and administration at the ages of 18 months and 12 years was introduced in 1982. The 12-year-old schoolchildren were tested yearly from 1985 to 1989 on serum samples obtained prior to and after vaccination. Each year between 420 and 756 children were tested. The method used for antibody testing was the haemolysis-in-gel (HIG) assay. For measles also the enzyme-linked immunosorbent assay (ELISA) and the neutralization titre (NT) were applied. Only minor variations of the prevaccination immunity to measles were seen during the period 3-7 years after introduction of the programme. The age groups studied had partly been vaccinated against measles earlier. Between 12 and 16% lacked prevaccination immunity. In contrast the immunity to mumps and rubella of the 12-year-old children decreased considerably during the study period. No general vaccination against these diseases had been performed. Thus the susceptibility to mumps increased from 14% in 1985 to 39% in 1989 and to rubella from 41 to 57%. The seroconversion rate of children seronegative for measles was high, i.e. 100% in 1985 and later varied between 96 and 97%. For mumps, the seroconversion rate was lower and varied between 72 and 88%. All sera converted to rubella. During the follow-up period there was a declining incidence of measles, mumps and rubella. The relationship between the vaccination and reduction of disease and natural immunity strongly suggests that the association is causal and that this vaccination policy reduced the transmission of infection.     

Measles and rubella IgG seroprevalence in persons 6 month-35 years of age,Mongolia, 2016

BackgroundIn 2015–2016, Mongolia experienced an unexpected large measles outbreak affecting mostly young children and adults. After two nationwide vaccination campaigns, measles transmission declined. To determine if there were any remaining immunity gaps to measles or rubella in the population, a nationally representative serosurvey for measles and rubella antibodies was conducted after the outbreak was over.MethodsA nationwide, cross-sectional, stratified, three-stage cluster serosurvey was conducted in November-December 2016. A priori, four regional strata (Ulaanbaatar, Western, Central, and Gobi-Eastern) and five age strata (6 months-23 months, 2–7 years, 8–17 years, 18–30 years, and 31–35 years) were created. Households were visited, members interviewed, and blood specimens were collected from age-appropriate members. Blood specimens were tested for measles immunoglobulin G (IgG) and rubella IgG (Enzygnost® Anti-measles Virus/IgG and Anti-rubella Virus/IgG, Siemens, Healthcare Diagnostics Products, GmbH Marburg, Germany). Factors associated with seropositivity were evaluated.ResultsAmong 4598 persons aged 6 months to 35 years participating in the serosurvey, 94% were measles IgG positive and 95% were rubella IgG positive. Measles IgG seropositivity was associated with increasing age and higher education. Rubella IgG seropositivity was associated with increasing age, higher education, smaller household size, receipt of MMR in routine immunization, residence outside the Western Region, non-Muslim religious affiliation, and non-Kazakh ethnicity. Muslim Kazakhs living in Western Region had the lowest rubella seroprevalence of all survey participants.ConclusionsNationally, high immunity to both measles and rubella has been achieved among persons 1–35 years of age, which should be sufficient to eliminate both measles and rubella if future birth cohorts have ≥ 95% two dose vaccination coverage. Catch-up vaccination is needed to close immunity gaps found among some subpopulations, particularly Muslim Kazakhs living in Western Region.