Sero-epidemiology of measles-specific IgG antibodies and predictive factors for low or missing titres in a German population-based cross-sectional study in children and adolescents (KiGGS)

Background and objective

In the European Region, measles elimination is now targeted to 2015. To measure progress towards elimination age-group specific susceptibility targets have been defined. Age-specific measles susceptibility in children and adolescents was evaluated in Germany. Taking into account a broad range of socio-demographic, health- and vaccination status related variables, populations for vaccination campaigns were identified.

Method

We analysed data from children aged 1-17 years in the representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Measles immunoglobulin G antibodies were measured in 13,977 participants by enzyme immunoassay (ELISA). Bivariate and multivariate logistic regression analyses were used to determine parental and infant related factors associated with measles susceptibility.

Results

The overall prevalence of seronegativity in children tested for measles IgG aged 1-17 years was 10.0% (95% CI 9.4-10.7). The prevalence of seronegativity in the German population was below the WHO targets for measles elimination in children aged 2-9 year-olds but exceeded the target for 10-17 year-olds. Age differences in the level of seronegativity were found to be mainly due to differences in vaccination coverage. A higher level of susceptibility was observed if parents did not comply with the request to present the child's vaccination card. In vaccinated children, immigration, male gender, very young age at first vaccination and a longer time period since last vaccination were associated with a higher level of susceptibility.

Conclusion

Further increase of the two-dose vaccination coverage is necessary in order to achieve the WHO targets. Catch up vaccination campaigns should focus on adolescents and immigrants.