Measles-Mumps-Rubella Revaccination; 18 Months vs. 4-6 Years of Age: Potential Impacts of Schedule Changes

Saffar, Mohammad Jafar; Fathpour, Golam Reza; Parsaei, Mohammed Reza; Ajami, Abolghasem; Khalilian, A R; Shojaei, Jalil; Saffar, Hiva

doi:10.1093/tropej/fmq102

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…We identified over 220 studies that provided cross‐sectional data and nearly 180 studies that reported on immunity for women of child‐bearing age, primarily for rubella. Table summarizes the over 400 cross‐sectional and women of child‐bearing age measles and rubella serological studies…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Measles and Rubella Serology Studies

Thompson

Odahowski²

2015

Risk Analysis

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Serological tests provide information about individual immunity from historical infection or immunization. Cross-sectional serological studies provide data about the age- and sex-specific immunity levels for individuals in the studied population, and these data can provide a point of comparison for the results of transmission models. In the context of developing an integrated model for measles and rubella transmission, we reviewed the existing measles and rubella literature to identify the results of national serological studies that provided cross-sectional estimates of population immunity at the time of data collection. We systematically searched PubMed, the Science Citation Index, and references we identified from relevant articles published in English. We extracted serological data for comparison to transmission model outputs. For rubella, serological studies of women of child-bearing age provide information about the potential risks of infants born with congenital rubella syndrome. Serological studies also document the loss of maternal antibodies, which occurs at different rates for the different viruses and according to the nature of the induced immunity (i.e., infection or vaccine). The serological evidence remains limited for some areas, with studies from developed countries representing a disproportionate part of the evidence. The collection and review of serological evidence can help program managers identify immunity gaps in the population, which may help them better understand the characteristics of individuals within their populations who may participate in transmission and manage risks.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of Measles and Rubella Serology Studies

Thompson

Odahowski²

2015

Risk Analysis

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“…Therefore, vaccinerelated factors such as lack of adequate potency of vaccine because of using more thermo-labile strains, inadequate control of cold chain shipment, storage, use, and other probable factors may be responsible [45][46][47]. Our assumption regarding the inadequate potency of vaccine is based on the results of studies that were designed to investigate the immunogenicity of MMR vaccine currently used in Iran [48][49][50][51][52][53]. The majority of these studies showed lower rates of seroconversion following the first and/or the second doses of MMR vaccine after the age of 12 months (Table 5).…”

Section: Discussionmentioning

confidence: 99%

Measles and rubella serosusceptibity among population vaccinated with different schedules: the potential impact on measles-rubella elimination in Iran

Saffar¹,

Khalifeloo²,

Saffar

et al. 2021

BMC Infect Dis

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Background Iranian children were vaccinated with the scheduled two doses of monovalent measles vaccine (mMV) from 1984. In December 2003, a nationwide campaign of measles-rubella (MR) immunization was established to vaccinate 5–25 year- old individuals. In 2004, the mMV was replaced with measles- mumps- rubella (MMR) vaccine. Despite the high vaccination coverage, the outbreaks of measles still occur in the country. In this Study, the MR immunity status of various age groups, vaccinated with different schedules was investigated, and the immunologic response of seronegative subjects to revaccination was examined. Methods This cross-sectional study was conducted among 7–33-year-old healthy individuals with a documented history of measles vaccination from November 2017 to June 2018. The subjects were categorized as follows: group A, including 20–33 year-old individuals; vaccinated with 1–2 doses of mMV at ages 9 and 15 months, and revaccinated with MR, group B, including 15–19-year-old individuals, vaccinated with two doses of mMV at 9 and 15 months of age, and received additional dose of MMR upon school entrance, group C, including 11–14 year-old individuals, vaccinated with two-doses of MMR at the ages of 15 months and 6 years, and group D, including 7–10 year-old individuals vaccinated with two-doses of MMR vaccine at the ages 12 and 18 months, respectively. Levels of antimeasles- antirubella IgG antibodies in the collected sera were measured. Also antimeasles- antirubella IgM and IgG of seronegative individuals were reexamined at 4–6 weeks after MMR revaccination. The collected data were analyzed using descriptive statistical methods. Results A total of 635 individuals were investigated in this study. Group A, 98; group B, 295; group C, 139; and group D, 103 persons. Overall, 12.3 and 18.4% of the population were seronegative for measles and rubella antibodies. This rate varied greatly between the 4 groups: group A, 0/0–2%; group B,15.2–25.0%; group C,11.5–17.2%; and groupD,14.6–18.4%. After revaccination, 92 and 94.9% of seronegative individuals showed IgG response to measles and rubella vaccines, respectively. Conclusion Despite the high coverage rate of M-R containing vaccines, a significant number of vaccinated subjects were seronegative for measles and rubella, possibly because of secondary vaccine failure; this may negatively affect measles-rubella elimination targets in the country. If these findings are confirmed in similar future studies, a more robust regional/national supplementary immunization activity will be considered.

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“…Therefore, vaccine-related factors such as lack of adequate potency of vaccine because of using more thermolabile strains, inadequate control of cold chain shipment/storage/ and use, and other probable factors may be responsible (45)(46)(47) . Our assumption regarding the inadequate potency of vaccine is based on the results of studies that were designed to investigate the immunogenicity of MMR vaccine currently in used in Iran (48)(49)(50)(51)(52)(53) . The majority of these studies showed lower rates of seroconversion following the rst and/or the second doses of MMR vaccine after the age of 12 months ( Table 5).…”

Section: Discussionmentioning

confidence: 99%

Measles and Rubella Serosusceptibity among Population Vaccinated with Different Schedule: The potential impact on Measles-Rubella elimination in Iran.

Saffar¹,

Khalifeloo

Saffar

et al. 2021

Preprint

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Background: Iranian children have been vaccinated with the scheduled two doses of monovalent measles vaccine (mMV) since 1984. In December 2003, a nationwide campaign of measles-rubella (MR) immunization targeted 5-25 years population was established. In 2004, the mMV was replaced with measles- mumps-rubella (MMR) vaccine. Despite the high vaccination coverage, the outbreaks of measles still occurs in the country. In this Study, the measles-rubella immunity status of various age groups, vaccinated with different schedules was investigated, and the immunologic response of seronegative subjects to revaccination was examined. Methods: This cross-sectional study was conducted among 7- 33-year-old healthy individuals with a documented history of measles vaccination from November 2017-to June 2018. The subjects were categorized as fallow: groupA: including 20-33 years-old; vaccinated with 1-2 dose of mMV, and revaccinated with MR, groupB, including 15-19-year-old individuals, vaccinated with two doses of mMV at nine and 15 months of age, and in addition to one dose MMR upon school entrance, groupC, including 11-14 year-old individuals vaccinated, with two-doses of MMR at the ages of 15 months and six years, and groupD, including 7-10 year individuals vaccinated with two-doses of MMR vaccine at the ages 12 and 18 months, respectively. Nest the consecrations of antimeasles-antirubella IgG antibodies in the collected sera were measured. Among seronegative subjects, the antimeasles-antirubella IgM and IgG were reexamined at 4-6 weeks after MMR revaccination. The collected data were analyzed using descriptive statistical methods.Results: A total of 635 individuals, including 322 females were investigated in this study. The relative distribution of subjects in each group was as falows: groupA, 98; groupB, 295; groupC, 139; and groupD, 103 persons. Overall, 12.3% and 18.4% of the population were seronegative for measles and rubella antibodies. This rate varied greatly between the 4 groups: groupA, 2%-0/0%; groupB,15.2%- 25.0%; groupC,11.5%- 17.2%; and groupD,14.6%- 18.4%. After revaccination, 92% and 94.9% of seronegative individuals only showed IgG response to measles and rubella vaccines, respectively.Conclusion: Despite the high coverage rate of M-R containing vaccines, a significant numbers of vaccinated subjects were seronegative for measles and rubella, possibly because of secondary vaccine failure; this may negatively affect measles-rubella elimination targets in the country. If these findings are confirmed in similar future studies, a more robust regional/national supplementary immunization activity should be considered.

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Measles-Mumps-Rubella Revaccination; 18 Months vs. 4-6 Years of Age: Potential Impacts of Schedule Changes

Abstract: This study showed that the majority of younger children were susceptible to MMR infection before revaccination. Earlier age policy provides more protection against MMR in preschool-aged children. Rubella strain seems to be less potent than reported.

Cited by 12 publications

References 16 publications

Systematic Review of Measles and Rubella Serology Studies

Systematic Review of Measles and Rubella Serology Studies

Measles and rubella serosusceptibity among population vaccinated with different schedules: the potential impact on measles-rubella elimination in Iran

Measles and Rubella Serosusceptibity among Population Vaccinated with Different Schedule: The potential impact on Measles-Rubella elimination in Iran.

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