Seroepidemiological study of rubella in Vojvodina, Serbia: 24 years after the introduction of the MMR vaccine in the national immunization programme

Abstract

Although rubella is usually a mild childhood disease, this infection in early pregnancy poses a serious problem due to its teratogenic effect. The goal of interrupted circulation and elimination of rubella virus was achieved in many countries in the world. The aim of this study was to determine the status of rubella immunity in Vojvodina and evaluate Serbia's progress toward this goal. A total of 3404 residual serum samples from patients of all ages (1 to 84 years) were included in the study. Samples were collected between May 2015 and December 2017 in Vojvodina. Rubella IgG antibodies were determined using an indirect chemiluminescent immunoassay. Percentage of participants seropositive for rubella antibodies was 92.9% in the entire sample. The highest number of seronegatives was in the youngest (1 year) age group (44.7%), followed by the group aged 24-49 (6.4%) and 2-11 years (6.2%). The absence of a higher percentage of children with protective anti-rubella antibodies in the group aged 2-11 can be explained by a lower immunization coverage during certain years. Participants in the group aged 24-49 were born during the pre-vaccination period with lower rubella incidence, leading to the conclusion that not all individuals of that age came into a contact with the virus. Comparing levels of anti-rubella IgG antibodies of seropositive males and females of different ages reveals that the immunity after a contact with the virus and a previously acquired infection is stronger than the immunity after the vaccination. Although the incidence rate of rubella in Vojvodina has been low for the last ten years, there is still a risk of an outbreak due to a decrease in immunization coverage. This study shows that the percentage of susceptible individuals is high, especially considering women aged 24-49, and that additional ("catch-up") immunization is required.

Seroprevalence of Measles-, Mumps-, and Rubella-specific antibodies in the German adult population – cross-sectional analysis of the German Health Interview and Examination Survey for Adults (DEGS1)

“…East Germany adopted this policy after reunification in 1991 [ [10] , [11] , [12] , [13] , [14] , 47 ]. This resulted in a higher proportion of seronegative men as also observed in other European countries with initial selective vaccination of girls and opposed to countries with mandatory vaccination for all children [48] , [49] , [50] , [51] . Those seronegative men pose a risk to unprotected women.…”

Screening for TORCH Antibodies in Croatian Childbearing-Aged Women, 2014–2023

“…In Romania, 94.1% of fertile women tested from 2008 to 2010 were rubella IgG-seropositive, while seropositivity was lower (91.5%) in those tested from 2015 to 2018 [ 51 ]. A decline in RUBV seropositivity in Croatia is a result of a decrease in immunization coverage, which was also observed in Serbia (92.9% seropositive) [ 52 ].…”

Childhood MMR Vaccination Effectiveness Against Rubella: A Longitudinal Cohort Study

“…For example, investigators examined the rubella infection rate in Vojvodina, Serbia over a 24 year period. 11 The investigators described in the pre-vaccination period from 1978 to 1993 that there were sporadic rubella cases combined with outbreak cases of rubella. A rubella vaccination program was initiated from 1993 onwards.…”