Seroimmunity status to Measles-Mumps-Rubella-Varicella-Pertussis- Diphtheria -Tetanus among Students Accepted to Mazandaran University of Medical Science, Sari, North of Iran, 2018-2019: Planning for Prevetive Method.

Abstract

Background. Healthcare sciences students(HSS)are at the higher risk of exposure to several infections during training. The most important are measles, mumps, varicella, pertussis and influenza, that are transmitted easily via respiratory routes. These infections are vaccine preventable, and commonly are more complicated while develop during adulthood. Confirming immunity before training are recommended, however, adherence to the policy is not satisfactory universally. To evaluate immunity status, and to determine the most appropriate approach to provide full protection against these infections, this study was designed. Methods. A cross-sectional study among newly accepted HSS was conducted. Their past vaccination status, and medical history of compatible clinical diseases were sought by personal interview and self-administered questionnaire. Sera specific IgG antibodies to these infections were measured using ELISA. The relative proportion of seroimmune students were calculated. The correlation between past clinical diseases and their immune status particularly among those who showed no history of earlier vaccination were determined. The most appropriate policy to provide full protection was determined. The collected data were analyzed using descriptive statistical methods as appropriate. Results. Overall, 242 students with mean age 23.9 years, 59% female were participated. All HSS declared that they had been vaccinated according to the national immunization program. Among them 188 students with additional dose of measles- rubella (MR), and 54 by measles- mumps- rubella (MMR) vaccines were re-vaccinated.Overall seropositivity rates were as: measles-80.1%, mumps-64%, rubella-93.4%, varicella-78.5%, pertussis-46.5%, diphtheria-87.3%, and tetanus-87.2%. There were not significant differences between two groups of HSS; MR vs MMR re-vaccinated students. The most cost-benefits strategy to provide immunity against MMR agents were universal vaccination. Conclusion. Nearly 63%of HSS were susceptible to MMR viruses, and universal MMR vaccination of the students just before training was the most appropriate policy to provide immunity. Efforts should be made to incorporate adult-type acellular pertussis vaccine to diphtheria- tetanus toxoids to and varicella vaccine provide protection against these agents.