Seroprevalence and durability of rubella virus antibodies in a highly immunized population

Abstract

Background: Although the administration of the measles-mumps-rubella (MMR) vaccine has been widespread in the United States for decades, gaps in vaccine coverage still persist for various reasons. The maintenance of herd immunity against rubella virus (RV) is important to controlling the spread and resurgence of rubella and congenital rubella syndrome. Methods: In this study, we sought to assess the seroprevalence of RV-specific antibodies in an adult population from a defined geographic area in Olmsted County, MN, and the surrounding municipalities, with relatively high vaccine coverage and no documented evidence of circulating RV in the past 24 years. Rubella-specific IgG antibodies were measured by ELISA in a large set of serum samples (n=1,393) obtained from the Mayo Clinic Biobank. This cohort was 80.2% female and ranged from 20-44 years of age. Results: In total, 97.8% of subjects were seropositive for rubella-specific IgG antibodies, with a median titer of 40.56 IU/mL, suggesting a high degree of immunization; however, 2.2% of subjects were found to be seronegative. Interestingly, 25.1% of subjects were seropositive but had titers lower than 25 IU/mL, indicating either a population of low responders or individuals that could potentially be at risk of waning immunity. No significant associations or differences were found between RV-specific titers and demographic variables such as age, sex, or body mass index (BMI). Conclusions: A high rate of seropositivity for rubella was found among this young adult cohort, but a significant percent of the cohort had lower titers that may indicate poor initial vaccine response and potential risk if their antibody titers decline.

Transcriptional signatures associated with rubella virus‐specific humoral immunity after a third dose of MMR vaccine in women of childbearing age

“…The methods described below are similar or identical to those published for our previous studies [13,15,16,18,19,[61][62][63][64].…”

“…Although rubella vaccine is effective for the majority of the population, data from the literature reveal sub-optimal long-term immunity and antibody titers below the level of protection (antibody titer <10 IU/mL) in a number of vaccinated subjects (ranging from 2 to 17%) who have received one or more doses of rubella-containing vaccine [4][5][6][7][8][9][10][11][12][13][14][15][16]. These findings suggest antibody waning and may indicate an increased subsequent risk for rubella among adolescents and adults (including women of childbearing age) years after vaccination.…”

Measles, mumps, rubella prevention: how can we do better?

“…Waning immunity for measles has been well-established in HIV-infected children, in particular if antiretroviral therapy has been interrupted [88]. For rubella, previous studies have shown that following two doses of MMR vaccine during childhood, the seropositivity rates remained high in young adults but antibody concentrations declined below protective levels in some individuals, which could have implications for the prevention of rubella in pregnancy [157][158][159].…”

Rising Incidence of Rubella among Patients With Febrile Rash Illness in a South Western State of Nigeria: a Ten Year Review

“…Many countries of the world have introduced Rubella vaccine (which is a Live attenuated virus vaccine) into their routine immunization programs and some have made the measlesmumps -rubella (MMR) vaccines readily available to protect their population, especially females of childbearing age against this infection. This has led to Rubella been verified as eliminated in the whole region of the Americas in 2015 6,10 .…”

“…Prevention of Rubella through vaccination is still largely unavailable in Africa. As at June 2017, only 18 countries in Africa have introduced Rubella containing vaccines (RCV) into their Routine immunization programs 10 as against only two in 2010 2 . However, Nigeria being the most populous country in Africa has not introduced Rubella vaccine into its immunization program but with the support of WHO, nationwide Rubella surveillance has been set up simultaneously with the elimination-standard surveillance for measles for more than a decade.…”