The state of specific immunity of population of the Republic of Tajikistan to measles, rubella, poliomyelitis viruses

Abstract

Relevance. To achieve the goals of measles and rubella elimination and poliomyelitis eradication programs, immunization coverage of at least 95% of the target population is required. Objective data on the state of specific herd immunity are provided only by the results of serosurveys. In the Republic of Tajikistan, such monitoring is not carried out regularly. Therefore, the purpose of the study was to assess the actual state of the specific herd immunity to measles, rubella, and poliomyelitis viruses.
 Materials and methods. The blood sera of 563 children and adults collected in 7 cities and 13 districts of Tajikistan in 2020 were investigated. The level of antibodies (ABs) to measles and rubella viruses was determined using enzyme immunoassay. Test systems VectoKor-IgG (VECTOR-BEST, Russia) and Ecolab, Russia were used to determine ABs to measles and rubella virus, respectively. Neutralizing antibodies (nABs) to the 3 types of poliovirus (PV) were determined in 359 sera using a neutralization reaction with Sabin strains of types 1, 2, 3.
 Results. The conducted serosurvey showed the level of the specific herd immunity to rubella to be 87.9% in total population, including 86.2% in children, 93.1% in adolescents, and 93.5% and adults, that is sufficient to prevent transmission of the rubella virus. The proportion of individuals seropositive to measles was 54.5%, which is not enough to prevent sustained secondary transmission of infection and the resumption of circulation of the endemic strain of measles virus. The children under 15 years of age should be considered a population at risk of the infection, since children accounted for 38% among seronegative individuals.
 In general, less than 95% of the examined patients had nABs to PV: 94.4% to PV1, 86.1% to PV2, 83.6% to PV3; 3.3% did not have antibodies to all three types of PV. The level of herd immunity varied in the examined groups depending on the vaccination schedule and the composition of the poliovirus vaccines used: nABs to PV2 had 59.6% of children born during the period when vaccines containing PV2 were not used, and 85.7% of children born after the introduction of trivalent IPV. Deficiency in immunity to PV2 was the cause of a polio outbreak in 2021 caused by circulating vaccine-derived PV type 2.
 Conclusion. A high level of humoral immunity to the rubella virus was determined. Shortcomings of routine immunization against measles and polio associated with insufficient coverage and lack of IPV have been identified. Conducting regular serological monitoring in the Republic of Tajikistan is advisable to obtain objective information about the level of herd immunity, identify vulnerable groups of the population, and plan additional immunization activities.