The Susceptibility of Young Adult Americans to Vaccine-Preventable Infections

Abstract

Patients.\p=m-\The study included 1547 US Army recruits who were inducted during September and October 1989. Outcome Measures.\p=m-\Seronegativityby various demographic factors. Results.\p=m-\Seronegativity rates, directly adjusted to the 15to 24-year-old US population in 1980, were 20.7% for measles, 15.6% for mumps, 17.5% for rubella, and 6.9% for varicella. For measles, mumps, and rubella, susceptibility was less in females, blacks, and college-educated recruits, and varicella susceptibility was greater in females and blacks. Recruits who were born after 1969 lacked measles, mumps, and rubella antibodies more often than older recruits. The adjusted seronegativity rates for poliovirus types 1, 2, and 3 were 2.3%, 0.6%, and 14.6%, respectively; trends by age, sex, and race-ethnicity were generally unremarkable.Conclusions.\p=m-\Amongyoung adult Americans, susceptibility to measles, mumps, and rubella is unevenly distributed and may be substantial. Our findings support national objectives to further improve immunization coverage in schoolage and adult populations and provide further impetus for legislation requiring college entrants to present evidence of having received at least two doses of measles vaccine, with one on or after entry into elementary school.

Varicella-Related Hospitalization and Emergency Department Visit Rates, Before and After Introduction of Varicella Vaccine, Among White and Black Children in Hamilton County, Ohio

“…Both national 27 and military [28][29][30] seroprevalence studies showed higher rates of varicella susceptibility among black subjects, compared with white subjects, for all age groups studied. Although the reasons for these findings are not well understood, one possible explanation may be the difference in child care center use for black children, compared with white children.…”

“…26 Racial disparities in varicella disease rates and susceptibility were described in several studies that examined disease rates before vaccine licensure. 13,14,[19][20][21][27][28][29][30] In military populations, there were significantly greater rates of varicella among black adults, compared with white adults, before vaccine licensure. [19][20][21] Similar findings were reported from an analysis of data for a managed care population 14 and from an analysis of Connecticut state hospital discharge data.…”

Age-related changes in serological susceptibility patterns to measles

“…Similarly, Kelley et al conducted a national serological survey of US Army recruits and found lower susceptibility to measles in women. 18 Hutchins et al reported that among persons born in the vaccine era, male sex was an independent predictor of measles susceptibility. 19 The higher seropositivity in women might be partly due to sex differences in the humoral antibody response to measles vaccine.…”

National serosurvey of poliovirus immunity in Australia, 1996–99

“…14 However, using the latter method, a serosurvey of preschool children from the US in the early 1990s reported a similar proportion of seropositive subjects to that in our preschool-aged group, 15 whereas a more recent (1997) US study of preschoolers found seropositivity levels of ≥94%, 16 and a study of US army recruits aged 17 to 23 years found 97% seropositive to type 1, 99% to type 2 and 87% to type 3. 17 The correlation between cut-off antibody titre, test method and protective immunity is uncertain, but a method with less sensitivity and greater specif icity should provide a more conservative estimate of immunity than a highly sensitive, less specific method. Serosurveys cannot easily be compared between different laboratories, but are useful to identify differences in seroprevalence in different age groups and monitor changes, in the same population, if the method remains constant.…”