Voluntary termination of pregnancy: An opportunity for Measles, Mumps and Rubella vaccination in an Italian healthcare local unit

Abstract

In Italy, the National Plan for the Elimination of Measles and Congenital Rubella 2010–15 suggests offering Measles, Mumps and Rubella (MMR) vaccination to susceptible women who underwent voluntary termination of pregnancy (VTP) In Rome, S. Eugenio Hospital is one of the structures where VTP is practised in an Operative Unit called “Family Planning” The primary goal of this study was to estimate the prevalence of susceptibility to rubella, using IgG and IgM immunoassays, among women accessing VTP and to offering MMR vaccination to susceptible women. Secondarily, this study evaluated acceptance of the vaccination offer From 2013 to 2015, data were collected from 1513 voluntary termination of pregnancy (VTP) cases The results show a significant increase of 5 percent in susceptibility prevalence in the target group from 13.6% in 2013 and 2014 to 18.4% in 2015 The association between rubella susceptibility and age was statistically significant (p<0.01) Throughout the entire period, acceptance of the vaccine proposal was 19% (45/232) among susceptible women; 58% (135/232) refused the vaccine and 23% (52/232) took time to think about it This study shows an increase of 5 percent in the prevalence of rubella susceptibility over two years. This result is worrying, even considering the short span of the data collection The rate of acceptance of vaccination is unsatisfactory considering the possibility of future pregnancies This issue deserves continued action, which, going forward, might transform a “project” into a shared strategy as part of a wider network with the goal of aligning Italy with international recommendations.

Rubella serosurvey and factors related to vaccine hesitancy in childbearing women in Italy

“…The achieved prevalence of rubella susceptibility in this study confirmed data of a recent meta-analysis (Pandolfi et al, 2017) showing that, at a global level, the proportion of rubella-susceptible childbearing women is still high. The higher susceptibility to rubella among women born in Italy confirmed previous Italian reports focused on wVTP (Pettinicchio et al, 2018) and continues to show a dramatically higher susceptibility rates when compared to women born in other European countries, especially if mEPP (Vilajeliu et al, 2015).…”

“…Voluntary termination of pregnancy (VTP), pre-conception and post-partum phases (Hisano et al, 2016), as well as Occupational Medicine assessments for healthcare workers were deemed to be opportunities for screening and vaccinating rubella seronegative women of childbearing potential. However, data about vaccination acceptance following these phases is rarely reported or considered suboptimal (Little et al, 2015; Pettinicchio et al, 2018; Santoro et al, 2016). In spite of implementation of several immunisation strategies, as in-hospital vaccination before discharge or active calls by public health services, anti-rubella vaccination rates following VTP in Italy have been considered worrying and widely unsatisfactory (Pettinicchio et al, 2018).…”

“…However, data about vaccination acceptance following these phases is rarely reported or considered suboptimal (Little et al, 2015; Pettinicchio et al, 2018; Santoro et al, 2016). In spite of implementation of several immunisation strategies, as in-hospital vaccination before discharge or active calls by public health services, anti-rubella vaccination rates following VTP in Italy have been considered worrying and widely unsatisfactory (Pettinicchio et al, 2018). Italian surveillance data from 2005 to 2013 reported 75 cases of congenital rubella infection and 160 cases of rubella infection in pregnancy, highlighting a probable underestimation due to unclassified newborns and women lost to follow-up (Giambi et al, 2015).…”

Complications and Management of Asymptomatic Patients with Measles Infection During Pregnancy

“…Transmission of measles virus from a pregnant woman to her fetus (congenital measles) has been reported in neonates born to women who had measles within 10 days of delivery 25,26 . Congenital measles is defined as presence of the rash at birth or VOLUME 18 ISSUE 2, APRIL-JUNE 2019…”