Seroprevalence of Measles-, Mumps- and Rubella-Specific IgG Antibodies in German Children and Adolescents and Predictors for Seronegativity

Wednesday, 11th of December 2013

[source]PLoS One[|source]

Vaccinations with MMR within the first years of life may induce a shift of the incidence to older age groups. Therefore, sero-epidemiological surveys are highly important for the assessment of current gaps in seroprevalence of disease-specific antibodies and possible adjustment of national vaccination policies. In many countries, there exists no representative sero-epidemiological data on the seroprevalence of measles-, mumps- and rubella antibodies in children.

In this article, the authors describe MMR seroprevalence as a whole and calculate independent predictors for seronegativity for measles-, mumps- and rubella antibodies.  The study documents that seronegativity to measles antibodies in 10 to 17 year-olds seen in our study exceeded the WHO European Region target for measles elimination of <5%. The report also confirms that the proportion of MMR seronegative children was highest in the youngest age group and the proportion of an equivocal titre level was highest among adolescents. The authors confirm the obvious that seronegativity was highest in unvaccinated children and was above 5% in one-dose vaccinees. But most importantly, the authors dare in the territory of waning immunity as a cause of seronegativity. More details are available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412821/

Abstract

We have undertaken a seroprevalence study with more than 13,000 children, who had been included in the German KIGGS survey, a representative sample of children and adolescents 0–17 years of age. The IgG titres against measles, mumps and rubella were determined in 1 to 17 year olds While 88.8% of the children were MMR-vaccinated at least once, 76.8% of children aged 1 to 17 years showed prevalence of antibodies to MMR. The highest seronegativity was seen with respect to mumps. Gender differences were most pronounced with regard to rubella IgG titres: girls aged 14 to 17 years were best protected, although seronegativity in 6.8% of this vulnerable group still shows the need of improvement. Search for predictors of missing seroprevalence identified young age to be the most important predictor. Children living in the former West and children born outside of Germany had a higher risk of lacking protection against measles and rubella, while children with a migration background but born in Germany were less often seronegative to measles antibodies than their German contemporaries. An association of seronegativity and early vaccination was seen for measles but not for mumps and rubella. A high maternal educational level was associated with seronegativity to measles and rubella. In vaccinated children, seronegativity was highest for mumps and lowest for rubella. For mumps, high differences were observed for seronegativity after one-dose and two-dose vaccination, respectively. Seronegativity increases as time since last vaccination passes thus indicating significant waning effects for all three components of MMR.