Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles mumps and rubella vaccination.

Wednesday, 25th of May 2016

PLoS One. 2014 Feb 20;9(2):e89361. doi: 10.1371/journal.pone.0089361. eCollection 2014.

Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles mumps and rubella vaccination.

Wang Z¹ Yan R¹ He H¹ Li Q¹ Chen G² Yang S³ Chen E¹.

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Abstract

BACKGROUND:

The reported coverage of the measles-rubella (MR) or measles-mumps-rubella(MMR) vaccine is greater than 99.0% in Zhejiang province. However the incidence of measles mumps and rubella remains high. In this study we assessed MMR seropositivity and disease distribution by age on the basis of the current vaccination program wherein the first dose of MR is administered at 8 months and the second dose of MMR is administered at 18-24 months.

METHODS:

Cross-sectional serological surveys of MMR antibodies were conducted by collecting epidemiological data in Zhejiang province China in 2011. In total 1015 participants were randomly selected from two surveillance sites. Serum MMR-specific immunoglobulin G levels were tested by enzyme-linked immunosorbent assay. The geometric mean titers and seroprevalence with 95% confidence intervals (CIs) were calculated by age and gender. Proportions of different dose of vaccine by age by vaccine were also identified. Statistically significant differences between categories were assessed by the Chi-square test.

RESULTS:

Over 95% seroprevalence rates of measles were seen in all age groups except <7 months infants. Children aged 5-9 years were shown lower seropositivity rates of mumps while elder adolescences and young adults were presented lower rubella seroprevalence. Especially rubella seropositivity was significantly lower in female adults than in male. Nine measles cases were unvaccinated or unknown vaccination history. Among them 66.67% (6/9) patients were aged 20-29 years while 33.33% (3/9) were infants aged 8-12 months. In addition 57.75% (648/1122) patients with mumps were children aged 5-9 years and 50.54% (94/186) rubella cases were aged 15-39 years.

CONCLUSIONS:

A timely two-dose MMR vaccination schedule is recommended with the first dose at 8 months and the second dose at 18-24 months. An MR vaccination speed-up campaign may be necessary for elder adolescents and young adults particularly young females.