Age-specific prevalence of IgG against measles/rubella and the impact of routine and supplementary immunization activities: A multistage random cluster sampling study with mathematical modelling

Int J Infect Dis. 2024 Jul:144:107053. doi: 10.1016/j.ijid.2024.107053. Epub 2024 Apr 17.

Abstract

Background: Vietnam continues to have measles and rubella outbreaks following supplementary immunization activities (SIA) and routine immunization despite both having high reported coverage. To evaluate immunization activities, age-specific immunity against measles and rubella, and the number of averted Congenital Rubella Syndrome (CRS) cases, must be estimated.

Methods: Dried blood spots were collected from 2091 randomly selected individuals aged 1-39 years. Measles and rubella virus-specific immunoglobulin G (IgG) were measured by enzyme immunoassay. Results were considered positive at ≥120 mIU/mL for measles and ≥10 IU/mL for rubella. The number of CRS cases averted by immunization since 2014 were estimated using mathematical modelling.

Results: Overall IgG seroprevalence was 99.7% (95%CI: 99.2-99.9) for measles and 83.6% (95%CI: 79.3-87.1) for rubella. Rubella IgG seroprevalence was higher among age groups targeted in the SIA than in non-targeted young adults (95.4% [95%CI: 92.9-97.0] vs 72.4% [95%CI: 63.1-80.1]; P < 0.001). The estimated number of CRS cases averted in 2019 by immunization activities since 2014 ranged from 126 (95%CI: 0-460) to 883 (95%CI: 0-2271) depending on the assumed postvaccination reduction in the force of infection.

Conclusions: The results suggest the SIA was effective, while young adults born before 1998 who remain unprotected for rubella require further vaccination.

Keywords: IgG prevalence; Mathematical modelling; Measles-rubella combined vaccine; Representative population; Serosurvey.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antibodies, Viral* / blood
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immunization Programs
  • Immunoglobulin G* / blood
  • Infant
  • Male
  • Measles Vaccine / administration & dosage
  • Measles Vaccine / immunology
  • Measles* / epidemiology
  • Measles* / immunology
  • Measles* / prevention & control
  • Models, Theoretical
  • Prevalence
  • Rubella Syndrome, Congenital / epidemiology
  • Rubella Syndrome, Congenital / immunology
  • Rubella Syndrome, Congenital / prevention & control
  • Rubella Vaccine / administration & dosage
  • Rubella Vaccine / immunology
  • Rubella virus / immunology
  • Rubella* / epidemiology
  • Rubella* / immunology
  • Rubella* / prevention & control
  • Seroepidemiologic Studies
  • Vaccination
  • Young Adult

Substances

  • Immunoglobulin G
  • Antibodies, Viral
  • Rubella Vaccine
  • Measles Vaccine