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Antibody Levels at 3-Years Follow-Up of a Third Dose of Measles-Mumps-Rubella Vaccine in Young Adults. Vaccines (Basel) 2022; 10:vaccines10010132. [PMID: 35062794 PMCID: PMC8781586 DOI: 10.3390/vaccines10010132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 02/01/2023] Open
Abstract
Mumps outbreaks and breakthrough infections of measles and rubella have raised concerns about waning of vaccine-induced immunity after two doses of measles-mumps-rubella (MMR) vaccination. In the present follow-up study, serum IgG antibodies against mumps, measles and rubella, as well as the functional neutralizing antibodies against both the mumps vaccine strain and mumps outbreak strains were measured longitudinally in young adults that received a third MMR (MMR3) dose. The mumps-specific IgG and virus neutralizing antibody levels at 3 years after vaccination were still elevated compared to pre-vaccination antibody levels, although the differences were smaller than at earlier timepoints. Interestingly, subjects with low antibody levels to mumps before vaccination benefited the most as they showed the strongest antibody increase after an MMR3 dose. Three years after an MMR3 dose, all subjects had antibody levels to measles and rubella above the internationally agreed antibody cutoff levels for clinical protection. Our data support the recommendation that an MMR3 dose may provide additional protection for those that have become susceptible to mumps virus infection during outbreaks. MMR3 also resulted in an increase in anti-measles and rubella antibody levels that lasted longer than might have been expected.
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Fournet N, Mollema L, Ruijs WL, Harmsen IA, Keck F, Durand JY, Cunha MP, Wamsiedel M, Reis R, French J, Smit EG, Kitching A, van Steenbergen JE. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews. BMC Public Health 2018; 18:196. [PMID: 29378545 PMCID: PMC5789742 DOI: 10.1186/s12889-018-5103-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/19/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite effective national immunisation programmes in Europe, some groups remain incompletely or un-vaccinated ('under-vaccinated'), with underserved minorities and certain religious/ideological groups repeatedly being involved in outbreaks of vaccine preventable diseases (VPD). Gaining insight into factors regarding acceptance of vaccination of 'under-vaccinated groups' (UVGs) might give opportunities to communicate with them in a trusty and reliable manner that respects their belief system and that, maybe, increase vaccination uptake. We aimed to identify and describe UVGs in Europe and to describe beliefs, attitudes and reasons for non-vaccination in the identified UVGs. METHODS We defined a UVG as a group of persons who share the same beliefs and/or live in socially close-knit communities in Europe and who have/had historically low vaccination coverage and/or experienced outbreaks of VPDs since 1950. We searched MEDLINE, EMBASE and PsycINFO databases using specific search term combinations. For the first systematic review, studies that described a group in Europe with an outbreak or low vaccination coverage for a VPD were selected and for the second systematic review, studies that described possible factors that are associated with non-vaccination in these groups were selected. RESULTS We selected 48 articles out of 606 and 13 articles out of 406 from the first and second search, respectively. Five UVGs were identified in the literature: Orthodox Protestant communities, Anthroposophists, Roma, Irish Travellers, and Orthodox Jewish communities. The main reported factors regarding vaccination were perceived non-severity of traditional "childhood" diseases, fear of vaccine side-effects, and need for more information about for example risk of vaccination. CONCLUSIONS Within each UVG identified, there are a variety of health beliefs and objections to vaccination. In addition, similar factors are shared by several of these groups. Communication strategies regarding these similar factors such as educating people about the risks associated with being vaccinated versus not being vaccinated, addressing their concerns, and countering vaccination myths present among members of a specific UVG through a trusted source, can establish a reliable relationship with these groups and increase their vaccination uptake. Furthermore, other interventions such as improving access to health care could certainly increase vaccination uptake in Roma and Irish travellers.
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Affiliation(s)
- N. Fournet
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - L. Mollema
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1 (internal P.O. Box 75), 3720 BA Bilthoven, the Netherlands
| | - W. L. Ruijs
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - I. A. Harmsen
- Municipal Health Service (GGD) Amsterdam, Amsterdam, The Netherlands
| | - F. Keck
- Laboratoire d’anthropologie sociale - Centre National de la Recherche Scientifique, Paris, France
| | - J. Y. Durand
- Centre for Research in Anthropology, Universidade do Minho (CRIA - UMinho), Braga, Portugal
| | - M. P. Cunha
- Centre for Research in Anthropology, Universidade do Minho (CRIA - UMinho), Braga, Portugal
| | - M. Wamsiedel
- Department of Public Health at Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - R. Reis
- Leiden University Medical Centre, Leiden, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- The Children’s Institute, University of Cape Town, Cape Town, South Africa
| | - J. French
- Strategic Social Marketing, Liphook, UK
- Brighton University Business School, Brighton, UK
| | - E. G. Smit
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - A. Kitching
- Department of Public Health, Health Service Executive, St Finbarr’s Hospital, Cork, Republic of Ireland
| | - J. E. van Steenbergen
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
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Wilson SE, Seo CY, Lim GH, Fediurek J, Crowcroft NS, Deeks SL. Trends in medical and nonmedical immunization exemptions to measles-containing vaccine in Ontario: an annual cross-sectional assessment of students from school years 2002/03 to 2012/13. CMAJ Open 2015; 3:E317-23. [PMID: 26457292 PMCID: PMC4596119 DOI: 10.9778/cmajo.20140088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Under Ontario legislation, for select vaccine-preventable diseases nonimmunized or under-immunized students must undergo vaccination or provide a statement of exemption, or risk suspension from school. At the time of this assessment, these diseases included measles, mumps, rubella, diphtheria, tetanus and polio. METHODS Exemptions data for the school years 2002/03 to 2012/13 were obtained from the Immunization Records Information System used in Ontario. Temporal trends were expressed for 7- and 17-year-old students by exemption classification (medical, prior immunity, religious or conscientious belief, total) at the provincial level, by school year and by birth cohort. Regional analysis was conducted for the 2012/13 school year. A temporal trend analysis of exemptions for measles-containing vaccines was performed by using a Poisson distribution with a 2-sided test (α = 5%). RESULTS For both 7- and 17-year-old students, religious or conscientious exemptions for measles-containing vaccines significantly increased over the study period (p < 0.001 in both age groups), whereas medical exemptions decreased (p < 0.001 in both age groups). The trends were reproduced when examined by birth cohort. The percentage of Ontario students with any exemption classification (total exemptions) remained low (< 2.5%) during the study period, although considerable geographic variation was noted. INTERPRETATION Ontario data suggest that nonmedical exemptions have increased during the last 11 years, consistent with trends reported elsewhere. The trend toward increasing religious or conscientious exemptions coupled with declining medical exemptions explains why total exemptions have remained stable or decreased at the provincial level. The prominent geographic variability in exemptions suggests that targeted interventions may be suitable for consideration.
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Affiliation(s)
- Sarah E Wilson
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
| | - Chi Yon Seo
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
| | - Gillian H Lim
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
| | - Jill Fediurek
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
| | - Natasha S Crowcroft
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
| | - Shelley L Deeks
- Public Health Ontario (Wilson, Seo, Lim, Fediurek, Crowcroft, Deeks), Toronto, Ont.; Dalla Lana School of Public Health (Wilson, Crowcroft, Deeks); Department of Laboratory Medicine and Pathobiology (Crowcroft), University of Toronto, Toronto, Ont
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Timen A, Hulscher ME, Rust L, van Steenbergen JE, Akkermans RP, Grol RP, van der Meer JW. Barriers to implementing infection prevention and control guidelines during crises: experiences of health care professionals. Am J Infect Control 2010; 38:726-33. [PMID: 20605262 PMCID: PMC7132712 DOI: 10.1016/j.ajic.2010.03.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 03/03/2010] [Accepted: 03/03/2010] [Indexed: 11/23/2022]
Abstract
Background Communicable disease crises can endanger the health care system and often require special guidelines. Understanding reasons for nonadherence to crisis guidelines is needed to improve crisis management. We identified and measured barriers and conditions for optimal adherence as perceived by 4 categories of health care professionals. Methods In-depth interviews were performed (n = 26) to develop a questionnaire for a cross-sectional survey of microbiologists (100% response), infection preventionists (74% response), public health physicians (96% response), and public health nurses (82% response). The groups were asked to appraise barriers encountered during 4 outbreaks (severe acute respiratory syndrome [SARS], Clostridium difficile ribotype 027, rubella, and avian influenza) according to a 5-point Likert scale. When at least 33% of the participants responded “strongly agree,” “agree,” or “rather agree than disagree,” a barrier was defined as “often experienced.” The common (“generic”) barriers were included in a univariate and multivariate model. Barriers specific to the various groups were studied as well. Results Crisis guidelines were found to have 4 generic barriers to adherence: (1) lack of imperative or precise wording, (2) lack of easily identifiable instructions specific to each profession, (3) lack of concrete performance targets, and (4) lack of timely and adequate guidance on personal protective equipment and other safety measures. The cross-sectional study also yielded profession-specific sets of often-experienced barriers. Conclusion To improve adherence to crisis guidelines, the generic barriers should be addressed when developing guidelines, irrespective of the infectious agent. Profession-specific barriers require profession-specific strategies to change attitudes, ensure organizational facilities, and provide an adequate setting for crisis management.
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Parkins MD, McNeil SA, Laupland KB. Routine immunization of adults in Canada: Review of the epidemiology of vaccine-preventable diseases and current recommendations for primary prevention. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2009; 20:e81-90. [PMID: 20808459 PMCID: PMC2770305 DOI: 10.1155/2009/474035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 12/08/2008] [Indexed: 01/23/2023]
Abstract
Vaccination is one of the greatest achievements in public health of the 20th century. However, the success of vaccine uptake and adherence to immunization guidelines seen in pediatric populations has not been observed among adult Canadians. As a result of the disparity in susceptibility to vaccine-preventable disease, there has been an increasing shift of vaccine-preventable childhood diseases into adult populations. Accordingly, morbidity and mortality due to vaccine-preventable illnesses now occur disproportionately in adults. All Canadians, irrespective of age, should have immunity to measles, mumps, rubella, tetanus, diphtheria, pertussis and varicella. All adult Canadians with significant medical comorbidities or those older than 65 years of age should receive the pneumococcal polysaccharide vaccine and yearly trivalent inactivate influenza vaccines. The present review summarizes the burden of illness of these vaccine-preventable diseases in the Canadian adult population and reviews the current immunization recommendations. Vaccination of all Canadians to these common agents remains a vital tool to decrease individual morbidity and mortality and reduce the overall burden of preventable disease in Canada.
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Affiliation(s)
| | - Shelly A McNeil
- Canadian Centre for Vaccinology
- Department of Medicine
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia
| | - Kevin B Laupland
- Department of Medicine, University of Calgary, Calgary, Alberta
- Department of Critical Care Medicine
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta
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