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Li M, Zhang W, Zheng S, Guo J, He H, Ma Y, Huang Y, Feng Y, Ji C. A real-world study on the changing characteristics of measles antibodies in premature infants in China. Hum Vaccin Immunother 2024; 20:2338505. [PMID: 38599768 PMCID: PMC11008540 DOI: 10.1080/21645515.2024.2338505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
The waning of maternal antibodies may cause infants to lose protection against measles before receiving measles-containing vaccine (MCV). The aim of this study is to investigate the changing characteristics and influencing factors of measles antibodies in preterm infants (PT), and to provide scientific basis for optimizing MCV vaccination strategy of the target population. Blood samples were collected from PT and full-term infants (FT) at the chronological age (CA) of 3, 6, and 12 months. Measles antibodies were quantitatively detected by enzyme-linked immunosorbent assay. Demographic and vaccination information were both collected. Kruskal-Wallis rank sum test was used to compare the measles antibodies among different gestation age (GA) groups, and multiple linear regression was performed to identify the correlative factors for the antibodies. Measles antibodies of PT decreased significantly with age increasing before MCV vaccination. The positive rates of antibodies of PT were 10.80% and 3.30% at the age of 3 and 6 months, respectively (p < .001). At 12 months, the measles antibodies and seropositive rate in the infants who received MCV vaccination increased sharply (p < .001). Regression analyzes showed that the younger the GA or the older the age, the lower the antibodies at 3 months(p < .001,p = .018); while the lower measles antibody levels at 3 months and older age predicted the lower antibodies at 6 months(p < .001, p = .029). PT were susceptible to measles due to the low level of maternally derived antibodies before MCV vaccination. More efforts should be considered to protect the vulnerable population during their early postnatal life.
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Affiliation(s)
- Mingyan Li
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weiwei Zhang
- Department of Child Health Care, Maternal and Child Health Hospital of Changxing, Huzhou, China
| | - Shuangshuang Zheng
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junxia Guo
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hanqing He
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yongjun Ma
- Department of Pediatrics, Maternal and Child Healthcare Hospital Department of Shangyu, Shaoxing, China
| | - Yan Huang
- Department of Immunization Program, Center for Disease Control and Prevention of Shangyu, Shaoxing, China
| | - Yan Feng
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chai Ji
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Shah N, Ghosh A, Kumar K, Dutta T, Mahajan M. A review of safety and immunogenicity of a novel measles, mumps, rubella (MMR) vaccine. Hum Vaccin Immunother 2024; 20:2302685. [PMID: 38236022 PMCID: PMC10798359 DOI: 10.1080/21645515.2024.2302685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
Measles, mumps, and rubella (MMR) are highly infectious viral diseases affecting young children and have high secondary attack rates. Present MMR vaccines show consistent seroconversion rates for anti-measles and anti-rubella antibodies with variable responses for anti-mumps antibodies. Most common strains for MMR vaccines, currently available in India, are the Edmonston-Zagreb measles strain, Leningrad Zagreb (L-Z) mumps strain, and the RA 27/3 rubella strain. L-Z strain of mumps virus has been found to be associated with aseptic meningitis by different studies from different parts of the world including India. Recently, a novel freeze-dried MMR vaccine developed by Zydus Lifesciences (Zyvac MMR) contains Edmonston Zagreb measles strain, Hoshino mumps strain, and RA 27/3 rubella strain. The Hoshino strain is WHO approved and was found to induce interferon gamma production. This review article aims to provide a comprehensive appraisal of the data available on the safety and immunogenicity of the novel MMR vaccine.
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Affiliation(s)
- Nitin Shah
- Department of Peadiatrics, P.D Hinduja Hospital & Medical Research Centre, Mumbai, India
| | - Apurba Ghosh
- Department of Peadiatrics, Institute of Child Health, Kolkata, India
| | - Kishore Kumar
- Department of Peadiatrics, CloudNine Group of Hospitals, Bengaluru, India
| | - Trayambak Dutta
- Medical Affairs, Zydus Lifesciences Ltd., Zydus Corporate Park, Ahmedabad, India
| | - Manish Mahajan
- Medical Affairs, Zydus Lifesciences Ltd., Zydus Corporate Park, Ahmedabad, India
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Cordero DA. Another measles outbreak in the Philippines? The essentiality of a successful vaccination program and public cooperation. Hum Vaccin Immunother 2024; 20:2312605. [PMID: 38347437 PMCID: PMC10865919 DOI: 10.1080/21645515.2024.2312605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Affiliation(s)
- Dalmacito A. Cordero
- Department of Theology and Religious Education, De La Salle University, Manila, Philippines
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George MS, Dey RC, Kumar H, Khadka S, Singh P, Sánchez-Velazco DF, Khadka S, Manandhar S. Resurging measles in Armenia: unravelling challenges, implementing solutions. Public Health 2024; 230:e1-e2. [PMID: 38485532 DOI: 10.1016/j.puhe.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 04/16/2024]
Affiliation(s)
- M S George
- Yerevan State Medical University, Yerevan, Armenia.
| | - R C Dey
- Altai State Medical University, Barnaul, Russia.
| | - H Kumar
- Dow University of Health Sciences, Karachi, Pakistan.
| | - S Khadka
- College of Medical Sciences, Nepal.
| | - P Singh
- Faisalabad Medical University, University of Health Sciences, Faisalabad, Pakistan.
| | | | - S Khadka
- College of Medical Sciences, Nepal.
| | - S Manandhar
- Nepal Medical College, Kathmandu University, Nepal.
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Mathis AD, Raines K, Masters NB, Filardo TD, Kim G, Crooke SN, Bankamp B, Rota PA, Sugerman DE. Measles - United States, January 1, 2020-March 28, 2024. MMWR Morb Mortal Wkly Rep 2024; 73:295-300. [PMID: 38602886 PMCID: PMC11008791 DOI: 10.15585/mmwr.mm7314a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Measles is a highly infectious febrile rash illness and was declared eliminated in the United States in 2000. However, measles importations continue to occur, and U.S. measles elimination status was threatened in 2019 as the result of two prolonged outbreaks among undervaccinated communities in New York and New York City. To assess U.S. measles elimination status after the 2019 outbreaks and to provide context to understand more recent increases in measles cases, CDC analyzed epidemiologic and laboratory surveillance data and the performance of the U.S. measles surveillance system after these outbreaks. During January 1, 2020-March 28, 2024, CDC was notified of 338 confirmed measles cases; 97 (29%) of these cases occurred during the first quarter of 2024, representing a more than seventeenfold increase over the mean number of cases reported during the first quarter of 2020-2023. Among the 338 reported cases, the median patient age was 3 years (range = 0-64 years); 309 (91%) patients were unvaccinated or had unknown vaccination status, and 336 case investigations included information on ≥80% of critical surveillance indicators. During 2020-2023, the longest transmission chain lasted 63 days. As of the end of 2023, because of the absence of sustained measles virus transmission for 12 consecutive months in the presence of a well-performing surveillance system, U.S. measles elimination status was maintained. Risk for widespread U.S. measles transmission remains low because of high population immunity. However, because of the increase in cases during the first quarter of 2024, additional activities are needed to increase U.S. routine measles, mumps, and rubella vaccination coverage, especially among close-knit and undervaccinated communities. These activities include encouraging vaccination before international travel and rapidly investigating suspected measles cases.
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Affiliation(s)
- Adria D. Mathis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Kelley Raines
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Nina B. Masters
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Thomas D. Filardo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Gimin Kim
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen N. Crooke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Bettina Bankamp
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - David E. Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
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Liu J, Qi Q, Liu Y, Ni P, Zhan X, Bao Y, Li Y, Liu L, Yang Q, Liu Y, Zhang K. A paired measles-rubella catch-up campaign in Sichuan China to stop an outbreak and strengthen local immunization programs. Vaccine 2024; 42:2155-2160. [PMID: 38485639 DOI: 10.1016/j.vaccine.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND China has been working towards measles elimination, but in 2017, measles outbreaks occurred in Ganzi and Aba prefectures of Sichuan province, representing 95% of all provincial cases and jeopardizing measles elimination. METHODS During March and April 2017, high-performing prefectures were paired with outbreak and other interested counties to jointly conduct a measles-rubella (MR) catch-up campaign, build population immunity, and strengthen the counties' programs. RESULTS House-to-house search identified 88,383 children in Ganzi that lacked MCV vaccination; 85,144 (96.34%) were vaccinated. Search identified 33,683 children in Aba who were not vaccinated against measles; 33,074 (98.19%) were vaccinated. The supporting prefectures helped install Immunization Information Systems and enroll unvaccinated children into the immunization program.The outbreak ended within a month and incidence has remained low for the subsequent six years. CONCLUSION A paired catch-up campaign represents an effective model of using measles elimination strategies to strengthen local immunization programs for long-term program effectiveness.
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Affiliation(s)
- Jiajie Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China.
| | - Qi Qi
- Sichuan Center for Disease Control and Prevention, Chengdu, China.
| | - Yu Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Ping Ni
- Ganzi Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Ganzi, China
| | - Xuhua Zhan
- Aba Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Aba, China
| | - Ying Bao
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yinqiao Li
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Lijin Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Qing Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yi Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Kai Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
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7
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Zhang H, Patenaude B, Zhang H, Jit M, Fang H. Global vaccine coverage and childhood survival estimates: 1990-2019. Bull World Health Organ 2024; 102:276-287. [PMID: 38562199 PMCID: PMC10976869 DOI: 10.2471/blt.23.290129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To quantify the association between reduction in child mortality and routine immunization across 204 countries and territories from 1990 to 2019. Methods We used child mortality and vaccine coverage data from the Global Burden of Disease Study. We used a modified child survival framework and applied a mixed-effects regression model to estimate the reduction in deaths in children younger than 5 years associated with eight vaccines. Findings Between 1990 and 2019, the diphtheria-tetanus-pertussis (DTP), measles, rotavirus and Haemophilus influenzae type b vaccines were significantly associated with an estimated 86.9 (95% confidence interval, CI: 57.2 to 132.4) million fewer deaths in children younger than 5 years worldwide. This decrease represented a 24.2% (95% CI: 19.8 to 28.9) reduction in deaths relative to a scenario without vaccines. The DTP and measles vaccines averted 46.7 (95% CI: 30.0 to 72.7) million and 37.9 (95% CI: 25.4 to 56.8) million deaths, respectively. Of the total reduction in child mortality associated with vaccines, 84.2% (95% CI: 83.0 to 85.1) occurred in 73 countries supported by Gavi, the Vaccine Alliance, with an estimated 45.4 (95% CI: 29.8 to 69.2) million fewer deaths from 2000 to 2019. The largest reductions in deaths associated with these four vaccines were in India, China, Ethiopia, Pakistan and Bangladesh (in order of the size of reduction). Conclusion Vaccines continue to reduce childhood mortality significantly, especially in Gavi-supported countries, emphasizing the need for increased investment in routine immunization programmes.
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Affiliation(s)
- Haijun Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Bryan Patenaude
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - Haonan Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England
| | - Hai Fang
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
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8
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Gungor K, Bukavaz S, Ekuklu G. Measles outbreak in the adult age group: Clinical, laboratory, and epidemiological features of the 11 patients admitted to the hospital. J Med Virol 2024; 96:e29583. [PMID: 38576266 DOI: 10.1002/jmv.29583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024]
Abstract
The measles virus, also known as the morbillivirus, or MV, is a virus that infects humans. The goal of this research is to assess to adult cases of measles. Eleven patients thought to be confirmed cases of measles were enrolled in the investigation. Following the identification of symptoms of tiredness, fever, and rash in one soldier, the results of 10 more troops from the pertinent military group were assessed. The diagnosis was made based on the presence of serum immunoglobulin M (IgM) and positive polymerase chain reaction (PCR) results. When the control IgM, immunoglobulin G, and PCR findings were evaluated a fortnight after hospitalization, a cluster of 11 incidents was found. It is now necessary to address the issue of the cautious stance towards vaccination or the anti-vaccination sentiment that has grown increasingly popular, particularly in light of the COVID-19 pandemic, for both our nation and the entire world.
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Affiliation(s)
- Kultural Gungor
- Department of Infectious Diseases, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey
| | - Sebnem Bukavaz
- Health and Vocational School, Trakya University, Edirne, Turkey
| | - Galip Ekuklu
- Department of Public Health, Trakya University, Edirne, Turkey
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9
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Ly H. Measles disease outbreaks and vaccination impacting global public health. J Med Virol 2024; 96:e29593. [PMID: 38572935 DOI: 10.1002/jmv.29593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Hinh Ly
- Department of Veterinary & Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
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Thangaraj JWV, Prosperi C, Kumar MS, Hasan AZ, Kumar VS, Winter AK, Bansal AK, Chauhan SL, Grover GS, Jain AK, Kulkarni RN, Sharma SK, Soman B, Chaaithanya IK, Kharwal S, Mishra SK, Salvi NR, Sarmah NP, Sharma S, Varghese A, Sabarinathan R, Duraiswamy A, Rani DS, Kanagasabai K, Lachyan A, Gawali P, Kapoor M, Chonker SK, Sangal L, Mehendale SM, Sapkal GN, Gupta N, Hayford K, Moss WJ, Murherkar MV. Post-campaign coverage evaluation of a measles and rubella supplementary immunization activity in five districts in India, 2019-2020. PLoS One 2024; 19:e0297385. [PMID: 38551928 PMCID: PMC10980234 DOI: 10.1371/journal.pone.0297385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 01/04/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In alignment with the Measles and Rubella (MR) Strategic Elimination plan, India conducted a mass measles and rubella vaccination campaign across the country between 2017 and 2020 to provide a dose of MR containing vaccine to all children aged 9 months to 15 years. We estimated campaign vaccination coverage in five districts in India and assessed campaign awareness and factors associated with vaccination during the campaign to better understand reasons for not receiving the dose. METHODS AND FINDINGS Community-based cross-sectional serosurveys were conducted in five districts of India among children aged 9 months to 15 years after the vaccination campaign. Campaign coverage was estimated based on home-based immunization record or caregiver recall. Campaign coverage was stratified by child- and household-level risk factors and descriptive analyses were performed to assess reasons for not receiving the campaign dose. Three thousand three hundred and fifty-seven children aged 9 months to 15 years at the time of the campaign were enrolled. Campaign coverage among children aged 9 months to 5 years documented or by recall ranged from 74.2% in Kanpur Nagar District to 90.4% in Dibrugarh District, Assam. Similar coverage was observed for older children. Caregiver awareness of the campaign varied from 88.3% in Hoshiarpur District, Punjab to 97.6% in Dibrugarh District, Assam, although 8% of children whose caregivers were aware of the campaign were not vaccinated during the campaign. Failure to receive the campaign dose was associated with urban settings, low maternal education, and lack of school attendance although the associations varied by district. CONCLUSION Awareness of the MR vaccination campaign was high; however, campaign coverage varied by district and did not reach the elimination target of 95% coverage in any of the districts studied. Areas with lower coverage among younger children must be prioritized by strengthening the routine immunization programme and implementing strategies to identify and reach under-vaccinated children.
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Affiliation(s)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Muthusamy Santhosh Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Alvira Z. Hasan
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - V. Saravana Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Amy K. Winter
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Avi Kumar Bansal
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Sanjay L. Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | | | - Ragini N. Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | - Biju Soman
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Achutha Menon Centre for Health Science Studies, Trivandrum, Kerala, India
| | - Itta K. Chaaithanya
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Sanchit Kharwal
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Sunil K. Mishra
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Neha R. Salvi
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Nilanju P. Sarmah
- Department of Health Research, Model Rural Health Research Unit-Chabua, Assam, India
| | - Sandeep Sharma
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Adarsh Varghese
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Achutha Menon Centre for Health Science Studies, Trivandrum, Kerala, India
| | - R. Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Augustine Duraiswamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - D. Sudha Rani
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - K. Kanagasabai
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Abhishek Lachyan
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Poonam Gawali
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Mitali Kapoor
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Saurabh Kumar Chonker
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - Lucky Sangal
- World Health Organization, Southeast Asia Region Office, New Delhi, India
| | | | | | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Kyla Hayford
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William J. Moss
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Manoj V. Murherkar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
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11
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Mahase E. Measles: South Sudan reports 12 000 cases in three months. BMJ 2024; 384:q777. [PMID: 38548295 DOI: 10.1136/bmj.q777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
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12
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Thomas CM, Hartley A, Schmitz A, Reid HD, Sullivan S, Huebner E, Robinson M, Mathis A, Fill MMA, Levinson KJ, Jones TF, Schaffner W, Newhouse CN, Dunn JR. Implications of Measles Inclusion by Commercial Syndromic Polymerase Chain Reaction Panels - United States, May 2022-April 2023. MMWR Morb Mortal Wkly Rep 2024; 73:260-264. [PMID: 38547036 PMCID: PMC10986817 DOI: 10.15585/mmwr.mm7312a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Syndromic polymerase chain reaction (PCR) panels are used to test for pathogens that can cause rash illnesses, including measles. Rash illnesses have infectious and noninfectious causes, and approximately 5% of persons experience a rash 7-10 days after receipt of a measles, mumps, and rubella (MMR) vaccine. MMR vaccine includes live attenuated measles virus, which is detectable by PCR tests. No evidence exists of person-to-person transmission of measles vaccine virus, and illness does not typically result among immunocompetent persons. During September 2022-January 2023, the Tennessee Department of Health received two reports of measles detected by syndromic PCR panels. Both reports involved children (aged 1 and 6 years) without known risk factors for measles, who were evaluated for rash that occurred 11-13 days after routine MMR vaccination. After public health responses in Tennessee determined that both PCR panels had detected measles vaccine virus, six state health departments collaborated to assess the frequency and characteristics of persons receiving a positive measles PCR panel test result in the United States. Information was retrospectively collected from a commercial laboratory testing for measles in syndromic multiplex PCR panels. During May 2022-April 2023, among 1,548 syndromic PCR panels, 17 (1.1%) returned positive test results for measles virus. Among 14 persons who received a positive test result and for whom vaccination and case investigation information were available, all had received MMR vaccine a median of 12 days before specimen collection, and none had known risk factors for acquiring measles. All positive PCR results were attributed to detection of measles vaccine virus. Increased awareness among health care providers about potential measles detection by PCR after vaccination is needed. Any detection of measles virus by syndromic PCR testing should be immediately reported to public health agencies, which can use measles vaccination history and assessment of risk factors to determine the appropriate public health response. If a person recently received MMR vaccine and has no risk factors for acquiring measles, additional public health response is likely unnecessary.
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13
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Samel-Kowalik P, Jankowski M, Tomaszewska A, Sobeczek K, Rakocy K, Samoliński BK, Gujski M, Pinkas J, Vatsenko A, Raciborski F. A national registry-based study on uptake of the first dose of MMR vaccine in 380 administrative regions in Poland, 2013-2016-2020. Ann Agric Environ Med 2024; 31:65-71. [PMID: 38549478 DOI: 10.26444/aaem/172887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION AND OBJECTIVE Regular monitoring of the measles, mumps, and rubella (MMR) vaccine uptake quickly exposes immunity gaps in the population. In Poland, the first dose of the MMR vaccine is mandatory for children between 13 and 15 months of life. This study aimed to assess the uptake of the first dose of MMR vaccine in 380 administrative counties in Poland in 2020, as well as to analyze the MMR vaccine uptake trends in 2013-2016-2020. MATERIAL AND METHODS This study is an epidemiological retrospective national registry-based analysis. Data on mandatory childhood vaccinations in all 380 counties in Poland were collected from the epidemiological reports of the State Sanitary Inspectorate territorial representatives. MMR vaccine uptake was calculated as the percentage of children who received the first dose of MRR vaccine to all children subject to mandatory vaccination in the county. RESULTS The uptake of the first dose of MMR vaccine decreased from 99.4% in 2013, to 95.5% in 2016 and 91.9% in 2020. In 2013, 93.2% of countys MMR vaccine uptake level reached the herd immunity level, followed by 77.1% of counties in 2016 and only 38.3% of countys in 2020. In 2020, two counties reached complete (100%) MMR vaccine uptake, and the lowest MMR vaccine uptake was 63.88%. Of the 380 counties in Poland, in 226 (61.1%) the MMR vaccine uptake level was lower than the herd immunity level, and a downward trend was observed. MMR vaccine uptake decreased with an increased number of residents in a county (r= -0.35; p<0.001). CONCLUSIONS This study revealed that in 61% of administrative regions in Poland, the MMR vaccine uptake was below the herd immunity level. Regional differences in the MMR vaccine uptake were observed. A significant decrease in MMR vaccine uptake between 2013 - 2020 poses a risk of measles outbreaks.
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Affiliation(s)
- Piotr Samel-Kowalik
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Aneta Tomaszewska
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Karolina Sobeczek
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | | | | | - Mariusz Gujski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University, Warsaw, Poland
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Helou M, Mouawad Y, El Ters F, Husni R. Measles Outbreak in Lebanon: July 2023. Disaster Med Public Health Prep 2024; 18:e49. [PMID: 38525826 DOI: 10.1017/dmp.2024.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
After the beginning of the Syrian crisis, increased rates of infectious diseases were reported. Lebanon, a neighboring country with a major socioeconomic crisis, witnessed a measles outbreak since July 2023, with 519 reported suspected cases. Half of the cases were under 5 y of age, most of them were unvaccinated. The mass displacement of refugees from conflict areas in Syria to Lebanon and the low vaccination coverage have made the situation more challenging. Further efforts are required in Lebanon to address identified gaps to prevent or at least better control future outbreaks.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Yara Mouawad
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Fadi El Ters
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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Abstract
Some organisations make vaccination a condition of employment. This means prospective employees must demonstrate they have been vaccinated (eg, against measles) to be hired. But it also means organisations must decide whether existing employees should be expected to meet newly introduced vaccination conditions (eg, against COVID-19). Unlike prospective employees who will not be hired if they do not meet vaccination conditions, existing employees who fail to meet new vaccination conditions risk being fired The latter seems worse than the former. Hence, objections to vaccination mandates commonly centre on the harms that will be visited on existing employees who are unwilling to be vaccinated. However, because this objection does not necessarily entail the claim that vaccination is unnecessary for the effective and safe performance of certain jobs, those making this objection should have less of an objection, or no objection at all (at least on these grounds), to introducing vaccination requirements in some cases for prospective employees. Yet, in this paper, I shall argue that if one has reason to believe vaccination requirements can be justified for prospective employees, one should also believe they are justified for existing employees despite any asymmetry in consequences experienced by the two groups. As a consequence, common objections made against vaccination mandates grounded solely in the harms that may be experienced by existing employees who are unwilling to be vaccinated should be considered unpersuasive.
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Affiliation(s)
- Maxwell J Smith
- Faculty of Health Sciences, Western University, London, Ontario, Canada
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16
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Rockson Adjei M, Longsignikuu A, Saeed Iddris I, Nang Suuri T, Asamoah B, Okoye M, Vanessa Baafi J, Kubio C, Ohene SA, Peter Grobusch M. Trend of measles-rubella vaccination coverage and impact on measles epidemiology in the Savannah Region, Ghana; 2018-2022: A secondary data analysis. Vaccine 2024; 42:1910-1917. [PMID: 38365480 DOI: 10.1016/j.vaccine.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Ghana witnessed an outbreak of measles in 2022 following the COVID-19 pandemic, and Savannah Region was among the regions severely impacted. The objective of this study was to conduct trend analysis of measles case incidence and measles-rubella (MR) vaccination coverage in the Savannah Region to identify gaps and propose remedial actions to mitigate future outbreaks of vaccine preventable diseases (VPDs). METHODS Analysis of measles surveillance and measles-rubella vaccination data for 2018-2022 was conducted to assess relationship between immunization coverage and measles case incidence. Data were extracted from the District Health Information Management System (DHIMS) platform and loaded into Microsoft Excel 16.0 spreadsheet for analysis. Coverages for first (MR1) and second (MR2) doses of measles-rubella vaccination, dropout rates, and measles incidence (per 100,000) were calculated. RESULTS The coverage trend for both vaccine doses followed similar trajectories, increasing from 2018 to a peak in 2019, and declining sequentially thereafter to the lowest (for the study period) in 2022. Generally, MR1/MR2 dropout rate was high across all districts during the entire study period. The regional incidence of confirmed measles rose sharply from less than 1/1,000,000 in 2018-2021 to 94 in 2022. Wide variations in vaccination coverage and dropout rates were observed among the districts. There was moderate to fairly strong negative correlation between MR vaccination coverage and measles case incidence. CONCLUSIONS The MR vaccination coverage in the Savannah Region declined probably due to pre-existing weaknesses in the immunization programme accentuated by impact of the COVID-19 pandemic. The lowered population immunity likely contributed to occurrence of the measles outbreak in 2022. Pragmatic actions are needed to catch-up on missed children, restore coverage to pre-pandemic levels, and strengthen the immunization programme as part of global efforts towards achieving the Immunization Agenda 2030 (IA2030) trajectory.
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Affiliation(s)
- Michael Rockson Adjei
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; World Health Organization, Country Office, Accra, Ghana.
| | - Amos Longsignikuu
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Ibrahim Saeed Iddris
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Thomas Nang Suuri
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | | | - Janet Vanessa Baafi
- Ghana Health Service, District Health Directorate, Sunyani West, Odumase, Ghana
| | - Chrysantus Kubio
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | - Martin Peter Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; Institute of Tropical Medicine, and German Center of Infectious Diseases (DZIF), University of Tuebingen, Tuebingen, Germany; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Centre de Recherches Médicales En Lambaréné (CERMEL), Lambaréné, Gabon; Masanga Medical Research Unit, Masanga, Sierra Leone
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Yadav RM, Gomare M, Gaikwad A, Waghmare U, Betodkar U, Vashi MD, Kamal VK, Thangaraj JWV, Bangar S, Bhatnagar T, Murhekar M. Interplay of missed opportunity for vaccination and poor response to the vaccine led to measles outbreak in a slum area of Eastern Mumbai, India. Epidemiol Infect 2024; 152:e56. [PMID: 38497493 DOI: 10.1017/s0950268824000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
In the third week of September 2022, an outbreak of measles was reported from a slum in Eastern Mumbai, India. We sought to investigate whether failure to vaccinate or vaccine failure was the cause. We constructed an epidemic curve, drew a spot map, and calculated the attack rate and case-fatality ratio. We calculated vaccine effectiveness (VE) for one and two doses of measles vaccine in an unmatched case-control study and did stratified analysis by sex, availability of vaccination card, and migrant status. We identified 358 cases and four deaths with a 11.3% attack rate and 1.1% case fatality, both being highest among 0-24-month-old boys. The epidemic curve suggested a propagated mode of spread. The VE for two doses was 64% (95% confidence interval (CI): 23-73%) among under-5-year-old children and 70% (95% CI: 28-88%) among 5-15-year-old children. Failure to vaccinate, consequent to the COVID-19 pandemic, and vaccine hesitancy might have led to the accumulation of susceptible children in the community. Additionally, the occurrence of case-patients among vaccinated suggests reduced VE, which needs further investigation into humoral and cell-mediated immunity as well as contributory factors including nutritional status. Outbreak response immunization to complete immunization of missed and dropout children was carried out to control the outbreak.
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Affiliation(s)
- Reetika Malik Yadav
- ICMR School of Public Health, ICMR-National Institute of Epidemiology, Chennai, India
- Department of Pediatric Immunology, ICMR-National Institute of Immunohaematology, Mumbai, India
| | - Mangala Gomare
- Public Health Department, Municipal Corporation of Greater Mumbai, Mumbai, India
| | - Arun Gaikwad
- Public Health Department, Municipal Corporation of Greater Mumbai, Mumbai, India
| | - Upalimitra Waghmare
- Public Health Department, Municipal Corporation of Greater Mumbai, Mumbai, India
| | - Utkarsh Betodkar
- ICMR School of Public Health, ICMR-National Institute of Epidemiology, Chennai, India
| | | | - Vineet Kumar Kamal
- ICMR School of Public Health, ICMR-National Institute of Epidemiology, Chennai, India
| | | | - Sampada Bangar
- Division of Epidemiology and Statistics, ICMR-National AIDS Research Institute, Pune, India
| | - Tarun Bhatnagar
- ICMR School of Public Health, ICMR-National Institute of Epidemiology, Chennai, India
| | - Manoj Murhekar
- ICMR School of Public Health, ICMR-National Institute of Epidemiology, Chennai, India
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Bemis K, Frias M, Giovanni S, Shackour T, Reid HD, Morgan J, TeKippe M, Christiansen D. Notes from the Field: Measles Outbreak - Cook County, Illinois, October-November 2023. MMWR Morb Mortal Wkly Rep 2024; 73:229-230. [PMID: 38483848 PMCID: PMC10948190 DOI: 10.15585/mmwr.mm7310a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
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19
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Parums DV. A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination. Med Sci Monit 2024; 30:e944436. [PMID: 38525549 PMCID: PMC10946219 DOI: 10.12659/msm.944436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
On 22 February 2024, the World Health Organization (WHO) stated that, following the recent resurgence of measles cases in Europe, more than half the world's countries could expect significant measles outbreaks this year. Measles is a highly infectious virus with a primary case reproduction number (R0) of 12-18. Measles infection can be severe, resulting in pneumonia, and also more rarely in subacute sclerosing panencephalitis (SSPE), which occurs in 1 child out of every 1,000 and can be fatal. Until the 1990s, the hope of eliminating measles seemed possible following the successful development of effective vaccines, given individually or in the combined measles, mumps, and rubella (MMR) vaccine. Vaccine hesitancy due to misinformation about possible vaccine side effects, reduced vaccine uptake during and after the COVID-19 pandemic, and lack of awareness of the severe consequences of measles infection have contributed to low vaccine uptake, resulting in vulnerable communities. This article aims to review the recent resurgence of measles cases in the US, Europe, and the UK, to provide a reminder of the potential severity of measles, and to consider the causes of the failure to eliminate this vaccine-preventable viral infection.
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Zibolenová J, Malobická E, Ulbrichtová R, Novák M, Chladná Z, Waczulíková I, Litvová S, Mikas J, Mečochová A, Hudečková H. Probability of exposure to the wild measles virus in adult population - Estimation from seroepidemiology and historical data. Vaccine 2024; 42:1648-1655. [PMID: 38342718 DOI: 10.1016/j.vaccine.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
Vaccination against measles is one of the most effective public health interventions which has saved millions of lives and interrupted circulation of the natural virus in the population. However, it is widely accepted that the immunity after vaccination can wane, especially in those who have had no contact with the virus. This study aimed to classify the particular birth cohorts of adults with regard to their exposure to the wild measles virus in the population with a long history of mandatory vaccination. We introduced two methods. In the first, we estimated the probability of exposure to the wild virus through an analysis of antibody levels from the Immunologic Survey performed in the Slovak Republic in 2018, while the second was based on historical epidemiological data. Both methods resulted in similar estimations. Cohorts born in Slovakia before 1964 can be considered to be cohorts in which most people were exposed to the wild measles virus. Cohorts born after 1977 can be designated as cohorts that most likely did not come into the contact with the wild virus. Cohorts born between 1965 and 1976 are composed of a mixture, with a decreasing proportion of people exposed to the wild virus with increasing year of birth. The proposed methods can help identify potential immunity gaps in the adult population. They can be applied in other countries with high measles vaccination coverage to estimate the probability of exposure to the wild measles virus in particular birth cohorts.
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Affiliation(s)
- Jana Zibolenová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Eva Malobická
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Romana Ulbrichtová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Martin Novák
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia.
| | - Zuzana Chladná
- Department of Applied Mathematics and Statistics, Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Mlynská dolina F1, 842 48 Bratislava, Slovakia
| | - Iveta Waczulíková
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Mlynská dolina F1, 842 48 Bratislava, Slovakia
| | - Slávka Litvová
- Faculty of Healthcare, Alexander Dubcek University of Trencin, Trencin, Slovakia
| | - Ján Mikas
- Public Health Authority of the Slovak Republic, Trnavská cesta 52, 826 45 Bratislava, Slovakia
| | - Adriana Mečochová
- Public Health Authority of the Slovak Republic, Trnavská cesta 52, 826 45 Bratislava, Slovakia
| | - Henrieta Hudečková
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
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Fortunato F, Musco A, Iannelli G, Meola M, Luigi Lopalco P, Martinelli D. Effectiveness of the combined MMRV Priorix-Tetra™ vaccine against varicella in a large Italian region: A case-control study. Vaccine 2024; 42:1608-1616. [PMID: 38341290 DOI: 10.1016/j.vaccine.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Priorix-Tetra™ (MMRV GlaxoSmithKline Biologicals' vaccine) was developed based on the existing measles-mumps-rubella and varicella vaccines. In this study, we aimed to estimate the effectiveness of the combined measles-mumps-rubella-varicella Priorix-Tetra™ vaccine against varicella in real-world conditions. We conducted a post-marketing retrospective case-control study in the Apulia region of Italy in children aged 1-9 years born between January 1, 2008 and December 31, 2016. We assessed the effectiveness against varicella of all grades of severity (including hospitalisation) and against hospitalisation for varicella of a single and two doses of Priorix-Tetra™. Moreover, we also assessed effectiveness of monovalent varicella (monovalent-V) vaccine and any varicella vaccines. Vaccine effectiveness was calculated as (1-OR) x 100. We introduced demographic variables in the model to adjust Vaccine effectiveness (aVE) by potential confounders (sex and year of birth). We recorded 625 varicella cases and matched them with 1,875 controls. Among 625 cases, 198 had received a single MMRV dose, 10 two MMRV doses, 46 a single monovalent-V dose, none two monovalent-V doses; four a monovalent-V as first dose and MMRV as second dose, and one a MMRV as first dose and monovalent-V as second dose; 366 cases were not vaccinated. The aVE against varicella of all grades of severity was 77.0% and 93.0% after a single dose and after two doses of MMRV, respectively. The aVE against varicella of all grades was 72.0% after a single dose of monovalent-V vaccine. The aVE against varicella of all grades of severity was 76.0% after a single dose and 94.0% after two doses of any varicella vaccine. The aVE against varicella hospitalisation was 96% after a single dose of any varicella vaccine. Priorix-Tetra™ showed to be an effective vaccine and the two-dose schedule should be recommended to optimise immunisation programmes. A single dose was able to provide protection against varicella hospitalisation.
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Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Angelo Musco
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppina Iannelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Martina Meola
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
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Caraffa E, Mascia C, Ciardi MR, Lichtner M, Ajassa C, Del Borgo C, Tieghi T, Vita S, Savinelli S, Iannetta M, Russo G, Mastroianni CM, Vullo V. Steroid use in measles: A retrospective cohort study during the 2017 outbreak in tertiary referral center, Rome and Latina, Italy. J Infect Chemother 2024; 30:201-207. [PMID: 37820949 DOI: 10.1016/j.jiac.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Since early January 2017, a new measles outbreak in Italy has been observed. The aim of the study was to compare features between adults and children measles cases and evaluate the effect of steroid treatment on the above parameters. METHODS A retrospective multicenter, descriptive study was performed. We analyzed all patients admitted to the Department of Public Health and Infectious Diseases, Sapienza University, Rome and Latina, from January 2017 to December 2017 and discharged with diagnosis of measles. RESULTS We identified 113 patients discharged with the diagnosis of measles infection cases of which 59 adults and 54 children (≤16 years). In adult population 32 patients (54 %) were males, with a median age of 30.5 years old and all unvaccinated (100 %). Keratoconjunctivitis 30 (50 %) was the most frequent complication. In pediatric population 27 (50 %) patients were males, with a median age of 3 years old. Information on measles vaccination status was available for only 21 (38.8 %) of cases. Keratoconjunctivitis 40 (74 %) was the most frequent complication. Analyzing the differences between adult and pediatric patients we found that children were significantly more likely to have keratoconjunctivitis and diarrhea as complications than adults in which the rate of thrombocytopenia and hepatitis was highest. Thirty-nine adult subjects (66 %) have been treated with systemic corticosteroids. CONCLUSIONS Pediatric patients differ from adults in complications and liver involvement. Regarding steroids use, although there is no clear indication of steroid use during measles, there is no evidence of a worse outcome in our cases series.
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Affiliation(s)
- Emanuela Caraffa
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy.
| | - Claudia Mascia
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Maria Rosaria Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; Infectious Diseases Unit, Sapienza University, Santa Maria Goretti Hospital, Latina, Italy
| | - Camilla Ajassa
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Cosmo Del Borgo
- Infectious Diseases Unit, Sapienza University, Santa Maria Goretti Hospital, Latina, Italy
| | - Tiziana Tieghi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; Infectious Diseases Unit, Sapienza University, Santa Maria Goretti Hospital, Latina, Italy
| | - Serena Vita
- Infectious Diseases Unit, Sapienza University, Santa Maria Goretti Hospital, Latina, Italy; National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Stefano Savinelli
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; Department of Infectious Diseases, St Vincent's University Hospital, Dublin, Ireland
| | - Marco Iannetta
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy; Department of Systems Medicine and Infectious Diseases Clinic, University Hospital Tor Vergata, Rome, Italy
| | - Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Addis M, Mekonnen W, Estifanos AS. Health system barriers to the first dose of measles immunization in Ethiopia: a qualitative study. BMC Public Health 2024; 24:665. [PMID: 38429806 PMCID: PMC10908078 DOI: 10.1186/s12889-024-18132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/17/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Ethiopia has made considerable progress toward measles elimination. Despite ongoing efforts, the country remains among those with the highest number of children missing their initial dose of measles vaccine, and the disease continues to be a public health emergency. The barriers within the health system that hinder the first dose of measles immunization have not been thoroughly investigated. This study aims to identify these barriers within the Ethiopian context. METHODS Qualitative research, using purposive expert sampling to select key informants from health organizations in Addis Ababa, Ethiopia was employed. We conducted in-depth face-to-face interviews using a semi-structured interview guide. A thematic analysis based on the World Health Organization's health systems building blocks framework was conducted. RESULTS The study uncovered substantial health system barriers to the uptake of the first dose of the measles vaccine in Ethiopia. These barriers include; restricted availability of immunization services, vaccine stockouts, shortage of cold chain technologies, data inaccuracy resulting from deliberate data falsification or accidental manipulation of data, as well as data incompleteness. CONCLUSION Our research highlighted significant health system barriers to MCV1 immunization, contributing to unmet EPI targets in Ethiopia. Our results suggest that to accelerate the country towards measles elimination, there is an urgent need to improve the health systems components such as service delivery, information systems, as well as access to vaccine and cold chain technologies.
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Affiliation(s)
- Meron Addis
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Wubegzier Mekonnen
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Seifu Estifanos
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Zemella A, Beer K, Ramm F, Wenzel D, Düx A, Merkel K, Calvignac-Spencer S, Stern D, Dorner MB, Dorner BG, Widulin N, Schnalke T, Walter C, Wolbert A, Schmid BG, Mankertz A, Santibanez S. Vaccine-induced neutralizing antibodies bind to the H protein of a historical measles virus. Int J Med Microbiol 2024; 314:151607. [PMID: 38367508 DOI: 10.1016/j.ijmm.2024.151607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/19/2024] Open
Abstract
Measles is a highly contagious airborne viral disease. It can lead to serious complications and death and is preventable by vaccination. The live-attenuated measles vaccine (LAMV) derived from a measles virus (MV) isolated in 1954 has been in use globally for six decades and protects effectively by providing a durable humoral and cell-mediated immunity. Our study addresses the temporal stability of epitopes on the viral surface glycoprotein hemagglutinin (H) which is the major target of MV-neutralizing antibodies. We investigated the binding of seven vaccine-induced MV-H-specific monoclonal antibodies (mAbs) to cell-free synthesized MV-H proteins derived from the H gene sequences obtained from a lung specimen of a fatal case of measles pneumonia in 1912 and an isolate from a current case. The binding of four out of seven mAbs to the H protein of both MV strains provides evidence of epitopes that are stable for more than 100 years. The binding of the universally neutralizing mAbs RKI-MV-12b and RKI-MV-34c to the H protein of the 1912 MV suggests the long-term stability of highly conserved epitopes on the MV surface.
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Affiliation(s)
- Anne Zemella
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Kerstin Beer
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Franziska Ramm
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Dana Wenzel
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Ariane Düx
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany; Helmholtz Institute for One Health, Helmholtz-Centre for Infection Research (HZI), 17489 Greifswald, Germany
| | - Kevin Merkel
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Sebastien Calvignac-Spencer
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany; Helmholtz Institute for One Health, Helmholtz-Centre for Infection Research (HZI), 17489 Greifswald, Germany; Faculty of Mathematics and Natural Sciences, University of Greifswald, 17489 Greifswald, Germany
| | - Daniel Stern
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Martin B Dorner
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Brigitte G Dorner
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | | | | | - Cornelia Walter
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Anne Wolbert
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Bernhard G Schmid
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Annette Mankertz
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Sabine Santibanez
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany.
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Hueppe K, Ortman J, Gauselmann H, Santibanez S, Mankertz A. Measles vaccination - An underestimated prevention measure: Analyzing a fatal case in Hildesheim, Germany. Int J Med Microbiol 2024; 314:151608. [PMID: 38335886 DOI: 10.1016/j.ijmm.2024.151608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Measles and rubella are targeted for elimination in the WHO region Europe. To reach the elimination goal, vaccination coverage of 95% must be achieved and sustained, the genotype information has to be provided for 80% of all outbreaks and transmission chains of a certain variant must not be detected for >12 months. The latter information is collected at Germany's National Reference Center Measles, Mumps, Rubella (NRC MMR). We describe here an outbreak of measles occurring in Hildesheim. The outbreak comprised 43 cases and lasted 14 weeks. Surprisingly, a high number of vaccination failures was observed since 11 cases had received two doses of the MMR vaccine and 4 additional cases were vaccinated once. A 33-year-old woman passed away during the outbreak. She was the mother of 5 children between 4 and 16 years of age. Two schoolchildren contracted measles and passed it on to the rest of the family. Due to delivery bottlenecks, the vaccination of the mother was delayed. She developed measles-like symptoms 3 days after vaccination and was found dead on the morning of day 8 after vaccination. A post-mortem examination was done to identify the cause of death. Moreover, molecular characterization of the virus was performed to analyze whether she was infected by the wildtype virus circulating at that time in Hildesheim or whether the vaccine may have been a concomitant and aggravating feature of her death. The result showed that the samples taken from her at the time of death and during necropsy contained the wildtype measles virus variant corresponding to MVs/Gir Somnath.IND/42.16 (WHO Seq-ID D8-4683) that fueled the Hildesheim outbreak and circulated in Germany from March 2018 to March 2020. The vaccine virus was not detected. Moreover, two aspects uncovered by the post-mortem examination were remarkable; the woman died from giant cell pneumonia, which is a complication seen in immune-suppressed individuals and she was actively using cannabis. THC is known to influence the immune system, but literature reports describing the effects are limited.
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Affiliation(s)
- Katharina Hueppe
- Local Health Authority, Hildesheim, Ludolfingerstr. 2, 31137 Hildesheim, Germany
| | - Jan Ortman
- Institute for Forensic Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Hannah Gauselmann
- Brandenburgisches Landesinstitut für Rechtsmedizin, Potsdam, Germany
| | - Sabine Santibanez
- National Reference Center Measles, Mumps, Rubella; Robert Koch-Institute; Seestr. 10, 13353 Berlin, Germany
| | - Annette Mankertz
- National Reference Center Measles, Mumps, Rubella; Robert Koch-Institute; Seestr. 10, 13353 Berlin, Germany.
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Soble A, Ko M, Gilchrist S, Malvolti S, Hasso-Agopsowicz M, Giersing B, Amorij JP, Jarrahian C, El Sheikh F, Menozzi-Arnaud M, Scarna T. A review of potential use cases for measles-rubella, measles-mumps-rubella, and typhoid-conjugate vaccines presented on microarray patches. Vaccine 2024; 42:1230-1246. [PMID: 38326130 DOI: 10.1016/j.vaccine.2023.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/22/2023] [Accepted: 12/17/2023] [Indexed: 02/09/2024]
Abstract
As an innovative vaccine delivery technology, vaccine microarray patches could have a meaningful impact on routine immunization coverage in low- and middle-income countries, and vaccine deployment during epidemics and pandemics. This review of the potential use cases for a subset of vaccine microarray patches in various stages of clinical development, including measles-rubella, measles-mumps-rubella, and typhoid conjugate, highlights the breadth of their applicability to support immunization service delivery and their potential scope of utilization within national immunization programs. Definition and assessment of the use cases for this novel vaccine presentation provide important insights for vaccine developers and policymakers into the strengths of the public health and commercial value propositions, and the preparatory requirements for public health systems for the future rollout of vaccine microarray patches. An in-depth understanding of use cases for vaccine microarray patches serves as a foundational input to overcoming the remaining technical, regulatory, and financial challenges. Additional efforts will help to realize the potential of vaccine microarray patches as part of the global effort to improve the coverage and equity of national immunization programs.
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Affiliation(s)
- Adam Soble
- MMGH Consulting GmbH, Geneva, Switzerland.
| | - Melissa Ko
- MMGH Consulting GmbH, Geneva, Switzerland.
| | | | | | | | - Birgitte Giersing
- Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
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Musa N, Ghoniem A, Hsu CH, Mubarak S, Sume G, Sharifuzzaman M, Jeongeun B, Hutin Y, Teleb N, Crowcroft N, O’Connor P, Mahoney F, Hassan Q. Progress Toward Measles Elimination - World Health Organization Eastern Mediterranean Region, 2019-2022. MMWR Morb Mortal Wkly Rep 2024; 73:139-144. [PMID: 38386606 PMCID: PMC10899078 DOI: 10.15585/mmwr.mm7307a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
In 2015, all 22 World Health Organization Eastern Mediterranean Region (EMR) countries and areas (countries) pledged to achieve measles elimination by 2020. Despite success in several countries, most countries in the region still have not eliminated measles. This report updates a previous report and describes progress toward measles elimination in EMR during 2019-2022. During that period, estimated regional coverage with the first and second doses of a measles-containing vaccine (MCV) was 82%-83% and 76%-78%, respectively. During 2019-2022, approximately 160 million children were vaccinated during national or subnational supplementary immunization activities. Reported confirmed regional measles incidence decreased from 29.8 cases per 1 million population in 2019 to 7.4 in 2020, but then increased 68%, to 50.0 in 2022 because of challenges providing immunization services and conducting surveillance during the COVID-19 pandemic. Surveillance indicators deteriorated in 11 (50%) of the 22 EMR countries. During 2019-2022, four countries in the region were verified as having achieved measles elimination, but other countries reported immunity gaps and increased measles incidence in 2022. To achieve measles elimination in EMR, national immunization programs, especially in those countries with high measles incidence, will need to continue to recover from the COVID-19 pandemic, increase overall vaccination coverage to close immunity gaps, and maintain high-quality disease surveillance.
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28
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Healy A. Measles: increasing vaccine uptake is vital in preventing outbreaks. BMJ 2024; 384:q402. [PMID: 38359945 DOI: 10.1136/bmj.q402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Affiliation(s)
- Amanda Healy
- Association of Directors of Public Health, London, UK
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29
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Mahase E. Measles: 500 cases are confirmed in England as clusters appear around the country. BMJ 2024; 384:q417. [PMID: 38359915 DOI: 10.1136/bmj.q417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
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30
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Davila-Payan CS, Hill A, Kayembe L, Alexander JP, Lynch M, Pallas SW. Analysis of the yearly transition function in measles disease modeling. Stat Med 2024; 43:435-451. [PMID: 38100282 DOI: 10.1002/sim.9951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 12/17/2023]
Abstract
Globally, there were an estimated 9.8 million measles cases and 207 500 measles deaths in 2019. As the effort to eliminate measles around the world continues, modeling remains a valuable tool for public health decision-makers and program implementers. This study presents a novel approach to the use of a yearly transition function that formulates mathematically the vaccine schedules for different age groups while accounting for the effects of the age of vaccination, the timing of vaccination, and disease seasonality on the yearly number of measles cases in a country. The methodology presented adds to an existing modeling framework and expands its analysis, making its utilization more adjustable for the user and contributing to its conceptual clarity. This article also adjusts for the temporal interaction between vaccination and exposure to disease, applying adjustments to estimated yearly counts of cases and the number of vaccines administered that increase population immunity. These new model features provide the ability to forecast and compare the effects of different vaccination timing scenarios and seasonality of transmission on the expected disease incidence. Although the work presented is applied to the example of measles, it has potential relevance to modeling other vaccine-preventable diseases.
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Affiliation(s)
- C S Davila-Payan
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Hill
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - L Kayembe
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J P Alexander
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M Lynch
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S W Pallas
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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31
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Santoro PE, Paladini A, Borrelli I, Amantea C, Rossi MF, Fortunato C, Gualano MR, Marchetti A, Cadeddu C, Moscato U. Vaccine-preventable diseases: Immune response in a large population of healthcare students. Vaccine 2024; 42:930-936. [PMID: 38246845 DOI: 10.1016/j.vaccine.2024.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at university. The aim of the present study was to investigate the seroprevalence characteristics of anti-HBsAg, anti-Measles, anti-Mumps, anti-Rubella and anti-Varicella IgG antibodies in healthcare students of a large teaching hospital in Rome. METHODS To accomplish the study's aims, antibody serology data were gathered from students of Medicine and Surgery, Dentistry, and Health Professions at the Catholic University of the Sacred Heart (Rome Campus) during their first Health Surveillance visit, that took place from 2013 to 2023. RESULTS Our study sample included 2523 students, 44.4 % were protected against Hepatitis B, 87.3 % against measles, 85.5 % against mumps, 94.6 % rubella and 95.2 % against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), except for mumps. It found a lower probability of having seronegative anti-HBVs with an older date since the presumed primary vaccination. CONCLUSION In our sample, seropositivity rate against vaccine-preventable diseases, especially for Hepatitis B, was often inadequate to prevent possible biological risks connected with the activities carried out on the ward.
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Affiliation(s)
- Paolo Emilio Santoro
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Andrea Paladini
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Ivan Borrelli
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carlotta Amantea
- Section of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Maria Francesca Rossi
- Section of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Corinna Fortunato
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Maria Rosaria Gualano
- Saint Camillus International University of Health Sciences, UniCamillus, Rome, Italy
| | - Antonio Marchetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Chiara Cadeddu
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Umberto Moscato
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy; Section of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome 00168, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
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32
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Affiliation(s)
- Helen Bedford
- UCL Great Ormond Street Institute of Child Health, London, UK
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Haidar S, Richard E, Vaux S, Allaire C, Castor C, Levy Bruhl D, Mondeilh A, Vandentorren S. Factors associated with vaccine adherence among an underserved population: the adult Travellers in Nouvelle-Aquitaine, France. Eur J Public Health 2024; 34:163-169. [PMID: 38031445 PMCID: PMC10843962 DOI: 10.1093/eurpub/ckad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND A measles epidemic affected the Nouvelle-Aquitaine region from November 2017 to May 2018 with clusters among Travellers. This indicates that measles vaccination rates among Travellers remain lower than in the general population. The objective of this study was to estimate the 'declarative vaccination' against measles, mumps and rubella (MMR) and to propose a conceptual framework to help identify determinants of MMR vaccination uptake among adult Travellers in Nouvelle-Aquitaine in 2019-20. METHODS A cross-sectional study using random sampling was performed and included 612 adult Travellers from 1 November 2019 to 31 March 2020. A conceptual framework to model vaccination adherence was tested among this underserved population by using structural equation modelling. This model included five latent variables: health literacy, attitudes toward preventive measures, stigma, accessibility to care and perceived needs and five measured variables: information received on vaccination, perception of barriers, support for administrative documents, social support and housing conditions. RESULTS Individuals who did not answer all the questions linked to the variables included in the model were excluded, thus 347 adults were included in the final sample. The declared vaccination rate against MMR was 74.0%, and 72.4% of the participants were favorable to vaccination. Vaccination adherence was significantly correlated with favorable attitudes toward preventive measures such as having a history of MMR vaccination and not having already refused a recommended vaccine and finally satisfactory information received on vaccination. DISCUSSION To improve vaccination adherence, health authorities should lean on personal history with vaccination and on transmitting information on vaccination.
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Affiliation(s)
- Sahar Haidar
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Elodie Richard
- Bordeaux Population Health Laboratory, Inserm U1219, University of Bordeaux, Bordeaux, France
| | - Sophie Vaux
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Cecile Allaire
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Christine Castor
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Daniel Levy Bruhl
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Aude Mondeilh
- Fédération Nationale des Associations Solidaires d’Action avec les Tsiganes et les Gens du Voyage (FNASAT—Gens du Voyage), Paris, France
| | - Stéphanie Vandentorren
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
- Bordeaux Population Health Laboratory, Inserm U1219, University of Bordeaux, Bordeaux, France
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Laue T, Junge N, Leiskau C, Mutschler F, Ohlendorf J, Baumann U. Diminished measles immunity after paediatric liver transplantation-A retrospective, single-centre, cross-sectional analysis. PLoS One 2024; 19:e0296653. [PMID: 38315673 PMCID: PMC10843477 DOI: 10.1371/journal.pone.0296653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/16/2023] [Indexed: 02/07/2024] Open
Abstract
Liver transplantation in childhood has an excellent long-term outcome, but is associated with a long-term risk of infection. Measles is a vaccine-preventable infection, with case series describing severe courses with graft rejection, mechanical ventilation and even death in liver transplant recipients. Since about 30% of liver transplanted children receive liver transplants in their first year of life, not all have reached the recommended age for live vaccinations. On the contrary, live vaccines are contraindicated after transplantation. In addition, vaccination response is poorer in individuals with liver disease compared to healthy children. This retrospective, single-centre, cross-sectional study examines measles immunity in paediatric liver transplant recipients before and after transplantation. Vaccination records of 239 patients, followed up at Hannover Medical School between January 2021 and December 2022 were analysed. Twenty eight children were excluded due to stem cell transplantation, regular immunoglobulin substitution or measles vaccination after transplantation. More than 55% of all 211 children analysed and 75% of all those vaccinated at least once are measles seropositive after transplantation-48% after one and 84% after two vaccinations-which is less than in healthy individuals. Interestingly, 26% of unvaccinated children also showed measles antibodies and about 5-15% of vaccinated patients who were seronegative at the time of transplantation were seropositive afterwards, both possibly through infection. In multivariable Cox proportional hazards regression, the number of vaccinations (HR 4.30 [95% CI 2.09-8.83], p<0.001), seropositivity before transplantation (HR 2.38 [95% CI 1.07-5.30], p = 0.034) and higher age at time of first vaccination (HR 11.5 [95% CI 6.92-19.1], p<0.001) are independently associated with measles immunity after transplantation. In contrast, older age at testing is inversely associated (HR 0.09 [95% CI 0.06-0.15], p<0.001), indicating a loss of immunity. Vaccination in the first year of life does not pose a risk of non-immunity. The underlying liver disease influences the level of measles titres of twice-vaccinated patients; those with acute liver failure being the lowest compared to children with metabolic disease. In summary, vaccine response is poorer in children with liver disease. Liver transplant candidates should be vaccinated before transplantation even if this is earlier in the first year of life. Checking measles IgG and re-vaccinating seronegative patients may help to achieve immunity after transplantation.
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Affiliation(s)
- Tobias Laue
- Division for Paediatric Gastroenterology and Hepatology, Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Norman Junge
- Division for Paediatric Gastroenterology and Hepatology, Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Christoph Leiskau
- Paediatric Gastroenterology, Department of Paediatrics and Adolescent Medicine, University Medical Centre Goettingen, Georg August University Goettingen, Goettingen, Germany
| | - Frauke Mutschler
- Division for Paediatric Gastroenterology and Hepatology, Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Johanna Ohlendorf
- Division for Paediatric Gastroenterology and Hepatology, Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Ulrich Baumann
- Division for Paediatric Gastroenterology and Hepatology, Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
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Michael F, Mirambo MM, Misinzo G, Minzi O, Beyanga M, Mujuni D, Kalabamu FS, Nyanda EN, Mwanyika-Sando M, Ndiyo D, Kasonogo R, Ismail A, Bahati A, Hassan F, Kaale E, Chai JJ, Kinyunyi P, Kyesi F, Tinuga F, Mongi D, Salehe A, Muhindi B, Mdachi J, Magodi R, Mwenesi M, Nyaki H, Katembo B, Tenga K, Kasya M, Mwengee W, Mshana SE. Trends of measles in Tanzania: A 5-year review of case-based surveillance data, 2018-2022. Int J Infect Dis 2024; 139:176-182. [PMID: 38122965 PMCID: PMC10784152 DOI: 10.1016/j.ijid.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES Tanzania observed a gradual increase in the number of measles cases since 2019 with a large outbreak recorded during 2022. This study describes the trend of measles in Tanzania over a 5-year period from 2018-2022. METHODS This was a descriptive study conducted using routine measles case-based surveillance system including 195 councils of the United Republic of Tanzania. RESULTS Between 2018 and 2022 there were 12,253 measles cases reported. Out of 10,691 (87.25%) samples tested by enzyme-linked immunosorbent assay, 903 (8.4%) were measles immunoglobulin M positive. The highest number of laboratory-confirmed measles cases was in 2022 (64.8%), followed by 2020 (13.8%), and 2019 (13.5%). Out of 1279 unvaccinated cases, 213 (16.7%) were laboratory-confirmed measles cases compared to 77/723 (10.6%) who were partially vaccinated and 71/1121 (6.3%) who were fully vaccinated (P < 0.001). Children aged between 1-4 years constituted the most confirmed measles cases after laboratory testing, followed by those aged 5-9 years. There was a notable increase in the number of laboratory-confirmed measles cases in children <1 year and 10-14 years during 2022 compared to previous years. The vaccination coverage of the first dose of measles-containing vaccine (MCV1) was maintained >90% since 2013 while MCV2 increased gradually reaching 88% in 2022. CONCLUSIONS Accumulation of susceptible children to measles due to suboptimal measles vaccination coverage over the years has resulted in an increase in the number of laboratory-confirmed measles cases in Tanzania with more cases recorded during the COVID-19 pandemic. Strengthening surveillance, routine immunization, and targeted strategies are key to achieving the immunity levels required to interrupt measles outbreaks.
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Affiliation(s)
- Fausta Michael
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Gerald Misinzo
- OR Tambo Africa Research Chair for Viral Epidemics, SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Omary Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Medard Beyanga
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Delphinus Mujuni
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Florence S Kalabamu
- Department of Pediatrics and Child Health, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Elias N Nyanda
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | | | - Daniel Ndiyo
- Directorate of Regulatory Services, Government Chemist Laboratory Authority, Dodoma, Tanzania
| | - Richard Kasonogo
- Tanzania Medicines and Medical Devices Authority, Ministry of Health, Dodoma, Tanzania
| | - Abbas Ismail
- Department of Mathematics and Statistics, University of Dodoma, Dodoma, Tanzania
| | - Andrew Bahati
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Farida Hassan
- Health System, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania
| | - Eliangiringa Kaale
- Pharm R&D Lab and Department of Medicinal Chemistry, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - John J Chai
- District Court of Kwimba, Judiciary of Tanzania, Ngudu, Tanzania
| | - Pricillah Kinyunyi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Furaha Kyesi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Florian Tinuga
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Dhamira Mongi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Abdul Salehe
- Immunization and Vaccine Development Program, Ministry of Health, Mnazimmoja, Zanzibar
| | - Bonaventura Muhindi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Joseph Mdachi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Richard Magodi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Mwendwa Mwenesi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Honest Nyaki
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Betina Katembo
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Kelvin Tenga
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Magdalena Kasya
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | | | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
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Durrheim DN, Murray P, Turner N. Resurgent global measles: A threat to Australia, New Zealand and Pacific Island Countries. J Paediatr Child Health 2024; 60:73-75. [PMID: 38426362 DOI: 10.1111/jpc.16530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Affiliation(s)
- David N Durrheim
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Peter Murray
- Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Nikki Turner
- Deparment of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
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Keutler A, Lainka E, Posovszky C. Live-attenuated vaccination for measles, mumps, and rubella in pediatric liver transplantation. Pediatr Transplant 2024; 28:e14687. [PMID: 38317348 DOI: 10.1111/petr.14687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Infections are a serious short- and long-term problem after pediatric organ transplantation. In immunocompromised patients, they can lead to transplant rejection or a severe course with a sometimes fatal outcome. Vaccination is an appropriate means of reducing morbidity and mortality caused by vaccine-preventable diseases. Unfortunately, due to the disease or its course, it is not always possible to establish adequate vaccine protection against live-attenuated viral vaccines (LAVVs) prior to transplantation. LAVVs such as measles, mumps, and rubella (MMR) are still contraindicated in solid organ transplant recipients receiving immunosuppressive therapy (IST), thus creating a dilemma. AIM This review discusses whether, when, and how live-attenuated MMR vaccines can be administered effectively and safely to pediatric liver transplant recipients based on the available data. MATERIAL AND METHODS We searched PubMed for literature on live-attenuated MMR vaccination in pediatric liver transplantation (LT). RESULTS Nine prospective observational studies and three retrospective case series were identified in which at least 833 doses of measles vaccine were administered to 716 liver transplant children receiving IST. In these selected patients, MMR vaccination was well tolerated and no serious adverse reactions to the vaccine were observed. In addition, an immune response to the vaccine was demonstrated in patients receiving IST. CONCLUSION Due to inadequate vaccine protection in this high-risk group, maximum efforts must be made to ensure full immunization. MMR vaccination could also be considered for unprotected patients after LT receiving IST following an individual risk assessment, as severe harm from live vaccines after liver transplantation has been reported only very rarely. To this end, it is important to establish standardized and simple criteria for the selection of suitable patients and the administration of the MMR vaccine to ensure safe use.
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Affiliation(s)
- Anne Keutler
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Elke Lainka
- University Children's Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Carsten Posovszky
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
- Gastroenterology and Nutrition, University Children's Hospital Zurich, Zurich, Switzerland
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Musa S, Salimović-Bešić I, Džambić JB, Tihić N, Bajramović A, Arapčić S, Dedeić-Ljubović A, Skočibušić S. Ongoing measles outbreak, the Federation of Bosnia and Herzegovina, December 2023 to February 2024. Euro Surveill 2024; 29:2400107. [PMID: 38426241 PMCID: PMC10986665 DOI: 10.2807/1560-7917.es.2024.29.9.2400107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 03/02/2024] Open
Abstract
We report on an ongoing measles outbreak in the Federation of Bosnia and Herzegovina with 141 cases notified between week 52 2023 and week 6 2024. Among those with known vaccination status, 97% were unvaccinated and the most affected group is children under the age of 5 years (n = 87) who were not vaccinated during the pandemic years. Sixty-eight cases were hospitalised, the most common complications were measles-related pneumonia and diarrhoea. The sequenced measles viruses from four cases belonged to genotype D8.
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Affiliation(s)
- Sanjin Musa
- Department of Infectious Disease Epidemiology, Institute for Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
- Sarajevo School of Science and Technology Sarajevo Medical School, Sarajevo, Bosnia and Herzegovina
| | - Irma Salimović-Bešić
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Jasmina Brkić Džambić
- Department of Epidemiology, Institute for Public Health of Tuzla Canton, Tuzla, Bosnia and Herzegovina
| | - Nijaz Tihić
- Department of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Anisa Bajramović
- Department of Epidemiology, Institute for Public Health of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
| | - Suzana Arapčić
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amela Dedeić-Ljubović
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Siniša Skočibušić
- Department of Infectious Disease Epidemiology, Institute for Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
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Parums DV. Editorial: Global Health Concerns as Vaccine-Preventable Infections Including SARS-CoV-2 (JN.1), Influenza, Respiratory Syncytial Virus (RSV), and Measles Continue to Rise. Med Sci Monit 2024; 30:e943911. [PMID: 38298093 PMCID: PMC10845785 DOI: 10.12659/msm.943911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/02/2024] Open
Abstract
In December 2023, the US Centers for Disease Control and Prevention (CDC) published the updated 2024 Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule, which is available online for access by the public and healthcare professionals. These new guidelines come at a time when the incidence of vaccine-preventable viral infections from SARS-CoV-2 (JN.1), respiratory syncytial virus (RSV), influenza, and measles are increasing in adults and children due to vaccine hesitancy, or non-compliance. This editorial aims to highlight the ongoing global health concerns for the consequences of increasing reports of vaccine-preventable infections, including SARS-CoV-2 (JN.1), influenza, RSV, and measles, to understand the causes of vaccine hesitancy, and introduce some public health measures that could improve vaccine uptake.
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Affiliation(s)
- Dinah V. Parums
- Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA, e-mail:
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Wilkinson E. Measles outbreaks: Investing in patient relationships through GP continuity will be key to boosting MMR confidence. BMJ 2024; 384:q221. [PMID: 38286475 DOI: 10.1136/bmj.q221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
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Dyda A, Broome A, Rawlinson W, Mahimbo A, Saha A, Kefalas B, Seale H, Macintyre CR, Zwar N, Gidding HF, Heywood AE. Measles, mumps, rubella and varicella antibodies among international and domestic university students. J Travel Med 2024; 31:taae004. [PMID: 38195239 DOI: 10.1093/jtm/taae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Vaccine-preventable infections are generally well controlled in Australia. However, gaps in immunity can lead to outbreaks and are important to identify. Young adults are a highly mobile population and a potential source of imported infections. We aimed to evaluate anti- measles, mumps, rubella and varicella (MMR&V) IgG seroprevalence and explore factors relating to antibody seropositivity. METHODS A cross-sectional online survey was conducted among students from a large Australian university to collect demographic, vaccination, infection and travel characteristics. Blood samples were collected to measure MMR&V seroprevalence. Logistic regression was used to identify factors associated with seropositivity. RESULTS Among 804 university students, seroprevalence (positive or equivocal) for measles was 82.3% (95% CI 79.6-84.8%), mumps 79.5% (95% CI 76.7-82.3%), rubella 91.5% (95% CI 89.6-93.5%) and varicella 86.2% (95% CI 84.1-88.8%), with 452 (56.2%, 95% CI 52.8-59.6) seropositive to all four viruses. Varicella seropositivity was highest in the older birth cohort (born 1988-1991). Measles seropositivity was higher for international students compared to domestic students. Among international students, mumps seroprevalence was significantly lower than measles and rubella seroprevalence. International travel in the previous 12 months was reported by 63.1% of students, but only 18.2% of travellers reported seeking pre-travel health advice prior to most recent international travel. CONCLUSIONS Overall, this study suggests immunity to MMR&V is sub-optimal. We found the university student population to be highly mobile and unlikely to seek pre-travel advice; thus, they are a potential source of infection importation. The implementation of university immunization policies could address the gaps identified and our findings can inform the development of targeted vaccination campaigns.
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Affiliation(s)
- Amalie Dyda
- School of Public Health, University of Queensland, Brisbane, QLD 4072, Australia
| | - Audrey Broome
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - William Rawlinson
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, NSW 2031, Australia
| | - Abela Mahimbo
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Amit Saha
- The Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bill Kefalas
- UNSW Health Service, University of New South Wales, Sydney, NSW 2052, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - C Raina Macintyre
- The Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nicholas Zwar
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Heather F Gidding
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anita E Heywood
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Wise J. Measles: Birmingham outbreak declared a national incident and likely to spread. BMJ 2024; 384:q159. [PMID: 38242580 DOI: 10.1136/bmj.q159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
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Rubin R. Despite Safe and Effective Vaccine, Measles Cases and Deaths Increased Worldwide From 2021 to 2022. JAMA 2024; 331:188-189. [PMID: 38117505 DOI: 10.1001/jama.2023.25527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
This Medical News story discusses the latest data on measles cases, deaths, and vaccination coverage worldwide.
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Tanne JH. Measles in the US: Philadelphia reports outbreak and travellers through DC airports warned of possible exposure. BMJ 2024; 384:q111. [PMID: 38224969 DOI: 10.1136/bmj.q111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
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Kurata T, Kaida Y, Kanbayashi D, Motomura K. Achieving measles elimination and emerging modified measles: Longitudinal measles epidemiology from 1982 to 2021 in Osaka Prefecture, Japan. Vaccine 2024; 42:271-286. [PMID: 38097458 DOI: 10.1016/j.vaccine.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND Measles is a contagious viral disease causing infant mortality in developing countries without vaccination programs. In Japan, measles vaccination was launched in 1978, surveillance commenced in 1981, and elimination was achieved in 2015. This was due to improved, legally required surveillance methods and vaccine programs. METHODS The data sets of sentinel (1982-2007) and notifiable (2008-2021) disease surveillance, as well as the vaccination coverage, detected genotypes, and seroepidemiology during the study period in Osaka Prefecture, were analyzed. Additionally, the trend under the current notifiable surveillance was compared before (2008-2014) and after (2015-2021) measles elimination. RESULTS Under sentinel surveillance, 51,107 cases were reported, predominantly infants aged 1-4 years (63.6 %). Under notifiable disease surveillance, the 781 patients were predominantly in their 20s-30s (43.7 %). From 2000, the age of the major susceptible group increased due to the rise in vaccination coverage, which exceeded 95% for the first dose in 1998 and 90% for the second dose in 2009. Consistent with these data, seroprevalence exceeded 95% in 2011. However, the geometric mean of the antibody titer showed a decreasing trend with a falling number of patients. Compared with before and after measles elimination, the number of modified measles cases increased from 10.1% to 48.2%. During the study period, 398 strains comprising eight genotypes were identified, and the dominant type changed over time. After measles elimination, genotypes B3 and D8, derived from imported cases, became predominant. CONCLUSIONS Improved vaccination coverage and surveillance reduced measles cases and increased herd immunity. However, the lack of a booster effect due to the low incidence of measles caused waning antibody titers despite high seroprevalence, which may contribute to the rising rate of vaccine failures causing modified measles. Careful monitoring of measles incidence and herd immunity are necessary for measles eradication.
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Affiliation(s)
- Takako Kurata
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Yuko Kaida
- Fujiidera Public Health Center, Inspection Division, Fujiidera 1-8-36, Fujiidera-shi, Osaka 583-0024, Japan.
| | - Daiki Kanbayashi
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Kazushi Motomura
- Osaka Institute of Public Health, Division of Public Health, Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
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Skirrow H, Foley K, Bedford H, Lewis C, Whittaker E, Costelloe C, Saxena S. Impact of pregnancy vaccine uptake and socio-demographic determinants on subsequent childhood Measles, Mumps and Rubella vaccine uptake: A UK birth cohort study. Vaccine 2024; 42:322-331. [PMID: 38072757 DOI: 10.1016/j.vaccine.2023.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake. METHODS We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake. RESULTS Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31-40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85-0.87), HR:0.87 (CI:0.85-0.88) & HR:0.89 (CI:0.88-0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81-0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41-1.45), 1.49 (CI:1.45-1.53). CONCLUSION Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy.
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Affiliation(s)
- H Skirrow
- School of Public Health, Imperial College London, United Kingdom.
| | - K Foley
- School of Public Health, Imperial College London, United Kingdom
| | - H Bedford
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - C Lewis
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom; London North Genomic Laboratory Hub, Great Ormond Street Hospital, London, United Kingdom
| | - E Whittaker
- Section of Paediatric Infectious Diseases, Imperial College London, United Kingdom; Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, United Kingdom
| | - C Costelloe
- School of Public Health, Imperial College London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - S Saxena
- School of Public Health, Imperial College London, United Kingdom
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Castiñeiras ACP, Sales AC, Picone CDM, Diogo CL, Rossi ÁD, Galliez RM, Ferreira ODC, Castiñeiras TMPP, Lopes MH, Sartori AMC. The decline of measles antibody titers in previously vaccinated adults: a cross-sectional analysis. Rev Inst Med Trop Sao Paulo 2024; 66:e4. [PMID: 38198377 PMCID: PMC10768653 DOI: 10.1590/s1678-9946202466004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/01/2023] [Indexed: 01/12/2024] Open
Abstract
The global reemergence of measles in 2018-2019 reinforces the relevance of high-coverage immunization to maintain the disease elimination. During an outbreak in the Sao Paulo State in 2019, several measles cases were reported in individuals who were adequately vaccinated according to the current immunization schedule recommends. This study aimed to assess measles IgG antibody seropositivity and titers in previously vaccinated adults. A cross-sectional study was conducted at CRIE-HC-FMUSP (Sao Paulo, Brazil) in 2019. It included healthy adults who had received two or more Measles-Mumps-Rubella vaccines (MMR) and excluded individuals with immunocompromising conditions. Measles IgG antibodies were measured and compared by ELISA (Euroimmun®) and chemiluminescence (LIASON®). The association of seropositivity and titers with variables of interest (age, sex, profession, previous measles, number of measles-containing vaccine doses, interval between MMR doses, and time elapsed since the last MMR dose) was analyzed. A total of 162 participants were evaluated, predominantly young (median age 30 years), women (69.8%) and healthcare professionals (61.7%). The median interval between MMR doses was 13.2 years, and the median time since the last dose was 10.4 years. The seropositivity rate was 32.7% by ELISA and 75.3% by CLIA, and a strong positive correlation was found between the tests. Multivariate analyses revealed that age and time since the last dose were independently associated with positivity. Despite being a single-center evaluation, our results suggest that measles seropositivity may be lower than expected in adequately immunized adults. Seropositivity was higher among older individuals and those with a shorter time since the last MMR vaccine dose.
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Affiliation(s)
- Anna Carla Pinto Castiñeiras
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amanda Caroline Sales
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
| | - Camila de Melo Picone
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
| | - Constância Lima Diogo
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Átila Duque Rossi
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Mello Galliez
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Orlando da Costa Ferreira
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Terezinha Marta Pereira Pinto Castiñeiras
- Universidade Federal do Rio de Janeiro, Núcleo de Enfrentamento e Estudos de Doenças Infecciosas e Emergentes e Reemergentes, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marta Heloísa Lopes
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM-48), São Paulo, São Paulo, Brazil
| | - Ana Marli Christovam Sartori
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Centro de Referência para Imunobiológicos Especiais, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM-48), São Paulo, São Paulo, Brazil
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Orhan Kilic B, Baskin E, Gulleroglu K, Kilic S, Aydin B, Akbulut O, Haberal M. Immunity Rates of Live Viral Vaccines in Pediatric Renal Transplant Candidates: A Single-Center Experience. EXP CLIN TRANSPLANT 2024; 22:275-280. [PMID: 38385412 DOI: 10.6002/ect.mesot2023.p79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Solid-organ transplant recipients are at an increased risk of severe infections due to their immunosuppressed state. Despite the recommendation of routine screening and vaccination before transplant to mitigate this danger, vaccination rates in these patients are still below desirable levels. We aimed to investigate the prevalence of positive antibody rates for measles, mumps, rubella, and varicella among children who are candidates for renal transplant. MATERIALS AND METHODS This retrospective study was conducted at a single center and included 144 pediatric kidney transplant patients for the past 7 years. We reviewed the medical records of all participants to evaluate their serologic status for measles, mumps, rubella, and varicella viruses before kidney transplant. RESULTS In this study, 144 pediatric kidney transplant candidates (mean age 11.5 years, 56.9% male) were enrolled, and the most frequent causes of the chronic renal disease were congenital anomalies of the kidney and urinary tract and glomerular diseases (32.6%). Seropositivity rates for measles, mumps, rubella, and varicella were 59.0%, 31.9%, 46.5%, and 43.6%, respectively, and all patients who tested negative for antibodies were vaccinated before transplant. Younger age at transplant (OR = 0.909, 95% CI = 0.840-0.923; P = .017) and congenital anomalies of the kidney and urinary tract (OR = 3.46, 95% CI = 1.1548-7.735; P = .002) were significantly associated with increased measles seropositivity, although no significant associations were observed for the other viruses. CONCLUSIONS We observed lower seropositivity rates for measles, mumps, rubella, and varicella in pediatric kidney transplant patients versus healthy children and other previous studies. It is essential to address these suboptimal rates to protect the health of these vulnerable patients. Future research should focus on targeted interventions to improve vaccination rates and outcomes in this population.
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Affiliation(s)
- Betul Orhan Kilic
- From the Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey
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50
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Das M. Measles-rubella vaccination and disease outbreaks. Lancet Infect Dis 2024; 24:e16. [PMID: 38141646 DOI: 10.1016/s1473-3099(23)00771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2023]
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