Immunogenicity and Reactogenicity of a Single Dose of Live Attenuated Varicella Vaccine and a Booster Dose of Measles–Mumps–Rubella Vaccine Given Concomitantly at 12 years of Age

Universal varicella-zoster virus (VZV) childhood vaccination is still debated, but adult chickenpox may be severe. It could be prevented by vaccination of seronegative adolescents. This study aimed to determine the feasibility of coadministration of a VZV vaccine and the measles-mumps-rubella (MMR) booster at 12 y of age. Guardians of 1231 12-y-old pupils where asked about the history of chickenpox in their children. 190 had no chickenpox history and 12 of 62 of them lacked VZV antibodies. Additional history-negative children were also recruited. 199 history-positive children received only MMR and 98 history-negative children received an MMR vaccine and a VZV vaccine. Serum samples were drawn before vaccination and after 8 weeks. Viral antibodies were measured by immunofluorescence (VZV) and enzyme-linked immunosorbent assays (VZV, MMR). All 184 history-positive children tested had VZV antibodies. 17/89 VZV-vaccinated and tested children (19%) lacked VZV antibodies before vaccination. 12 (71%) seroconverted after 1 dose. Cell-mediated immunity (CMI) against varicella was tested in 3/5 children who did not seroconvert after 1 dose of VZV vaccine. They seroconverted after a second dose and had measurable CMI. VZV vaccination did not affect the MMR response and there were no severe side-effects. A history of varicella infection, as reported by the guardian, is reliable, but a negative history was incorrect in 81% of the cases. This population of 12-y-old children may require 2 doses of VZV vaccine, at least when given simultaneously with the MMR vaccine.

[Functional state of specific immunity in children and teenagers vaccinated against mumps]

The functional state of immunity was evaluated from the avidity index (AI) of specific antibodies (IgG) and the level and spectrum of their neutralizing activity. The study recruited 200 subjects immunized with Russian vaccine against mumps according to the mandatory scheme. A group of vaccinees with a low AI of specific IgG was identified mainly among old children and teenagers. The vaccinees with a low AI had a significantly lower protective immunity (as shown from the level and spectrum of serum neutralizing activity) than those with a high AI. The vacinees with no humoral, incomplete, or complete postvaccination immunity, but with a low AI of specific IgG, can constitute a population stratum that preserves sensitivity to wild-type mumps viruses and serves as a favorable medium for their circulation.

[Delayed results of vaccination of children with recurrent respiratory infections against measles and mumps]

AIM

Assessment of results of immunization against measles and mumps in children with recurrent respiratory infections.

MATERIALS AND METHODS

Levels of IgG against measles and mumps viruses were measured using enzyme immunoassay. Two hundred and twelve serum samples obtained from 6 groups of children with 20 - 45 persons (boys and girls) in each were tested. Children of various ages were presented in each group. Also, immunologic parameters were measured in all children.

RESULTS

It was established that mean antibody titers to measles and mumps viruses did not change during 10 years. In more than 50% of children correlation between high and low titers of antibodies of different specificity was found.

CONCLUSION

Recurrent respiratory illnesses determine complex regulation of transition of memory cells into cells secreting antibodies to measles and mumps viruses.

[Evolution of the immunization coverage of 13 to 14 year-old adolescents in Geneva between four years]

This study aims to examine changes in immunization coverage for diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella and hepatitis B during the academic calendars of 2003-2004 and 2007-2008 for students aged 13 to 14 years. Data were collected on an annual basis and systematically from the vaccination records 85% of adolescents enrolled in public institutions in Geneva. The immunization coverage increased for diphtheria, tetanus and polio by 2.3, 2.1 and 1.1 points respectively. Vaccination for pertussis (whooping cough) increased from 20.7% in 2003-2004 to 61% in 2007-2008. Vaccinations administered against measles, mumps and rubella increased by nearly 20 points. During this period, the coverage rate for hepatitis B increased by 10.3 points in 5 years. The recommended vaccination coverage rates are not being achieved for any of the vaccines currently being used in Switzerland, with the exception of those for diphtheria and polio.

Seroprevalence of mumps before inclusion of mumps vaccination in the Iranian expanded programme on immunization

The current target groups for measles, mumps and rubella vaccination in the Islamic Republic of Iran are children at 12 months and 4-6 years. A study of the age-specific seroprevalenceRepublic of Iran are children at 12 months and 4-6 years. A study of the age-specific seroprevalence of antibodies against mumps in children aged 3-18 years in Shahrekord aimed to establish the needof antibodies against mumps in children aged 3-18 years in Shahrekord aimed to establish the need for booster vaccinations to cover non-immune children. Of 338 children, 19.8% were seronegative. Age-specific seronegativity was 33.3%, 20.5% and 4.6% in age groups 7-11, 12-14 and 15-18 years respectively. To obtain herd immunity, we suggest that for the next 5 years children aged 7-11 years entering guidance school are selected as the main group for vaccination.

Evaluation of live attenuated S79 mumps vaccine effectiveness in mumps outbreaks: a matched case-control study

BACKGROUND

Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live attenuated S(79) mumps vaccine has been licensed for pediatric use since 1990. The objective of this study was to determine the effectiveness of live attenuated S(79) mumps vaccine against clinical mumps in outbreaks.

METHODS

Cases were selected from mumps outbreaks in schools in Guangzhou between 2004 and 2005. Each case was matched by gender, age and classroom. Vaccination information was obtained from Children's EPI Administrative Computerized System. Vaccine effectiveness (VE) was calculated for 1 or 2 doses of S(79) vaccine with 95% confidence intervals (CI).

RESULTS

One hundred and ninety-four cases and 194 controls were enrolled into the study. VE of the S(79) mumps vaccine for 1 dose versus 0 confer protection 80.4% (95% CI, 60.0%-90.4%) and VEs against mumps in outbreaks for 1 dose of mumps vaccine are similar among those children aged 4-9 years and aged over 10 years old.

CONCLUSION

The live attenuated S(79) mumps vaccine can be effective in preventing clinical mumps outbreaks.

[Initial results and evaluation of igg antibody levels for measles, mumps, rubella and chickenpox viruses in young adults born in 1989]

The study presents results of the examination of IgG antibody levels for measles, mumps, rubella and chickenpox viruses in Warsaw high school students born in 1989. Results of the analysis of serum samples were confronted with data from questionnaires filled in by the students, containing information on completed vaccination and cases of the studied infectious diseases. Initial results have been especiallyalarming for the measles virus, as they may testify to a lack of immunity in 22.6% of the studied population, including 22.3% of the respondents declaring completion of vaccination to the measles virus. The results of the study indicate a need to repeat (periodical) serological surveys ofvaccine-preventable diseases, in order to obtain an assessment of immunity levels in different age groups.

Matched case-control study of effectiveness of live, attenuated S79 mumps virus vaccine against clinical mumps

Mumps virus infection is a potentially serious viral infection of childhood and early adulthood. In China, live, attenuated S(79) mumps virus vaccine has been licensed for pediatric use since 1990. There has been no assessment of its efficacy. Thus, the objective of this study was to determine the effectiveness of live, attenuated S(79) mumps virus vaccine against clinical mumps. Cases were selected from the China Information System for Disease Control and Prevention during September 2004 to March 2005. Each case was matched to a control by gender, age, and area of residency. In all, 469 cases and 469 controls were enrolled in the study. Vaccination information was obtained from the Children's EPI Administrative Computerized System. Vaccine effectiveness (VE) was calculated for one or two doses of S(79) vaccine, with 95% confidence intervals (CI). VE of mumps virus vaccine for one dose versus none was protection of 86.0% (95% CI, 77.2% to 91.5%) of recipients, and VE was much higher in the first 4 years than in the 5 to 12 years after vaccination. The S(79) vaccine can effectively prevent clinical mumps, and a second dose of mumps virus vaccine is necessary for the protection of children in China.

A case of fulminant type 1 diabetes associated with significant elevation of mumps titers

Type 1 diabetes mellitus is classified as either autoimmune or idiopathic. Fulminant type 1 diabetes was originally reported as a subtype of idiopathic type 1 diabetes. Though involvement of viral infections has been suggested as a triggering mechanism, its pathogenesis remains unknown. Here, we present a case of fulminant type 1 diabetes associated with significant elevation of mumps titers. A 56-year-old Japanese man had suffered from nausea and generalized fatigue for two days before being transferred to our hospital in a confused state. Findings on admission revealed a high blood glucose level, near-normal HbA1c level, metabolic acidosis, and increased urinary ketone levels. Serum tests for islet-associated autoantibodies were negative. The serum, urinary C-peptide levels and the result of glucagon test indicated severe impairment of insulin secretion. These results were compatible with the diagnosis of fulminant type 1 diabetes. Also, he was suspected as having mumps infection on the basis of serological testing. These findings suggest that fulminant type 1 diabetes developed after mumps virus infection in our case. To the best of our knowledge, no other report has indicated an association between a recent mumps infection and the onset of fulminant type 1 diabetes. This case suggests an association between fulminant type 1 diabetes and mumps virus infection.

Measles and mumps immunity in Northern Greece, 2004-2007

A cross-sectional study was conducted in order to determine the prevalence of mumps and measles antibodies in a representative sample of the general population in Northern Greece between January 2004 and May 2007. Overall, 900 healthy individuals participated in the study. The great majority were found to be protected against measles. The total protection rate against mumps was significantly less (87% versus 72%, respectively; p<0.01). Compared to all other age groups, statistically significantly lower protection rates were found in children younger than 1.5 years (p<0.01). The lowest rates of all adult groups were found in the age group of 21 to 30 years (86% and 68% for measles and mumps, accordingly). In conclusion, protection rates against both measles and mumps seem to be lower than expected in certain age groups, such as infants and young adults.

Reliability of medical students' vaccination histories for immunisable diseases

BACKGROUND

Medical students come into contact with infectious diseases early on their career. Immunity against vaccine-preventable diseases is therefore vital for both medical students and the patients with whom they come into contact.

METHODS

The purpose of this study was to compare the medical history and serological status of selected vaccine-preventable diseases of medical students in Germany.

RESULTS

The overall correlation between self-reported medical history statements and serological findings among the 150 students studied was 86.7 %, 66.7 %, 78 % and 93.3 % for measles, mumps, rubella and varicella, conditional on sufficient immunity being achieved after one vaccination. Although 81.2 % of the students' medical history data correlated with serological findings, significant gaps in immunity were found.

CONCLUSION

Our findings indicate that medical history alone is not a reliable screening tool for immunity against the vaccine-preventable diseases studied.

Detection of measles- and mumps-specific IgG antibodies in paired serum and oral fluid samples from Norwegian conscripts

The aim of this study was to measure the seroprevalence to mumps in Norwegian conscripts belonging to the first children vaccination cohorts that had been offered two doses of MMR vaccine. The seroprevalence to mumps was 76% with the Microimmune assay and 85% with the Enzygnost assay. We also compared the performance of the Microimmune assay for detection of mumps- and measles-specific IgG antibodies in 340 paired serum and oral fluid samples from the conscripts and evaluated the effect of revaccination. Mumps-specific IgG antibodies were detected in only 61% of the oral fluids. In contrast, high levels of measles-specific IgG antibodies were detected in both the serum and oral fluid samples. Based on these results, we are only able to recommend the use of oral fluid for surveillance of measles in Norway. Our results may also indicate that the seroprevalence necessary to interrupt transmission of mumps has not been reached in vaccinated young adult Norwegians. Seroconversion was observed in all initially measles seronegative conscripts after revaccination, whereas 23 of 27 initially mumps seronegative conscripts failed to seroconvert.

[Enhancement of measles-mumps divaccine using myelopeptide 2 in experiment]

Combined application of mumps and measles vaccine strains in equal doses results in significant decrease of immune response to the former component in humans. It is possible that this phenomenon is related with well-known immunodepressive effect of measles virus, which was demonstrated both in vivo and in vitro. It was previously shown that myelopeptide-2 (MP-2) partially neutralizes suppressive effect of measles vaccine on blast transformation of activated human lymphocytes in vitro. Partial supression of immune response to mumps vaccine by live measles vaccine was reproduced in laboratory animals. It was shown that in experiment MP-2 partially neutralized suppressive effect of measles vaccine.

The contribution of single antigen measles, mumps and rubella vaccines to immunity to these infections in England and Wales

OBJECTIVE

To obtain information on the use of single antigen measles, mumps and rubella vaccines to improve estimates of population immunity and help predict outbreaks.

DESIGN

We requested information from providers of single antigen vaccines and from the Medicine and Healthcare products Regulatory Agency on requests for importation of single antigen measles and mumps vaccines.

SETTING

England and Wales.

MAIN OUTCOME MEASURES

Number of doses of single measles, mumps and rubella vaccine, by age of child (in months), year given and area of residence, and number of children who have received all three single vaccinations.

RESULTS

Of 27 providers identified, 13 held single site clinics: nine were individual general practitioners and five held clinics at multiple sites. Data were received from 9/27 (33%) providers operating 40/74 (54%) clinic sites. We received information on 60 768 vaccinations administered by single vaccine providers and 269 917 doses requested for importation. For children born in 2001/2002, the minimum estimates for the proportion who received single measles vaccine are 1.7% in 2001 and 2.1% in 2002, with a reasonable maximum estimate of 5.6% over the 2 years. For single mumps vaccine, the minimum estimates are 0.3% in 2001 and 0.02% in 2002, with a maximum estimate of 4.0%.

CONCLUSION

The contribution of single vaccines to immunity is small in comparison to that of the combined measles, mumps and rubella vaccine (MMR). For recent birth cohorts this contribution could increase routine coverage for measles-containing vaccines by around 2%, still below the level of immunity required to sustain elimination.

Ethnicity as a correlate of the uptake of the first dose of mumps, measles and rubella vaccine

The aim of this study was to investigate whether a relationship exists between ethnicity and uptake of the first dose of mumps, measles and rubella (MMR1) vaccination, and to study important factors influencing the parental decision about vaccination. Examination of routine data on uptake of MMR1 vaccine among children living in the London borough of Brent, North West London, for associations with ethnicity was carried out. Six focus group interviews were held and a questionnaire on factors related to immunisation by convenience samples of mothers from Asian, Afro-Caribbean and White backgrounds was completed. The routine data reported MMR1 vaccine status for 6444 children living in Brent who were aged between 18 months and 3 years on 1 December 2003. A total of 37 mothers took part in the 6 focus group sessions. Significantly higher coverage by MMR1 vaccine in the Asian population (87.1%) compared with Afro-Caribbeans (74.7%) and the White group (57.5%) was noticed. The qualitative data revealed clear differences between the ethnic groups with respect to awareness of the controversy surrounding MMR vaccination (related to use of English-language media) and influence of grandparents and health professionals in decisions about immunisation. A multiple logistic regression model showed that although coverage of MMR vaccination increased with increasing socioeconomic status, there was no evidence of a statistically significant interaction between socioeconomic status and ethnicity. An important association between ethnicity and uptake of MMR1 vaccine is observed. This has implications for efforts to improve the currently inadequate levels of MMR vaccination across the population as a whole.