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Hachiya M, Vynnycky E, Mori Y, Do HT, Huynh MK, Trinh LH, Nguyen DD, Tran NAT, Hoang TT, Hoang HHT, Vo NDT, Le TH, Ichimura Y, Miyano S, Okawa S, Thandar MM, Yokobori Y, Inoue Y, Mizoue T, Takeda M, Komada K. Age-specific prevalence of IgG against measles/rubella and the impact of routine and supplementary immunization activities: A multistage random cluster sampling study with mathematical modelling. Int J Infect Dis 2024; 144:107053. [PMID: 38641317 DOI: 10.1016/j.ijid.2024.107053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Vietnam continues to have measles and rubella outbreaks following supplementary immunization activities (SIA) and routine immunization despite both having high reported coverage. To evaluate immunization activities, age-specific immunity against measles and rubella, and the number of averted Congenital Rubella Syndrome (CRS) cases, must be estimated. METHODS Dried blood spots were collected from 2091 randomly selected individuals aged 1-39 years. Measles and rubella virus-specific immunoglobulin G (IgG) were measured by enzyme immunoassay. Results were considered positive at ≥120 mIU/mL for measles and ≥10 IU/mL for rubella. The number of CRS cases averted by immunization since 2014 were estimated using mathematical modelling. RESULTS Overall IgG seroprevalence was 99.7% (95%CI: 99.2-99.9) for measles and 83.6% (95%CI: 79.3-87.1) for rubella. Rubella IgG seroprevalence was higher among age groups targeted in the SIA than in non-targeted young adults (95.4% [95%CI: 92.9-97.0] vs 72.4% [95%CI: 63.1-80.1]; P < 0.001). The estimated number of CRS cases averted in 2019 by immunization activities since 2014 ranged from 126 (95%CI: 0-460) to 883 (95%CI: 0-2271) depending on the assumed postvaccination reduction in the force of infection. CONCLUSIONS The results suggest the SIA was effective, while young adults born before 1998 who remain unprotected for rubella require further vaccination.
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Affiliation(s)
- Masahiko Hachiya
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
| | - Emilia Vynnycky
- United Kingdom Health Security Agency, London, UK; London School of Hygiene & Tropical Medicine, London, UK
| | - Yoshio Mori
- Department of Virology 3 and World Health Organization Global Specialized Laboratory for Measles and Rubella, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Hung Thai Do
- Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Mai Kim Huynh
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Long Hoang Trinh
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Duy Duc Nguyen
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Nhu Anh Thi Tran
- Microbiology and Immunology, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Thanh Tien Hoang
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Hai Hang Thi Hoang
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Ngoc Dieu Thi Vo
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Thieu Hoang Le
- Infectious Diseases Control and Prevention, Pasteur Institute in Nha Trang, Nha Trang City, Viet Nam
| | - Yasunori Ichimura
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shinsuke Miyano
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Sumiyo Okawa
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Moe Moe Thandar
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yuta Yokobori
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Makoto Takeda
- Department of Virology 3 and World Health Organization Global Specialized Laboratory for Measles and Rubella, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Kenichi Komada
- Bureau of International Health Cooperation and World Health Organization Collaborating Center for Health Systems Development, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
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Vittrup DM, Jensen A, Sørensen JK, Zimakoff AC, Malon M, Charabi S, Johansen MR, Simões EA, Kirkby NS, Buus S, Svensson J, Stensballe LG. Immunogenicity and reactogenicity following MMR vaccination in 5-7-month-old infants: a double-blind placebo-controlled randomized clinical trial in 6540 Danish infants. EClinicalMedicine 2024; 68:102421. [PMID: 38292039 PMCID: PMC10825632 DOI: 10.1016/j.eclinm.2023.102421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Background Measles is a highly contagious viral disease. Vaccinated mothers transfer fewer antibodies during pregnancy, resulting in shortened infant immunity. Earlier primary vaccination might avert the gap in protection. Methods Healthy 5-7-month-old Danish infants were assigned in a 1:1 ratio to M-M-RVaxPro or placebo (solvent) in a double-blind, randomized trial between April 15, 2019 and November 1, 2021 (ClinicalTrials.govNCT03780179, EudraCT 2016-001901-18). Eligibility criteria were birth weight >1000 g and gestational age ≥32 weeks.Immunogenicity was measured by plaque reduction neutralization test (PRNT) and IgG ELISA before intervention, four weeks after intervention and routine MMR. Reactogenicity data were collected for six weeks and measured by hazard ratios (HR). Findings 647 and 6540 infants participated in the immunogenicity and reactogenicity study, respectively; 87% and 99% completed follow-up. After early MMR, seroprotection rates (SPRs) were 47% (13%) in measles PRNT; 28% (2%), 57% (8%) in mumps and rubella IgG (placebo). For measles PRNT, geometric mean ratio was 4.3 (95% CI: 3.4-5.3) between randomization groups after intervention and 1.5 (95% CI: 1.3-1.9) after routine MMR.Reactogenicity was independent of randomization (HR, 1.0; 95% CI: 0.9-1.1). Severe adverse events occurred in 25 infants (HR, 1.8; 95% CI: 0.8-4.0); none deemed vaccine related. Interpretation Early MMR elicited low SPRs but did not negatively impact short-term responses to a subsequent MMR. MMR at 5-7 months was safe and not associated with higher rates of reactogenicity than placebo. Funding Innovation Fund Denmark.
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Affiliation(s)
- Dorthe Maria Vittrup
- The Child and Adolescent Department, The University Hospital Herlev, Denmark
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Andreas Jensen
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Jesper Kiehn Sørensen
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Anne Cathrine Zimakoff
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Michelle Malon
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Salma Charabi
- Department of Cardiology, Nordsjaellands Hospital, Hilleroed, Denmark
| | | | - Eric A.F. Simões
- School of Medicine, and Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Nikolai Søren Kirkby
- Dept. of Microbiology, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Søren Buus
- Dept. of Immunology, University of Copenhagen, Denmark
| | - Jannet Svensson
- The Child and Adolescent Department, The University Hospital Herlev, Denmark
- Steno Diabetes Centre Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Lone Graff Stensballe
- The Child and Adolescent Clinic, The Juliane Marie Centre, The Danish National University Hospital “Rigshospitalet”, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
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Santibanez S, Mankertz A. Measles Foci Reduction Neutralization Test (FRNT). Methods Mol Biol 2024; 2808:209-224. [PMID: 38743373 DOI: 10.1007/978-1-0716-3870-5_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The plaque reduction neutralization test (PRNT) and the enzyme-linked immunosorbent assay (ELISA) are both widely used to assess immunity to infectious diseases such as measles, but they use two different measurement principles: ELISA measures the ability of antibodies to bind to virus components, while the PRNT detects the aptitude of antibodies to prevent the infection of a susceptible cell. As a result, detection of measles virus (MV) neutralizing antibodies is the gold standard for assessing immunity to measles. However, the assay is laborious and requires experience and excellent technical skills. In addition, the result is only available after several days. Therefore, the classical PRNT is not suitable for high-throughput testing. By using an immunocolorimetric assay (ICA) to detect MV-infected cells, the standard PRNT has been developed into a focus reduction neutralization test (FRNT). This assay is faster and has improved specificity. The FRNT described here is extremely useful when immunity to measles virus needs to be assessed in patients with a specific medical condition, such as immunocompromised individuals in whom presumed residual immunity needs to be assessed. The FRNT is not generally recommended for use with large numbers of specimens, such as in a seroprevalence study.
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Affiliation(s)
- Sabine Santibanez
- National Reference Center Measles, Mumps, Rubella, Robert Koch-Institute, Berlin, Germany
| | - Annette Mankertz
- National Reference Center Measles, Mumps, Rubella, Robert Koch-Institute, Berlin, Germany.
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