Seroprevalence of measles, mumps, rubella and varicella antibodies in the United States population, 2009-2010

Background.  In the United States, measles, mumps, rubella, and varicella immunity is now primarily achieved through vaccination. Monitoring population immunity is necessary. Methods.  We evaluated seroprevalence of antibodies to measles, mumps, rubella, and varicella using the National Health and Nutrition Examination Survey during 2009-2010. Results.  Measles, mumps, rubella, and varicella seroprevalence was 92.0% (95% confidence interval [CI], 90.9%-93.0%), 87.6% (CI, 85.8%-89.2%), 95.3% (CI, 94.3%-96.2%), and 97.8% (CI, 97.1%-98.3%), respectively. United States (US)-born persons had lower mumps seroprevalence and higher varicella seroprevalence than non-US born persons. Conclusions.  Seroprevalence was high (88%-98%) for all 4 viruses in the US population during 2009-2010.

Seroprevalence of antibody to mumps virus in the US population, 1999-2004

BACKGROUND

In 2006, the largest mumps outbreak in the United States in 20 years occurred. To understand prior mumps seroprevalence and factors associated with the presence of antibody to mumps virus, data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed.

METHODS

A mumps virus-specific enzyme immunoassay was used to measure the seroprevalence of serum immunoglobulin G (IgG) antibody among NHANES participants aged 6-49 years. Participants were grouped on the basis of 10-year birth cohorts, 95% confidence intervals (CIs) were calculated using SUDAAN software, and logistic regression was used to identify independent predictors.

RESULTS

The overall age-adjusted seroprevalence of IgG antibody to mumps virus during 1999-2004 was 90.0% (95% CI, 88.8%-91.1%). Seroprevalence was higher among US-born non-Hispanic blacks (96.4% [95% CI, 95.5%-97.2%]) and non-US-born Mexican Americans (93.7% [95% CI, 92.0%-95.2%]). Seroprevalence was significantly lower in the 1967-1976 birth cohort (85.7% [95% CI, 83.5%-87.8%]). The variables sex, education, and race/ethnicity/birthplace were independent predictors in at least 1 of the birth cohorts.

CONCLUSIONS

The overall estimate of 90.0% is at the lower end of the estimated population immunity (90%-92%) needed to achieve herd immunity. Lower seroprevalence among groups suggest that they represent populations at an increased risk. For mumps control, high vaccine coverage and high population immunity must be achieved and maintained.

Tetanus and diphtheria immunity among females in the United States: are recommendations being followed?

OBJECTIVE

The purpose of this study was to examine prevalence and factors associated with tetanus and diphtheria immunity among women in the United States.

STUDY DESIGN

Sera from 9411 female participants from the third National Health and Nutrition Examination Survey were tested for diphtheria and tetanus antitoxin. Interview information for adult women was analyzed to examine associations with immunity.

RESULTS

Fifty-seven percent of the female subjects who were > or =6 years old were positive for diphtheria, and 64% of the female subjects for tetanus anti-toxin. Among women > or =20 years old, only 41% of the women were protected against both antigens. Older age, birth outside the United States, and less education was associated with lower immunity. Markers for contact with the health care system were not related to higher immunity.

CONCLUSION

More than one half of US women > or =20 years old who were tested were not protected fully against diphtheria and tetanus. All physicians, including obstetricians and gynecologists who may be the sole medical providers for women, should be familiar with the current Advisory Committee on Immunization Practices recommendations regarding tetanus and diphtheria toxoid booster vaccines.