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Gehrt L, Englund H, Laake I, Nieminen H, Möller S, Feiring B, Lahdenkari M, Trogstad L, Benn CS, Sørup S. Is vaccination against measles, mumps, and rubella associated with reduced rates of antibiotic treatments among children below the age of 2 years? Nationwide register-based study from Denmark, Finland, Norway, and Sweden. Vaccine 2024; 42:2955-2965. [PMID: 38508926 DOI: 10.1016/j.vaccine.2024.03.026] [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: 05/17/2023] [Revised: 02/06/2024] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Previous studies have shown that vaccination against measles, mumps, and rubella (MMR) may have beneficial non-specific effects, reducing the risk of infections not targeted by the vaccine. We investigated if MMR vaccine given after the third dose of diphtheria-tetanus-acellular pertussis vaccine (DTaP3), was associated with reduced rates of antibiotic treatments. METHODS Register-based cohort study following children from the age of recommended MMR vaccination until age 2 years. We included 831,287 children born in Denmark, Finland, Norway, and Sweden who had received DTaP3 but not yet MMR vaccine. Cox proportional hazards regression with age as the underlying timescale and vaccination status as a time-varying exposure was used to estimate covariate-adjusted Hazard Ratios (aHRs) and inverse probability of treatment weighted (IPTW) HRs of antibiotic treatments. Summary estimates were calculated using random-effects meta-analysis. RESULTS Compared with only having received DTaP3, receipt of MMR vaccine after DTaP3 was associated with reduced rates of antibiotic treatments in all countries: the aHR was 0.92 (0.91-0.93) in Denmark, 0.92 (0.90-0.94) in Finland, 0.84 (0.82-0.85) in Norway, and 0.87 (0.85-0.90) in Sweden, yielding a summary estimate of 0.89 (0.85-0.93). A stronger beneficial association was seen in a negative control exposure analysis comparing children vaccinated with DTaP3 vs two doses of DTaP. CONCLUSIONS Across the Nordic countries, receipt of MMR vaccine after DTaP3 was associated with an 11% lower rate of antibiotic treatments. The negative control analysis suggests that the findings are affected by residual confounding. Findings suggest that potential non-specific effects of MMR vaccine are of limited clinical and public health importance for the milder infections treated out-of-hospital in the Nordic setting.
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Affiliation(s)
- Lise Gehrt
- Bandim Health Project, Research Unit OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Odense C, Denmark; Danish Institute for Advanced Study, University of Southern Denmark, Odense C, Denmark.
| | - Hélène Englund
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - Ida Laake
- Division of Infection Control, Norwegian Institute of Public Health Oslo, Norway
| | - Heta Nieminen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Tampere, Finland
| | - Sören Möller
- Research Unit OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Odense C, Denmark
| | - Berit Feiring
- Division of Infection Control, Norwegian Institute of Public Health Oslo, Norway
| | - Mika Lahdenkari
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lill Trogstad
- Division of Infection Control, Norwegian Institute of Public Health Oslo, Norway
| | - Christine Stabell Benn
- Bandim Health Project, Research Unit OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Odense C, Denmark; Danish Institute for Advanced Study, University of Southern Denmark, Odense C, Denmark
| | - Signe Sørup
- Bandim Health Project, Research Unit OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Odense C, Denmark; Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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da Silva TMR, de Sá ACMGN, Vieira EWR, Prates EJS, Beinner MA, Matozinhos FP. Number of doses of Measles-Mumps-Rubella vaccine applied in Brazil before and during the COVID-19 pandemic. BMC Infect Dis 2021; 21:1237. [PMID: 34886804 DOI: 10.1186/s12879-021-06927-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Background Due to the social isolation measures adopted in an attempt to mitigate the risk of transmission of SARS-CoV-2, there has been a reduction in vaccination coverage of children and adolescents in several countries and regions of the world. Objective Analyze the number of doses of vaccine against Measles-Mumps-Rubella (MMR) applied before and after the beginning of mitigation measures due to COVID-19 pandemic in Brazil.
Methods The data collected refer to the number of doses of the MMR vaccine applied monthly to the target population residing in Brazil: cahildren, aged 12 months (first dose) and children, aged 9 years (second dose), from April 2019 to December 2020. Differences in MMR vaccine doses from April 2019 to March 2020 (before the start of mitigation measures) and April 2020 to September 2020 (after the start of the mitigation measures) were evaluated. Spatial analysis identified clusters with a high percentage of reduction in the median of applied doses no Brazil. Results There was a reduction in the median of doses applied in the Regions North (− 33.03%), Northeast (− 43.49%) and South (− 39.01%) e nos Estados Acre (− 48.46%), Amazonas (− 28.96%), Roraima (− 61.91%), Paraíba (− 41.58%), Sergipe (− 47.52%), Rio de Janeiro (-59.31%) and Santa Catarina (− 49.32) (p < 0.05). High-high type spatial clusters (reduction between 34.00 and 90.00%) were formed in the five regions of Brazil (Moran’s I = 0.055; p = 0.01). Conclusion A reduction in the number of MMR vaccine doses was evidenced as a possible effect by the restrictive actions of COVID-19 in Brazil.
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McDonald HI, Tessier E, White JM, Woodruff M, Knowles C, Bates C, Parry J, Walker JL, Scott JA, Smeeth L, Yarwood J, Ramsay M, Edelstein M. Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32431288 PMCID: PMC7238742 DOI: 10.2807/1560-7917.es.2020.25.19.2000848] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: −20.7 to −18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing.
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Affiliation(s)
- Helen I McDonald
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Elise Tessier
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom
| | - Joanne M White
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom
| | - Matthew Woodruff
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | | | - Chris Bates
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | - John Parry
- The Phoenix Partnership (TPP) (Leeds) Ltd, Leeds, United Kingdom
| | - Jemma L Walker
- Statistics, Modelling and Economics Department, Public Health England, Colindale, United Kingdom.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - J Anthony Scott
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Liam Smeeth
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Joanne Yarwood
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Mary Ramsay
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
| | - Michael Edelstein
- Immunisation and Countermeasures Division, Public Health England, Colindale, United Kingdom.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,NIHR Health Protection Research Unit (HPRU) in Immunisation, London, United Kingdom
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Kwak YG, Song JE, Oh GB, Jeong IH, Cho CR, Kim N, Yoo HM, Yoo GM, Lee MJ, Kim BN. Comparison of the Seroprevalence of Measles Antibodies among Healthcare Workers in Two Korean Hospitals in 2019. Infect Chemother 2020; 52:93-97. [PMID: 31997601 PMCID: PMC7113453 DOI: 10.3947/ic.2020.52.1.93] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/08/2020] [Indexed: 11/24/2022] Open
Abstract
We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test. The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs. 89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.
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Affiliation(s)
- Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Je Eun Song
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Gang Bok Oh
- Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - In Hye Jeong
- Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Chong Rae Cho
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Namhee Kim
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hyeon Mi Yoo
- Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Gyeong Min Yoo
- Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Myung Jin Lee
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Baek Nam Kim
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
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Rieck T, Matysiak-Klose D, Hellenbrand W, Koch J, Feig M, Siedler A, Wichmann O. [Compliance with adult measles and pertussis vaccination recommendations : Analysis of data from the national monitoring system KV-Impfsurveillance]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:422-432. [PMID: 30805673 DOI: 10.1007/s00103-019-02902-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The Standing Committee on Vaccination recommends adult measles and pertussis vaccination. The measles vaccine has been recommended since 2010 to adults born after 1970 with less than two doses in childhood, and an acellular pertussis vaccine (ap) since 2009 to be administered to all adults, with the next recommended decennial tetanus (T) and diphtheria (d) booster as a Tdap combination vaccine.We aim to determine the annual uptake of the measles vaccine (vaccination incidence) and its proportion in pediatric and gynecological practices as interdisciplinary services (2009-2016). We further aim to calculate the 10-year ap vaccination coverage and missed vaccination opportunities as the proportion vaccinated with Td only among all Td and Tdap vaccinees (2007-2016).Within the national vaccination monitoring system KV-Impfsurveillance of the Robert Koch Institute and all Associations of Statutory Health Insurance Physicians, all persons receiving the relevant vaccinations were identified in nationwide statutory health insurance claims and related to the numbers of insured persons.The measles vaccination incidence in 2009 was 0.4%, increasing to ≥1.0% annually since 2013. It was higher in western than eastern federal states and higher among women than men. Of all measles vaccinations, 6.8% were given by pediatricians. Men received 2.6% of their vaccinations by gynecologists. The ap vaccination coverage was 32.4%. The proportion of exclusively Td vaccinated adults fell from 84% (2007) to 24% (from 2013 onwards).Since their recommendation, the KV-Impfsurveillance system shows increased uptake of measles and pertussis vaccines with regional and sex differences and is thus instrumental in their evaluation. Analyses of interdisciplinary vaccinations and missed vaccination opportunities provide insight into the potential for increasing uptake.
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Affiliation(s)
- Thorsten Rieck
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland. .,Charité Universitätsmedizin Berlin, Berlin, Deutschland.
| | | | - Wiebke Hellenbrand
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Judith Koch
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Marcel Feig
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Anette Siedler
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Ole Wichmann
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
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Jung J, Kim SK, Kwak SH, Hong MJ, Kim SH. Seroprevalence of Measles in Healthcare Workers in South Korea. Infect Chemother 2019; 51:58-61. [PMID: 30941939 PMCID: PMC6446017 DOI: 10.3947/ic.2019.51.1.58] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/12/2019] [Indexed: 12/02/2022] Open
Abstract
There are only limited data regarding the seroprevalence of measles of healthcare workers (HCWs) in Korea. We evaluated the seroprevalence of measles in HCWs in a tertiary care hospital in Korea. A total of 7,411 HCWs born from 1952 to 1995 underwent antibody test. The overall seropositivity of measles was 73% (95% confidence interval, 72 – 74). The seropositivity of measles sharply declined from 85% in the 1986 birth cohort to 42% in the 1995 birth cohort, thus signifying pockets of under-immunity. Our data warrant the need for routine antibody tests, followed by measles vaccination or routine measles vaccination in young Korean HCWs.
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Affiliation(s)
- Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Office for Infection Control, Asan Medical Center, Seoul, Korea
| | - Sun Kyung Kim
- Office for Infection Control, Asan Medical Center, Seoul, Korea
| | - Sun Hee Kwak
- Office for Infection Control, Asan Medical Center, Seoul, Korea
| | - Min Jee Hong
- Office for Infection Control, Asan Medical Center, Seoul, Korea
| | - Sung Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Office for Infection Control, Asan Medical Center, Seoul, Korea.
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Ovsyannikova IG, Larrabee BR, Schaid DJ, Poland GA. Immunoglobulin GM and KM genes and measles vaccine-induced humoral immunity. Vaccine 2017; 35:5444-7. [PMID: 28274637 DOI: 10.1016/j.vaccine.2017.02.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 11/20/2022]
Abstract
Identifying genetic polymorphisms that explain variations in humoral immunity to live measles virus vaccine is of great interest. Immunoglobulin GM (heavy chain) and KM (light chain) allotypes are genetic markers known to be associated with susceptibility to several infectious diseases. We assessed associations between GM and KM genotypes and measles vaccine humoral immunity (neutralizing antibody titers) in a combined cohort (n=1796) of racially diverse healthy individuals (age 18-41years). We did not discover any significant associations between GM and/or KM genotypes and measles vaccine-induced neutralizing antibody titers. African-American subjects had higher neutralizing antibody titers than Caucasians (1260mIU/mL vs. 740mIU/mL, p=7.10×10-13), and those titers remained statistically significant (p=1.68×10-09) after adjusting for age at enrollment and time since last vaccination. There were no statistically significant sex-specific differences in measles-induced neutralizing antibody titers in our study (p=0.375). Our data indicate a surprising lack of evidence for an association between GM and KM genotypes and measles-specific neutralizing antibody titers, despite the importance of these immune response genes.
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