Comparing Seroprotective Levels of IgG Antibody Against Single and Two Shots of Measles-Rubella-Mumps (MMR) Vaccine in Children Aged 12 Months to 15 Years Old in Southern Iran, Ahvaz in 2018
DOI:
https://doi.org/10.6000/2292-2598.2019.07.03.12Keywords:
Rubella, Measles, IgG, Vaccination, Serum Level.Abstract
Background and Objective: Despite inclusive measles and rubella vaccination programs, the epidemics are still present in some areas. The present study aimed to evaluate the efficacy of these two vaccines simultaneously by testing the levels of IgG antibodies in children aged 12 months to 15 years old in Southern Iran.
Methods: This was a cross-sectional study on serum blood samples of 400 children aged 12 months to 15 years old in Ahvaz, Southern Iran in 2018. The children were divided into the following age groups: age group of 12 months to 17 months and 29 days who received a single dose of Measles, Rubella, Mumps (MMR) vaccine; age group of 18 months to 10 years old who received two doses of MMR vaccine at the ages of 12 months and 18 months; and age group of 11 to 15 years old who received two doses of MMR vaccine at the age of 12 months and 4-6 years old. In the assessments, the protective levels were defined as per the guidelines of the ELISA kit (VIRCELL Co., Spain) as follows: The serum IgG antibody levels above 11 IU/ml were defined as positive protective level, 9 to 11 IU/ml as an equivalent state, and the serum antibody level below 9 IU/ml as a negative state. Accordingly, the equivalent and negative cases were reported as negative and cases above 11 IU/ml were positive.
Results: The male to female ratio was 1.02. Most of the patients (69%) were in the age group 18 months to 10 years old. In all age groups, the number of people with a high serum anti-rubella and anti-measles IgG antibody level was higher than the protective level. There was no significant difference between the mean serum anti-rubella and anti-measles IgG antibody level between the age groups (P= 0.515, P= 0.176, respectively). For rubella, 86.66% of females and 83.16% of males, and for measles, 86.36% of females and 83.66% of males were seropositive, and there was no significant difference by two sexes (P= 0.486 and P= 0.412, respectively).
Conclusions: The frequency of seropositive anti-measles and anti-rubella vaccine was not significantly different between the subjects with a single dose and those with two doses of MMR vaccine. Further studies are needed to evaluate the adequacy of the MMR vaccine for Iranian children. Moreover, due to the lower average serum IgG antibody level measles and rubella in males, further investigation is needed to find out the causal relationship between the lack of appropriate response to vaccine injection and male gender.
References
Yahyapour YAM. A review of pathogenic viruses in human. Babol Karpi Press. Babol University of Medical Sciences 2013; 22-6.
Mokhtari HBN, Mahdavian Naghash-Zargar SH. The prevalence of anti-Rubella antibody in pregnant women (In Persian). J Mashhad Azad Univ Med Sci 2010; 6(2): 131-6.
Wolfson LJ, Grais RF, Luquero FJ, Birmingham ME, Strebel PM. Estimates of measles case fatality ratios: a comprehensive review of community-based studies. International Journal of Epidemiology 2009; 38(1): 192-205. https://doi.org/10.1093/ije/dyn224 DOI: https://doi.org/10.1093/ije/dyn224
WHO Measles Fact sheet No 286 December 2009. Available from: URL: www.who.int/mediacentre/factsheets/ fs286/en (Accessed Date: 21 Dec 2010).
World Health Organization. Weekly epidemiological record 2011; 86(29): 301-316.
de Vries RDMA, Geijtenbeek TB, Duprex WP, de Swart RL. Te pathogenesis of measles. Curr Opin Virol 2012; 2: 248-55. https://doi.org/10.1016/j.coviro.2012.03.005 DOI: https://doi.org/10.1016/j.coviro.2012.03.005
Leuridan EHN, Hutse V, Ieven M, Aerts M, Van Damme P. Early waning of maternal measles antibodies in era of measles elimination: longitudinal study. BMJ 2010; 340: c1626. https://doi.org/10.1136/bmj.c1626 DOI: https://doi.org/10.1136/bmj.c1626
Waaijenborg S, Hahne SJM, Mollema L, Smits GP, Berbers GAM, van der Klis FRM, et al. Waning of Maternal Antibodies Against Measles, Mumps, Rubella, and Varicella in Communities With Contrasting Vaccination Coverage. J Infect Dis 2013 Jul 1; 208(1): 10-6. https://doi.org/10.1093/infdis/jit143 DOI: https://doi.org/10.1093/infdis/jit143
Kontio MPA, Syrjänen RK, Lahdenkari M, Ruokokoski E, Davidkin I, Vaarala O, et al. Similar Antibody Levels in 3-Year-Old Children Vaccinated Against Measles, Mumps, and Rubella at the Age of 12 Months or 18 Months. The Journal of Infectious Diseases 2016; 2013: 2005-13. https://doi.org/10.1093/infdis/jiw058 DOI: https://doi.org/10.1093/infdis/jiw058
(WHO). WHO. Global measles and rubella strategic plan: 2012 2020. Geneva; 2012 [accessed 2017 Mar 01] http: //appswhoint/iris/bitstream/10665/44855/1/9789241503396_engpdf
Emami-Naeini AGN, Emami-Naeini S. Measurement of serum antibody titer against measles in a group of adults receiving Measles-Rubella Mass Vaccination. J Esfahan Med Sch (In Persian) 2011; 28(114): 854-8.
Abdollahpour SM, Yahyapour Y, Dargahi S, Tashakori F, Alinejad S, Hajiahmadi M. Seroepidemiology of Measles and Rubella among Medical Sciences Students of Babol University in 2012. J Babol Univ Med Sci 2014; 16(10): 75-80.
Esteghamati AR, Shiva F, Abdinia B, Khairkhah M. Detection of serum antibodies against Measles, Mumps and Rubella after Primary Measles, Mumps and Rubella (MMR) vaccination in children. Archives of Iranian medicine 2013; 16(1): 38.
Jeong YW, Park BH, Kim KH, Han YR, Go UY, Choi WS, et al. Timeliness of MMR vaccination and barriers to vaccination in preschool children. Epidemiology & Infection 2011; 139(2): 247-56. https://doi.org/10.1017/S0950268810000889 DOI: https://doi.org/10.1017/S0950268810000889
Khaki MGA, Mosakhani N. Seroepidemiology of rubella in students of Arak University of Medical Sciences, Three years after national vaccination program (In Persian). Med Lab J Gorgan Univ Med Sci 2009; 3(1): 40-4.
Tsuji YaK, C. Serum Antibody Titers of Measles and Rubella among Japanese Children. World Journal of Vaccines 2015; 5: 149-54. https://doi.org/10.4236/wjv.2015.54017 DOI: https://doi.org/10.4236/wjv.2015.54017
Parizi D, Hassan M, Najafi HR, Arabzadeh SA, Mollaei HR, Iranmanesh Z. Association of Serum Antibodies Between Single and Double MMR Vaccination in Children Under Three Years Old Referred to Pediatric Ward of Kerman Afzalipour Hospital. Urmia Medical Journal 2012; 23(5): 485-91.
Moghadami M, Afsarkazerooni P, Ebrahimi M, Soltani M, Razmpoor A, Pirasteh E, et al. Measles outbreak in south of Iran, where vaccine coverage was high: A case-series study. Iran J Public Health 2014; 43(3): 375-80.