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Randomized Controlled Trial
. 2014 Feb 20;9(2):e89361.
doi: 10.1371/journal.pone.0089361. eCollection 2014.

Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles, mumps, and rubella vaccination

Zhifang Wang  1 , Rui Yan  1 , Hanqing He  1 , Qian Li  1 , Guohua Chen  2 , Shengxu Yang  3 , Enfu Chen  1
Affiliations
Randomized Controlled Trial

Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles, mumps, and rubella vaccination

Zhifang Wang et al. PLoS One. .

Abstract

Background: The reported coverage of the measles-rubella (MR) or measles-mumps-rubella (MMR) vaccine is greater than 99.0% in Zhejiang province. However, the incidence of measles, mumps, and rubella remains high. In this study, we assessed MMR seropositivity and disease distribution by age on the basis of the current vaccination program, wherein the first dose of MR is administered at 8 months and the second dose of MMR is administered at 18-24 months.

Methods: Cross-sectional serological surveys of MMR antibodies were conducted by collecting epidemiological data in Zhejiang province, China in 2011. In total, 1015 participants were randomly selected from two surveillance sites. Serum MMR-specific immunoglobulin G levels were tested by enzyme-linked immunosorbent assay. The geometric mean titers and seroprevalence with 95% confidence intervals (CIs) were calculated by age and gender. Proportions of different dose of vaccine by age by vaccine were also identified. Statistically significant differences between categories were assessed by the Chi-square test.

Results: Over 95% seroprevalence rates of measles were seen in all age groups except <7 months infants. Children aged 5-9 years were shown lower seropositivity rates of mumps while elder adolescences and young adults were presented lower rubella seroprevalence. Especially, rubella seropositivity was significantly lower in female adults than in male. Nine measles cases were unvaccinated or unknown vaccination history. Among them, 66.67% (6/9) patients were aged 20-29 years while 33.33% (3/9) were infants aged 8-12 months. In addition, 57.75% (648/1122) patients with mumps were children aged 5-9 years, and 50.54% (94/186) rubella cases were aged 15-39 years.

Conclusions: A timely two-dose MMR vaccination schedule is recommended, with the first dose at 8 months and the second dose at 18-24 months. An MR vaccination speed-up campaign may be necessary for elder adolescents and young adults, particularly young females.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Reported cases number of measles, mumps and rubella by age group in 2011.
Figure 2
Figure 2. Percentage of vaccination history with different dose by age in 2011.
Approximately 90% of children aged <14 years old received at least one dose of MCV and 70% was immunized with two doses (A). However, adults aged >15 years reported with lower coverage of RCV (B) and less than one half of children aged 5–9 years were recorded with two dose of MuCV (C). MCV: measles-containing vaccine; RCV: rubella-containing vaccine; MuCV: mumps-containing vaccine.
Figure 3
Figure 3. GMTs and seroprevalence of measles, mumps and rubella antibodies in different age group in 2011.
See this image and copyright information in PMC

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