Seroprevalence of measles antibodies and factors associated with susceptibility: a national survey in Mexico using a plaque reduction neutralization test

Abstract

Measles continues to be one of the leading causes of child mortality worldwide, even though a highly effective vaccine has existed for more than 40 years. We aimed to describe the seroprevalence of measles antibodies in Mexico in 2012 and the risk factors associated with susceptibility. A total of 7,785 serum samples were analyzed from the National Health and Nutrition Survey in Mexico. This national survey is representative of the general population, including noninstitutionalized adult, adolescent, and child populations. Antibody titers were classified into protective (> 120 mIU/mL) or susceptible (≤ 120 mIU/mL) levels. The weighted seroprevalence and susceptibility of the overall population were 99.37% (95% CI 99.07-99.58) and 0.63% (95% CI 0.42-0.93), respectively. Among 1-to-4-year-old children, 2.18% (95% CI 1.36-3.48) were susceptible to measles. Among adolescents and young adults, the prevalence of susceptibility was as follows: those 15-19 years of age had a prevalence of 0.22% (95% CI 0.09-0.57), and those 30-39 years of age had a prevalence of 1.17% (95% CI 0.47-2.85). Susceptibility was associated with young age, living in Mexico City, living in crowded households and unknown or nonvaccinated status among 1- to 5-year-old children. Although the overall sample population seroprevalence for measles is above 95%, increased susceptibility among younger children signals the importance of the timely administration of the first vaccine dose at 12 months of age. Furthermore, increased susceptibility among specific subgroups indicates the need to reinforce current vaccination policies, including the immunization of unvaccinated or incompletely vaccinated individuals from 10 to 39 years of age.

Figure 1

Percentage of seropositivity (PRNT antibodies > 120 mIU/mL) according to age group. We have highlighted the 89% and 94% cut-offs for achieving herd immunity.