Measles and rubella serosurvey identifies rubella immunity gap in young adults of childbearing age in Zambia: The added value of nesting a serological survey within a post-campaign coverage evaluation survey

Kyla Hayford, Simon Mutembo, Andrea Carcelen, Hellen K. Matakala, Passwell Munachoonga, Amy Winter, Jane W. Wanyiri, Kelly Searle, Francis D. Mwansa, Angels Mwiche, Caroline Phiri, Chris Book, Philip E Thuma, William J Moss

Research output: Contribution to journalArticle

Abstract

Background: Serological surveys can potentially complement vaccine coverage surveys, such as post-vaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. We estimate age-specific population immunity to measles and rubella viruses in Southern Province, Zambia, and assess the value of adding serological data to vaccination coverage estimates by nesting a serological survey within a PCES. Methods: Dried blood spots (DBS) from fingerprick blood were collected from all individuals ages nine months or older in households participating in the PCES and tested for measles and rubella virus-specific immunoglobulin G (IgG) by enzyme immunoassay (Siemens Enzygnost, Marburg, Germany). Results: Overall seroprevalence was 95.5% (95% CI: 92.8, 97.2) for measles virus-specific IgG and 97.7% (95% CI: 96.0, 98.7) for rubella virus-specific IgG. Rubella seroprevalence was 98.4% (95% CI: 95.9, 99.4) among children eligible for the MR vaccination campaign, significantly higher than the reported measles-rubella (MR) vaccination campaign coverage of 89.8% (p = 0.003), and higher than the 91.3% rubella seroprevalence for adolescents and adults 16–30 years of age (p = 0.049). Conclusion: Seroprevalence to measles and rubella viruses in children younger than 16 years of age was significantly higher than expected from vaccination coverage estimates, likely reflecting exposure to wild-type viruses and underreporting of vaccination. The serosurvey revealed rubella immunity gaps among women 16–30 years of age, precisely the age group in which protection from rubella is most important to prevent congenital rubella syndrome. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs.

Original languageEnglish (US)
Pages (from-to)2387-2393
Number of pages7
JournalVaccine
Volume37
Issue number17
DOIs
StatePublished - Apr 17 2019

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Zambia
Rubella
Immunization Programs
Measles
serological surveys
value added
young adults
Young Adult
Immunity
immunity
vaccination
Rubella virus
Measles virus
Seroepidemiologic Studies
seroprevalence
immunoglobulin G
Vaccination
Immunoglobulin G
Dried Blood Spot Testing
Congenital Rubella Syndrome

Keywords

  • Dried blood spots
  • IgG antibody
  • Immunization coverage
  • Measles
  • Rubella
  • Serological survey
  • Serology
  • Surveillance
  • Vaccination

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Measles and rubella serosurvey identifies rubella immunity gap in young adults of childbearing age in Zambia : The added value of nesting a serological survey within a post-campaign coverage evaluation survey. / Hayford, Kyla; Mutembo, Simon; Carcelen, Andrea; Matakala, Hellen K.; Munachoonga, Passwell; Winter, Amy; Wanyiri, Jane W.; Searle, Kelly; Mwansa, Francis D.; Mwiche, Angels; Phiri, Caroline; Book, Chris; Thuma, Philip E; Moss, William J.

In: Vaccine, Vol. 37, No. 17, 17.04.2019, p. 2387-2393.

Research output: Contribution to journalArticle

Hayford, Kyla ; Mutembo, Simon ; Carcelen, Andrea ; Matakala, Hellen K. ; Munachoonga, Passwell ; Winter, Amy ; Wanyiri, Jane W. ; Searle, Kelly ; Mwansa, Francis D. ; Mwiche, Angels ; Phiri, Caroline ; Book, Chris ; Thuma, Philip E ; Moss, William J. / Measles and rubella serosurvey identifies rubella immunity gap in young adults of childbearing age in Zambia : The added value of nesting a serological survey within a post-campaign coverage evaluation survey. In: Vaccine. 2019 ; Vol. 37, No. 17. pp. 2387-2393.
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abstract = "Background: Serological surveys can potentially complement vaccine coverage surveys, such as post-vaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. We estimate age-specific population immunity to measles and rubella viruses in Southern Province, Zambia, and assess the value of adding serological data to vaccination coverage estimates by nesting a serological survey within a PCES. Methods: Dried blood spots (DBS) from fingerprick blood were collected from all individuals ages nine months or older in households participating in the PCES and tested for measles and rubella virus-specific immunoglobulin G (IgG) by enzyme immunoassay (Siemens Enzygnost, Marburg, Germany). Results: Overall seroprevalence was 95.5{\%} (95{\%} CI: 92.8, 97.2) for measles virus-specific IgG and 97.7{\%} (95{\%} CI: 96.0, 98.7) for rubella virus-specific IgG. Rubella seroprevalence was 98.4{\%} (95{\%} CI: 95.9, 99.4) among children eligible for the MR vaccination campaign, significantly higher than the reported measles-rubella (MR) vaccination campaign coverage of 89.8{\%} (p = 0.003), and higher than the 91.3{\%} rubella seroprevalence for adolescents and adults 16–30 years of age (p = 0.049). Conclusion: Seroprevalence to measles and rubella viruses in children younger than 16 years of age was significantly higher than expected from vaccination coverage estimates, likely reflecting exposure to wild-type viruses and underreporting of vaccination. The serosurvey revealed rubella immunity gaps among women 16–30 years of age, precisely the age group in which protection from rubella is most important to prevent congenital rubella syndrome. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs.",
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T1 - Measles and rubella serosurvey identifies rubella immunity gap in young adults of childbearing age in Zambia

T2 - The added value of nesting a serological survey within a post-campaign coverage evaluation survey

AU - Hayford, Kyla

AU - Mutembo, Simon

AU - Carcelen, Andrea

AU - Matakala, Hellen K.

AU - Munachoonga, Passwell

AU - Winter, Amy

AU - Wanyiri, Jane W.

AU - Searle, Kelly

AU - Mwansa, Francis D.

AU - Mwiche, Angels

AU - Phiri, Caroline

AU - Book, Chris

AU - Thuma, Philip E

AU - Moss, William J

PY - 2019/4/17

Y1 - 2019/4/17

N2 - Background: Serological surveys can potentially complement vaccine coverage surveys, such as post-vaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. We estimate age-specific population immunity to measles and rubella viruses in Southern Province, Zambia, and assess the value of adding serological data to vaccination coverage estimates by nesting a serological survey within a PCES. Methods: Dried blood spots (DBS) from fingerprick blood were collected from all individuals ages nine months or older in households participating in the PCES and tested for measles and rubella virus-specific immunoglobulin G (IgG) by enzyme immunoassay (Siemens Enzygnost, Marburg, Germany). Results: Overall seroprevalence was 95.5% (95% CI: 92.8, 97.2) for measles virus-specific IgG and 97.7% (95% CI: 96.0, 98.7) for rubella virus-specific IgG. Rubella seroprevalence was 98.4% (95% CI: 95.9, 99.4) among children eligible for the MR vaccination campaign, significantly higher than the reported measles-rubella (MR) vaccination campaign coverage of 89.8% (p = 0.003), and higher than the 91.3% rubella seroprevalence for adolescents and adults 16–30 years of age (p = 0.049). Conclusion: Seroprevalence to measles and rubella viruses in children younger than 16 years of age was significantly higher than expected from vaccination coverage estimates, likely reflecting exposure to wild-type viruses and underreporting of vaccination. The serosurvey revealed rubella immunity gaps among women 16–30 years of age, precisely the age group in which protection from rubella is most important to prevent congenital rubella syndrome. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs.

AB - Background: Serological surveys can potentially complement vaccine coverage surveys, such as post-vaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. We estimate age-specific population immunity to measles and rubella viruses in Southern Province, Zambia, and assess the value of adding serological data to vaccination coverage estimates by nesting a serological survey within a PCES. Methods: Dried blood spots (DBS) from fingerprick blood were collected from all individuals ages nine months or older in households participating in the PCES and tested for measles and rubella virus-specific immunoglobulin G (IgG) by enzyme immunoassay (Siemens Enzygnost, Marburg, Germany). Results: Overall seroprevalence was 95.5% (95% CI: 92.8, 97.2) for measles virus-specific IgG and 97.7% (95% CI: 96.0, 98.7) for rubella virus-specific IgG. Rubella seroprevalence was 98.4% (95% CI: 95.9, 99.4) among children eligible for the MR vaccination campaign, significantly higher than the reported measles-rubella (MR) vaccination campaign coverage of 89.8% (p = 0.003), and higher than the 91.3% rubella seroprevalence for adolescents and adults 16–30 years of age (p = 0.049). Conclusion: Seroprevalence to measles and rubella viruses in children younger than 16 years of age was significantly higher than expected from vaccination coverage estimates, likely reflecting exposure to wild-type viruses and underreporting of vaccination. The serosurvey revealed rubella immunity gaps among women 16–30 years of age, precisely the age group in which protection from rubella is most important to prevent congenital rubella syndrome. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs.

KW - Dried blood spots

KW - IgG antibody

KW - Immunization coverage

KW - Measles

KW - Rubella

KW - Serological survey

KW - Serology

KW - Surveillance

KW - Vaccination

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