Abstract
BackgroundSerological 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. MethodsDried 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). ResultsOverall 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). ConclusionSeroprevalence 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.
Highlights
Mass vaccination campaigns for measles and rubella are designed to rapidly increase population immunity [1]
This study evaluated agespecific population immunity to measles and rubella viruses in Southern Province, Zambia, by conducting a serological survey nested within a postvaccination campaign coverage evaluation surveys (PCES) to assess the value of adding serological data to vaccination coverage estimates
A national catch-up measles and rubella (MR) vaccination campaign was conducted in Zambia from 19th to 24th September 2016 targeting all children 9 months to younger than 15 years of age
Summary
Mass vaccination campaigns for measles and rubella are designed to rapidly increase population immunity [1]. ⇑ Corresponding author at: International Vaccine Access Center, 415 N. from mass campaigns are not consistently recorded on the child’s home-based records (vaccination card), multi-purpose surveys such as the Demographic and Health Surveys or Multiple Indicator Cluster Surveys may underestimate measles and rubella vaccination coverage [3,4,5]. Probability-based household surveys, such as post-campaign coverage evaluation surveys (PCES), can provide accurate estimates of vaccination coverage within months of the campaign but require expertise in sampling and statistics [6,7]. Serological surveys can potentially complement vaccine coverage surveys, such as postvaccination campaign coverage evaluation surveys (PCES), by providing direct information on population immunity within and outside the target age range of the mass vaccination campaign. Nesting serological surveys within existing surveys can leverage resources and infrastructure while providing complementary information important to immunization programs
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