Vaccination in secondary school students expedites rubella control and prevents congenital rubella syndrome.

Hanqing He,Rui Yan,Xuan Deng,Shuyun Xie,Xuewen Tang,Yang Zhou

doi:10.1186/s12879-016-2046-5

Abstract

BackgroundIn order to control the spread of rubella and reduce the risk for congenital rubella syndrome, an additional rubella vaccination program was set up for all secondary school students since 2008 in Zhejiang, China.MethodsWe conducted a descriptive analysis of rubella incidence among different age groups from 2005 to 2015 and a serosurvey of female subjects aged 15–39 years to understand the possible effects of this immunization program.ResultsThe average annual rubella incidence rate had decreased from 15.86 per 100,000 population (2005–2007) to 0.75 per 100,000 population (2013–2015) in Zhejiang. The decrease in the rate of rubella incidence in girls aged 15–19 years was more accelerated (from 138.30 to 0.34 per 100,000) than in the total population during 2008–2015 (from 32.20 to 0.46 per 100,000). Of 1225 female subjects in the serosurvey, 256 (20.9%) were not immune to rubella. The proportion of subjects immune to rubella was significantly different among different age groups (Wald χ2 = 22.19, p = 0.000), and subjects aged 15–19 years old had the highest immunity (88.0%). Rubella antibody levels were significantly lower in women aged 25–30 years with 26.7% of them not immune, followed by the group aged 20–24 years (25.0%) and 30–35 years (24.5%).ConclusionsRubella vaccine included in the Expanded Program on Immunization together with vaccination activities for secondary school students can help in rubella control, particularly in targeted age groups in the program. Seroprevalence of antibodies to the rubella virus amongst the female population within childbearing age in Zhejiang, China, is still too low to provide immunity. In addition to vaccination programs in the secondary schools, rubella vaccination should also be encouraged in women of childbearing age, which can be done effectively combined with pre-marital examination in China.

Highlights

In order to control the spread of rubella and reduce the risk for congenital rubella syndrome, an additional rubella vaccination program was set up for all secondary school students since 2008 in Zhejiang, China
rubella-containing vaccine (RCV) was included into the Expanded Program on Immunization (EPI) at the end of 2007, and the vaccine was administered free of charge to children at 8 months and 18–24 months of age
Epidemiological effects on the total population According to National Notifiable Diseases Reporting System (NNDRS), the average annual rubella incidence rate had decreased from 15.86 per 100,000

Summary

Introduction

In order to control the spread of rubella and reduce the risk for congenital rubella syndrome, an additional rubella vaccination program was set up for all secondary school students since 2008 in Zhejiang, China. Rubella can result in some detrimental results including miscarriage, fetal death, and congenital rubella syndrome (CRS) when infection with the virus occurs in early pregnancy, during the first 16 weeks among non-immunized women [3, 4]. RCV was introduced for children in Zhejiang since 1994, but recipients had to pay for the vaccine until 2007. The rubella vaccine coverage in children was less than 50% in Zhejiang as many other places in China from 1994 to 2007 [6, 7]. RCV was included into the Expanded Program on Immunization (EPI) at the end of 2007, and the vaccine was administered free of charge to children at 8 months and 18–24 months of age. The reported coverage rate of rubella was more than 90% in

Methods

Results

Discussion

Conclusion