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Measles-Mumps-Rubella-Varicella Vaccination

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Clinical Immunology".

Deadline for manuscript submissions: closed (1 February 2021) | Viewed by 21955

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Prof. Dr. Silvio Tafuri

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Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
Interests: long time immunogenicity of vaccination; adverse events following immunization; vaccination of high risk subgroups
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

According to the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020. This goal, established in 2015, has been postponed and probably will be delayed, according to the actual world epidemiological scenario.

Global measles deaths have declined from 550,100 deaths in 2000 to 89,780 deaths in 2016. Furthermore, we noted a very important resurgence of this disease; WHO statistics showed over 112,000 confirmed measles cases globally in the first 4 months of 2019. Europe has also seen a 300% increase in measles infection, with Italy and the German state of Brandenburg ordering mandatory vaccinations.

Additionally, Rubella remains a public health priority: in 2017, the WHO reported 16,391 cases of rubella worldwide, and this figures was 26,606 for 2018, with 449 cases of congenital rubella.

Since 2005, a MMRV tetravalent vaccine has been marketed and used in several National Universal Mass Strategies, but its use has been questioned due to possible increased risk of seizure after immunization. Additionally, this questioning has contributed to suboptimal immunization coverage. The use of MMRV has contributed to the change of varicella epidemiological patterns in some parts of the world.

The actual epidemiological scenario is characterized by an increase of the average age of infection, cases of vaccination failure (in particular among subjects immunized several years before), and circulation of measles and varicella in high-risk settings with complicated cases (e.g., among patients affected by malignancies or with an important decrease in immunity response).

Public health institutions probably need to plan other activities to reach their elimination goals, and the revision of experimental and observational data could help this process. This is the aim of this Special Issue, and I hope that you collaborate with us.

Prof. Silvio Tafuri
Guest Editor

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Keywords

advances in elimination goals
hard-to-reach groups
seizure after MMRV vaccination
vaccination effectiveness
vaccination in the real life

Published Papers (9 papers)

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Research

11 pages, 555 KiB

Open AccessArticle

Low Seroprevalence of Measles-Specific IgG in Children of Three Ethnic Groups from Mexico: Influence of Age, Sex, Malnutrition and Family Size

by Miguel A. Sánchez-Alemán, Ilse A. Gutiérrez-Pérez, Nayeli Díaz-Salgado, Oscar Zaragoza-García, María Olamendi-Portugal, Natividad Castro-Alarcón, Isela Parra-Rojas and Iris P. Guzmán-Guzmán

Vaccines 2021, 9(3), 295; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9030295 - 22 Mar 2021

Cited by 5 | Viewed by 2487

Abstract

Background: The reemergence of measles represents a public health problem. The aim of the study was to determine the seroprevalence of IgG antibodies against measles in children of three ethnic groups in southern Mexico and the nutritional status and demographic risk factors associated. Methods: A cross-sectional study in 416 school-age children, 207 belonging to the Tlapaneco ethnic group, 101 to the Mixteco group and 108 were considered Mestizo. Sociodemographic data were collected, an anthropometric evaluation of the children was performed and a fasting blood sample was obtained from each child for the measurement of measles IgG antibodies by Enzyme-Linked Immunosorbent Assay (ELISA). Results: From the total sample, 59% of the children were seropositive for IgG antibodies against measles; in contrast, 41% lacked IgG antibodies. Measles antibody seropositivity was higher in girls (64%). 90.5% of 6-year-old children had higher antibodies seroprevalence, compared to the children between 10 and 13 years old (45.5%). In the three ethnic groups, age was negatively correlated with the index standard ratio (ISR) of measles antibody levels and the families with ≥8 members showed less seropositivity. According to the antibodies levels, most of the positive cases remained around 1 Standard Deviation (SD) of the ISR values and no underweight children had antibody levels above 2 SD. Conclusions: The Anti-Measles serological coverage is low in children of three ethnic groups from Southern Mexico and the age, sex, malnutrition and family size are associated factors. Therefore, it is important to strengthen immunization campaigns, principally in vulnerable groups. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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11 pages, 1521 KiB

Open AccessArticle

Vaccination Status of Mothers and Children from the ‘Mamma & Bambino’ Cohort

by Martina Barchitta, Andrea Maugeri, Roberta Magnano San Lio, Maria Clara La Rosa, Claudia La Mastra, Giuliana Favara, Giuliana Giunta, Antonio Cianci and Antonella Agodi

Vaccines 2021, 9(2), 168; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020168 - 17 Feb 2021

Cited by 9 | Viewed by 2404

Abstract

According to the evidence demonstrating vaccines’ safety and effectiveness in anticipation of and during pregnancy, several countries have established immunization programs during the periconceptional period. Here, we evaluated vaccination status among 220 mother–child pairs, using data from the ‘Mamma & Bambino’ cohort. The self-reported data were evaluated at delivery, and with planned follow-ups at 1–2 years after delivery. In general, we noted that the vaccination status among the women was heterogeneous, ranging from 8.3% (vaccine against Human Papillomavirus, HPV) to 65.6% (vaccine against Diphtheria Tetanus and Pertussis, DTaP). Excluding the women who contracted the diseases in the past, the main ground for refusal was the lack of information. We also demonstrated that increasing age was associated with higher odds of not being vaccinated against Measles-Mumps-Rubella (MMR; OR = 1.12; 95% CI = 1.04–1.21; p = 0.004), HPV (OR = 1.20; 95% CI = 1.08–1.33; p = 0.001) and DTaP (OR =1.09; 95% CI = 1.01–1.18; p = 0.040). As expected, we showed that the proportion of newborns vaccinated with the Hexavalent and Pneumococcal vaccines was high (99.5% and 98.6%, respectively), while the vaccination coverage against MMRV did not reach the auspicated threshold (84.1%). Overall, these results underlined the need for the improvement of women’s knowledge about the recommendations for vaccination, especially during pregnancy. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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10 pages, 743 KiB

Open AccessArticle

A Study of Varicella Seroprevalence in a Pediatric and Adolescent Population in Florence (Italy). Natural Infection and Vaccination-Acquired Immunization

by Beatrice Zanella, Angela Bechini, Benedetta Bonito, Marco Del Riccio, Alessandra Ninci, Emilia Tiscione, Working Group DHS, Working Group AOUMeyer, Working Group AUSLTC, Paolo Bonanni and Sara Boccalini

Vaccines 2021, 9(2), 152; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020152 - 14 Feb 2021

Cited by 2 | Viewed by 1899

Abstract

Background: Varicella is a well-known infectious disease that can have severe complications, also in young children. The Universal Varicella Vaccination (UVV) program was introduced in Tuscany (Italy) in 2003, with a two-dose vaccine schedule given to children between their 13th and 15th month, and at 5–6 years old, as a monovalent for varicella (V) or tetravalent (measles, mumps, rubella and varicella (MMRV)) formulation. Although varicella notifications have dramatically fallen in the last two decades, varicella disease underreporting remains a challenge. Methods: A qualitative immunoenzymatic test (ELISA) was used to measure the presence of anti-varicella antibodies in 165 sera of subjects aged 1–18 years residing in the province of Florence (Italy). Information regarding the anamnestic and vaccination status (including disease notification) was also collected. Results: Our study showed an overall varicella seropositivity of 75.8% (reaching the maximum at 96.3% in the 15–18 years age group). We found that varicella disease notification had been recorded for only 7/165 subjects; however, since 42/165 recalled having had the disease, we can hypothesize that some of them must have been underreported. Furthermore, our study showed that the presence of antibodies after the varicella vaccination remained over time, lasting up to 12 years. Conclusions: Although varicella seroprevalence is <95% in almost all our age groups (except for the 15–18 years age group), our data are encouraging and reflect the success of the introduction of the UVV program and the vaccination campaigns promoted in the Tuscany region. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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10 pages, 1220 KiB

Open AccessArticle

Humoral Immunity against Measles in Mother–Infant Pairs during the First Year of Life in Greece: A Cross-Sectional Study

by Florentia Kanakoudi-Tsakalidou, Evangelia Farmaki, Eleni Papadimitriou, Anna Taparkou, Eleni Agakidou, Styliani Glykou and Fotiοs Papachristou

Vaccines 2021, 9(2), 143; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020143 - 10 Feb 2021

Cited by 1 | Viewed by 1737

Abstract

Measles outbreaks have surfaced in Europe during the last decades. Infants <12 months of age were the most severely affected pediatric population. The aim of this study was to investigate the duration of maternally derived measles antibodies in infants aged 1 to 12 months in relation to maternal humoral immune status and other parameters. In a prospective, cross-sectional cohort study, 124 mother/infant pairs and 63 additional infants were recruited from October 2015 through December 2019. Infants were hospitalized in a university pediatric department of a general hospital. Demographic and epidemiological data were recorded and blood samples were collected from mothers and their infants. Commercially available enzyme-linked immunosorbent assay (ELISA) was used for measuring measles antibodies. Fifty nine percent of mothers had vaccine-induced and 15% infection-acquired measles immunity. Eighty-eight percent and 94% of infants were unprotected by 5 and 10 months of age, respectively. Maternal antibody levels and infant age were significant independent predictors of infants’ antibody levels whereas the method of maternal immunity acquisition, age, and origin [Greek/non-Greek] were not. Our findings suggest that about 90% of infants are susceptible to measles beyond the age of 4 months. To our knowledge, these are the first data from Greece reported under the current community composition and epidemiological conditions. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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11 pages, 711 KiB

Open AccessArticle

Prevalence of Rubella Antibodies among Fertile Women in the West of Romania, 18 Years after the Implementation of Immunization

by Florin Gorun, Daniel Malita, Ioana Ciohat, Tatjana Vilibic-Cavlek, Horea Feier, Irena Tabain, Marius Craina, Octavian Cretu and Dan Navolan

Vaccines 2021, 9(2), 104; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines9020104 - 29 Jan 2021

Cited by 6 | Viewed by 2372

Abstract

Seronegative women are susceptible to primary rubella virus (RV) infection during pregnancy, which can cause fetal damage. Vaccination represents the main strategy in rubella prevention. The aim of this study was to analyze changes in the rubella seroprevalence and identify populations with a high susceptibility to RV. A cross-sectional study was performed on 6914 Caucasian fertile women who had Toxoplasma gondii, other viruses, Rubella, Cytomegalovirus, and the herpes simplex virus (TORCH) screening in two distinct periods—1452 at the Timișoara Municipal Hospital, Romania (Group 1: 2008–2010) and 5462 at the laboratory Bioclinica S.A., Timișoara, Romania (Group 2: 2015–2018). The RV seroprevalence decreased (Group 1 versus Group 2; 94.1% (92.7–95.2) versus 91.4% (90.6–92.1), OR = 0.76 (p = 0.0007)). According to the year of birth and eligibility to vaccination program, RV seroprevalence rates were 82.4% (76.8–86.8)/1997–2004, 85.4% (80.5–89.3)/1995–1996, 90.1% (89.0–91.1)/<1989, and 95.8% (94.7–96.6)/1989–1994. No significant difference in the RV seropositivity according to the place of residence was found. The overall RV susceptibility increased from 2008–2010 to 2015–2018. The highest susceptibility was found in women born between 1997–2004 eligible for measles-mumps-rubella (MMR) vaccine through the family practice system and the lowest in women born between 1989–1994 eligible for monovalent rubella vaccine conducted in schools. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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10 pages, 315 KiB

Open AccessArticle

Rubella Seroprevalence Boost in the Pediatric and Adolescent Population of Florence (Italy) as a Preventive Strategy for Congenital Rubella Syndrome (CRS)

by Beatrice Zanella, Sara Boccalini, Benedetta Bonito, Marco Del Riccio, Federico Manzi, Emilia Tiscione, Paolo Bonanni, Working Group DHS, Working Group AOUMeyer, Working Group AUSLTC and Angela Bechini

Vaccines 2020, 8(4), 599; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8040599 - 12 Oct 2020

Cited by 3 | Viewed by 2152

Abstract

Background: Despite the availability of an effective vaccine since the 1970s, rubella disease and, importantly, congenital rubella syndrome (CRS) remain a public health concern. The aim of this study was to analyze the rubella seroprevalence in the children population of the province of Florence and compare the obtained results to a previous survey conducted in 2005–2006. Methods: A qualitative measurement of anti-rubella antibodies was performed on 165 sera using the enzyme-linked immunosorbent Assay (ELISA). The anamnestic and vaccination status was also collected. Results: Our study highlighted a very high rubella seroprevalence (85–100%) in our enrolled population. In the vaccinated group (153/165), 98.7% of them were positive to rubella antibodies. Conclusions: Our study showed the highest seroprevalence rate reached in the province of Florence for rubella in the last 15 years, thanks to the several successful vaccination campaigns promoted in the Tuscany region. Our findings in pediatric and adolescent subjects are a key factor in preventing CRS in adult life, specifically in childbearing women. Thus, the set goal will be to keep the awareness about the vaccination for this preventable disease high. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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14 pages, 1193 KiB

Open AccessArticle

Increasing Measles Seroprevalence in a Sample of Pediatric and Adolescent Population of Tuscany (Italy): A Vaccination Campaign Success

by Beatrice Zanella, Sara Boccalini, Benedetta Bonito, Marco Del Riccio, Emilia Tiscione, Paolo Bonanni, Working Group DHS, Working Group AOUMeyer, Working Group AUSLTC and Angela Bechini

Vaccines 2020, 8(3), 512; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8030512 - 08 Sep 2020

Cited by 5 | Viewed by 2379

Abstract

Background: Despite the National Plan for the Elimination of Measles and congenital Rubella (NPEMcR), in 2017, a measles outbreak occurred in Italy, due to sub-optimal vaccination coverage (<95%) for many years. Since that year, the anti-measles vaccination became compulsory in minors (0–16 years) for school attendance. The aim of our study was to assess the immunity/susceptibility against measles in a representative sample of pediatric and adolescent (1–18 years) residents of the province of Florence (Tuscany, Italy), and to compare these results with two previous surveys (2003 and 2005–2006). Methods: The enzyme-linked immunosorbent assay (ELISA) was applied for a qualitative measurement of anti-measles antibodies on 165 sera. The anamnestic and vaccination status was also collected. Results: No measles notification was reported. The overall seropositivity was 88.5%; mostly in the 5–9 years old subjects (97.9%). Among the 152 vaccinated, 92.1% were positive. The seropositivity persisted after many years since the last dose of vaccine and tended to be more long-lasting in those who had received two or three doses. The susceptibility towards measles decreased over time, reaching a lower value in the current survey (8.5%) than in 2003 (30.8%) and in 2005–2006 (25.5%). Conclusions: This study confirmed the anti-measles vaccination campaign success, which allowed for the increase in vaccination coverage and immunity levels against measles in the Florentine pediatric and adolescent population following the NPEMcR implementation. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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16 pages, 1117 KiB

Open AccessArticle

Adherence to Vaccination Policy among Public Health Professionals: Results of a National Survey in Italy

by Maria Teresa Montagna, Osvalda De Giglio, Christian Napoli, Fabrizio Fasano, Giusy Diella, Rosalba Donnoli, Giuseppina Caggiano, Silvio Tafuri, Pier Luigi Lopalco, Antonella Agodi and GISIO-SItI Working Group

Vaccines 2020, 8(3), 379; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8030379 - 11 Jul 2020

Cited by 15 | Viewed by 3324

Abstract

Starting from 2013, the number of unvaccinated people alarmingly increased in Italy; therefore, in 2017 a new Vaccine National Plan was approved. Healthcare workers (HCWs), especially public health professionals (PHPs, i.e., workers in in the sector of hygiene and preventive medicine), have an important role in informing and promoting vaccinations. In this context, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health (GISIO-SItI) conducted a national survey to assess knowledge, attitude, and practices towards recommended vaccinations among PHPs. The survey was conducted during October 2019 with an anonymous questionnaire distributed to PHPs attending the 52° SItI National Congress. Overall, 57.1% of operators answered correctly to all seven recommended vaccinations, 12.8% reported to be vaccinated for all seven recommended vaccinations, while 30% were naturally immunized. A higher immunization coverage was reported for anti-hepatitis B (88.9%) and measles (86.1%), and 81.3% of the participants reported being offered the influenza vaccination during the 2018/2019 season. The majority of our sample indicated that hepatitis B (95%) and influenza (93.7%) were the recommended vaccines for HCWs, while less was known regarding varicella, pertussis, diphtheria, and tetanus boosters every 10 years. PHPs who were vaccinated (or who intended to be vaccinated) were more likely to recommend vaccinations to their patients and provided a reassuring example to those hesitant patients. Finally, this is the first study that identified good algorithms (using the techniques of machine learning as Random Forest and Deep Learning) to predict the knowledge of PHPs regarding recommended vaccinations with possible applications in other national and international contexts. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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6 pages, 352 KiB

Open AccessCommunication

Evaluation of Varicella Immunity during Pregnancy in Apulia Region, Southern Italy

by Claudia M. Trombetta, Emanuele Montomoli, Simonetta Viviani, Rosa Coluccio and Serena Marchi

Vaccines 2020, 8(2), 214; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8020214 - 10 May 2020

Cited by 2 | Viewed by 2190

Abstract

Varicella is a highly contagious, infectious disease caused by the varicella-zoster virus. Those at higher risk of severe complications are immunocompromised individuals, adults, non-immune pregnant women, and newborns. According to the gestational time, when varicella-zoster virus infection is acquired during pregnancy, serious complications can potentially occur for both the woman and the fetus. The present study was conducted to assess the profile of varicella susceptibility in pregnant women in Apulia, a large region in Southern Italy, from 2016 to 2019. The data showed that pregnant women between the age of 15–24 and 40–49 years, the youngest and the oldest, respectively, are the most protected against varicella-zoster virus infection, exceeding the prevalence rate of 90%. Conversely, pregnant women between the age of 25 and 34 years seem to be the most vulnerable and the most at risk for acquiring varicella-zoster virus infection during pregnancy. Analysis of the immunity status against varicella should be introduced as a screening test before pregnancy, together with a strategic vaccination campaign targeting non-immune women of childbearing age, in order to reduce the risk of congenital and perinatal varicella. Full article

(This article belongs to the Special Issue Measles-Mumps-Rubella-Varicella Vaccination)

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