Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany.
PLoS One. 2012;7(8):e42867. doi: 10.1371/journal.pone.0042867. Epub 2012 Aug 6.
We have undertaken a seroprevalence study with more than 13,000 children, who had been included in the German KIGGS survey, a representative sample of children and adolescents 0-17 years of age. The IgG titres against measles, mumps and rubella were determined in 1 to 17 year olds While 88.8% of the children were MMR-vaccinated at least once, 76.8% of children aged 1 to 17 years showed prevalence of antibodies to MMR. The highest seronegativity was seen with respect to mumps. Gender differences were most pronounced with regard to rubella IgG titres: girls aged 14 to 17 years were best protected, although seronegativity in 6.8% of this vulnerable group still shows the need of improvement. Search for predictors of missing seroprevalence identified young age to be the most important predictor. Children living in the former West and children born outside of Germany had a higher risk of lacking protection against measles and rubella, while children with a migration background but born in Germany were less often seronegative to measles antibodies than their German contemporaries. An association of seronegativity and early vaccination was seen for measles but not for mumps and rubella. A high maternal educational level was associated with seronegativity to measles and rubella. In vaccinated children, seronegativity was highest for mumps and lowest for rubella. For mumps, high differences were observed for seronegativity after one-dose and two-dose vaccination, respectively. Seronegativity increases as time since last vaccination passes thus indicating significant waning effects for all three components of MMR.
我们对超过 13000 名儿童进行了一项血清流行率研究,这些儿童都曾参与德国 KIGGS 调查,该调查是儿童和青少年 0-17 岁的代表性样本。我们测定了 1 至 17 岁儿童对麻疹、腮腺炎和风疹的 IgG 滴度。虽然 88.8%的儿童至少接受过一次 MMR 疫苗接种,但 1 至 17 岁的儿童中有 76.8%的人对 MMR 具有抗体流行率。腮腺炎的血清阴性率最高。就风疹 IgG 滴度而言,性别差异最为显著:14 至 17 岁的女孩受到的保护最好,尽管这一脆弱群体中仍有 6.8%的人血清阴性,这表明仍需改进。寻找缺失血清流行率的预测因素发现,年龄是最重要的预测因素。在前西德居住的儿童和在德国境外出生的儿童对麻疹和风疹缺乏保护的风险更高,而有移民背景但在德国出生的儿童对麻疹抗体的血清阴性率低于德国同龄人。麻疹的血清阴性与早期接种之间存在关联,但腮腺炎和风疹则没有。母亲的受教育程度高与麻疹和风疹的血清阴性有关。在接种疫苗的儿童中,腮腺炎的血清阴性率最高,风疹的血清阴性率最低。对于腮腺炎,一剂和两剂接种后的血清阴性率差异很大。随着上次接种后时间的推移,血清阴性率增加,这表明 MMR 的所有三个成分的衰减效应都很显著。