Boulton Matthew L, Wang Xiexiu, Wagner Abram L, Zhang Ying, Carlson Bradley F, Gillespie Brenda W, Ding Yaxing
Department of Epidemiology, School of Public Health.
Department of Internal Medicine, Division of Infectious Diseases.
J Infect Dis. 2017 Nov 27;216(9):1122-1129. doi: 10.1093/infdis/jix453.
Many measles cases in Tianjin, China, occur in infants whose mothers were born after widespread vaccination programs. We assessed age-specific decreases in maternal measles antibodies in infants and examined maternal and infant characteristics in relation to infant antibody titers.
Infant and mother dyads were enrolled from a sample of immunization clinics in all Tianjin districts. Participants' antibody titers were measured from dried blood spots. A multivariable log-linear model regressed infant antibody titers onto infant and mother characteristics.
Among 551 infants aged ≤8 months, protective levels of measles antibodies were observed in infants whose mothers had measles titers ≥800 IU/mL (mean antibody titer, 542.5 IU/mL) or 400 to <800 IU/mL (mean, 202.2 IU/mL). Compared with infants whose mothers had no history of disease or vaccination, those with a history of disease had 1.60 times higher titers (95% confidence interval, 1.06-2.43).
Limited vaccination programs in the 1980s have resulted in many Chinese women with inadequate protection against measles and an accordingly low efficiency of transplacental transmission to a fetus. Current vaccination programs, which target children aged 8 months through adolescence may be ineffective in controlling transmission of measles to infants.
在中国天津，许多麻疹病例发生在其母亲出生于广泛接种疫苗计划实施之后的婴儿中。我们评估了婴儿中母体麻疹抗体随年龄的下降情况，并研究了与婴儿抗体滴度相关的母婴特征。
从天津所有区的免疫诊所样本中招募母婴对。通过干血斑测量参与者的抗体滴度。一个多变量对数线性模型将婴儿抗体滴度回归到婴儿和母亲的特征上。
在551名年龄≤8个月的婴儿中，其母亲麻疹滴度≥800 IU/mL（平均抗体滴度，542.5 IU/mL）或400至<800 IU/mL（平均，202.2 IU/mL）的婴儿中观察到了保护性水平的麻疹抗体。与母亲无疾病或疫苗接种史的婴儿相比，有疾病史的婴儿滴度高1.60倍（95%置信区间，1.06 - 2.43）。
20世纪80年代有限的疫苗接种计划导致许多中国女性对麻疹的防护不足，从而导致经胎盘向胎儿的传播效率较低。目前针对8个月至青少年的儿童疫苗接种计划在控制麻疹向婴儿传播方面可能无效。
