Zhang Lei, Wang Zhiguo, Hu Ying, Deng Xiuying, Guo Hongxiong, Sun Xiang, Tang Fenyang, Zhou Minghao, Liu Yuanbao
a Department of Epidemiology , School of Public Health, Nanjing Medical University , Nanjing , Jiangsu province , China.
b Department of Expanded Program on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , Jiangsu province , China.
Hum Vaccin Immunother. 2018;14(11):2654-2659. doi: 10.1080/21645515.2018.1480239. Epub 2018 Jun 28.
A single dose of the measles-mumps-rubella (MMR) vaccine has been applied in routine immunizations for children in China; however, the Immunoglobulin G (IgG) antibody level of mumps in children from kindergarten to early school age with MMR vaccine immunization history has not been elucidated. This study aimed to describe the immunity profile of children from kindergarten to early school age to identify the susceptible population. In Jiangsu Province, a cross-sectional survey of 4- to 8-year-old children who were vaccinated with at least one dose of MMR vaccine was conducted. IgG antibody results were analyzed by employing both the Enzyme-Linked Immunosorbent Assay (ELISA) cutoff values and the mixture model. A total of 7436 eligible subjects were enrolled: 3386 subjects were in kindergarten, and 4450 were in primary school. The overall seroprevalence (75.4%, 95% CI: 74.4%-76.4%) and Geometric mean concentration (GMC, 201.4U/ml, 95% CI: 194.1-209.4) of mumps antibodies in 2016 were low. The seroprevalence of children in kindergarten (78.1%, 95% CI: 76.6%-79.4%) was significantly higher than that of children in primary school (73.2%, 95% CI: 71.2%-74.6%). The GMC was negatively correlated with the time of inoculation (F = 32.17, = 0.002). The mixture model enables a more comprehensive understanding of serological results by investigating four levels of antibody response, suggesting that there is a small fraction of the population with waning immunity. Children in kindergarten and primary school whom had received one dose of MMR vaccine were at a higher risk of mumps infection, particularly the 7-year-old group in the central region. Therefore, the single-dose MMR vaccine schedule has a limited impact on mumps control and prevention, and a two-dose MMR vaccine schedule should be introduced.
在中国，儿童常规免疫接种使用单剂量的麻疹-腮腺炎-风疹（MMR）疫苗；然而，尚未阐明有MMR疫苗免疫史的幼儿园至小学低年级儿童的腮腺炎免疫球蛋白G（IgG）抗体水平。本研究旨在描述幼儿园至小学低年级儿童的免疫状况，以确定易感人群。在江苏省，对至少接种过一剂MMR疫苗的4至8岁儿童进行了横断面调查。采用酶联免疫吸附测定（ELISA）临界值和混合模型分析IgG抗体结果。共纳入7436名符合条件的受试者：3386名在幼儿园，4450名在小学。2016年腮腺炎抗体的总体血清阳性率（75.4%，95%CI：74.4%-76.4%）和几何平均浓度（GMC，201.4U/ml，95%CI：194.1-209.4）较低。幼儿园儿童的血清阳性率（78.1%，95%CI：76.6%-79.4%）显著高于小学儿童（73.2%，95%CI：71.2%-74.6%）。GMC与接种时间呈负相关（F = 32.17，P = 0.002）。混合模型通过研究四个抗体反应水平，能够更全面地了解血清学结果，表明有一小部分人群免疫力正在下降。接种过一剂MMR疫苗的幼儿园和小学儿童感染腮腺炎的风险较高，尤其是中部地区的7岁组。因此，单剂量MMR疫苗接种方案对腮腺炎的控制和预防效果有限，应引入两剂MMR疫苗接种方案。
