Department of Epidemiology and Modern Vaccination Technologies of I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Laboratory of Vaccine Prophylaxis and Immunotherapy of Allergic Diseases of I.I.Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia.
Front Immunol. 2021 Jul 8;12:680506. doi: 10.3389/fimmu.2021.680506. eCollection 2021.
It has been proven that post-vaccination immunity to measles virus after two doses of vaccine is not able to persistently protect against infection throughout life. The goal of this research was to determine the immune layer to the measles virus among women in labor and maternity ward personnel in the same medical institution. The levels of IgG antibodies to measles virus in the umbilical cord blood of 594 women in labor and 88 workers of the maternity ward were studied by ELISA. It was revealed that 22.7% of umbilical cord blood serum samples from parturient women and 21.4% of blood serum samples from maternity ward personnel were seronegative (<0.18 IU/ml). Levels of IgG antibodies to measles virus in low values (<1.0 IU/ml) were detected in 67% of blood serum samples among women in labor and 68.9% among employees of the maternity ward. Among women in labor, women under 35 years of age are at the highest risk of contracting measles; the proportion of women with low levels of protective antibodies in this age group was almost 70%, and the proportion of women without protective levels of antibodies was 23%. Compared with the age group 36-43, the age of women in labor under 35 was associated with a higher chance of not having immune protection against infection with measles virus OR [95% CI] = 2.2 [1.1-4.5] (p = 0.02) or had a low level of protection OR [95% CI] = 1.9 [1.2-3.0] (p = 0.001). It was also found that among women over 35 years of age, the proportion of persons with a high level of antibodies in women in labor was statistically significantly higher than among members of the maternity ward staff (13 and 0%, respectively, p = 0.007). Thus, maternity ward employees and women in labor constitute a risk group for measles due to the presence of a high proportion of seronegative persons among women of childbearing age (both maternity ward employees and women in labor). These conditions create the need to revise current approaches to present vaccination procedures, especially in the current epidemiological situation with COVID-19.
已证实,两剂麻疹疫苗接种后的麻疹病毒后免疫无法持续终生预防感染。本研究的目的是确定同一医疗机构分娩妇女和产房工作人员对麻疹病毒的免疫水平。通过 ELISA 法研究了 594 名分娩妇女和 88 名产房工作人员脐带血中麻疹病毒 IgG 抗体的水平。结果显示,22.7%的分娩妇女脐带血血清样本和 21.4%的产房工作人员血清样本呈血清阴性(<0.18 IU/ml)。67%的分娩妇女和 68.9%的产房工作人员血清样本中检测到麻疹病毒 IgG 抗体低水平(<1.0 IU/ml)。在 35 岁以下的妇女中,感染麻疹的风险最高;在这个年龄组中,保护性抗体水平较低的妇女比例几乎为 70%,而无保护性抗体水平的妇女比例为 23%。与 36-43 岁年龄组相比,35 岁以下分娩妇女未感染麻疹病毒的免疫保护率更高 OR [95%CI] = 2.2 [1.1-4.5](p = 0.02)或保护性抗体水平较低 OR [95%CI] = 1.9 [1.2-3.0](p = 0.001)。还发现,在 35 岁以上的妇女中,分娩妇女中高抗体水平的比例明显高于产房工作人员(分别为 13%和 0%,p = 0.007)。因此,由于育龄妇女中血清阴性者比例较高,产房工作人员和分娩妇女构成麻疹的高危人群(产房工作人员和分娩妇女均为 0%,p = 0.007)。这些情况需要修改当前的疫苗接种程序,特别是在当前 COVID-19 的流行病学情况下。