Seroconversion rates following 2 doses of measles- mumps- rubella vaccination given at the ages 12 and 18 months: data for possible additional dose at older age

Background Despite high rate of vaccination coverage with 2-doses of measles containing vaccine among Iranian children, outbreaks of measles occurred among different age groups and fully vaccinated subjects. Although the main reason for these outbreaks is unknown, however, vaccine failure was supposed to be an important cause. This study was designed to determine the seroconversion rates to measles- mumps- rubella (MMR) vaccine currently in use among Iranian children. Methods This prospective study was conducted among healthy children older than 12 months who were candidates of scheduled MMR vaccination. Blood samples were obtained from each mother- infant pair just before vaccination, and from infants 4–6 weeks after MMR1 and MMR2 immunization. Collected sera were tested for specific lgG antibodies against MMR agents using ELISA method. The proportion of seroprotected subjects among mother- infant pairs before vaccination as well as the prevalence rates of seroconversion after MMR1 and MMR2 vaccination were calculated. Collected data were analyzed using descriptive statistical methods. Results During 22-months study period, 92 mother- infant pairs were participated. Seroimmunity rates against MMR viruses were 85.8%, 84.7% and 86.9% for mothers, and 3.2%, 2.1% and 1.0% for children, respectively. After MMR1 vaccination from 52 seronegative children, 80.7%, 78.8% and 75% were seroconverted. These rates increased to 94.8%, 89.7% and 94.8% after the MMR2 vaccination. Also, the specific immunity was enhanced among seropositive children. Conclusion Majority of the mothers and few infants were immune to MMR viruses prior to MMR1 vaccination. Immune responses detected after MMR1 injection, and overall seroconversion rates achieved after 2-doses of MMR vaccination were less than expected and inadequate to preserve long-term protection against MMR agents.

Using geospatial models to map zero-dose children: factors associated with zero-dose vaccination status before and after a mass measles and rubella vaccination campaign in Southern province, Zambia

IntroductionDespite gains in global coverage of childhood vaccines, many children remain undervaccinated. Although mass vaccination campaigns are commonly conducted to reach these children their effectiveness is unclear. We evaluated the effectiveness of a mass vaccination campaign in reaching zero-dose children.MethodsWe conducted a prospective study in 10 health centre catchment areas in Southern province, Zambia in November 2020. About 2 months before a national mass measles and rubella vaccination campaign conducted by the Ministry of Health, we used aerial satellite maps to identify built structures. These structures were visited and diphtheria-tetanus-pertussis (DTP) and measles zero-dose children were identified (children who had not received any DTP or measles-containing vaccines, respectively). After the campaign, households where measles zero-dose children were previously identified were targeted for mop-up vaccination and to assess if these children were vaccinated during the campaign. A Bayesian geospatial model was used to identify factors associated with zero-dose status and measles zero-dose children being reached during the campaign. We also produced fine-scale zero-dose prevalence maps and identified optimal locations for additional vaccination sites.ResultsBefore the vaccination campaign, 17.3% of children under 9 months were DTP zero-dose and 4.3% of children 9–60 months were measles zero-dose. Of the 461 measles zero-dose children identified before the vaccination campaign, 338 (73.3%) were vaccinated during the campaign and 118 (25.6%) were reached by a targeted mop-up activity. The presence of other children in the household, younger age, greater travel time to health facilities and living between health facility catchment areas were associated with zero-dose status. Mapping zero-dose prevalence revealed substantial heterogeneity within and between catchment areas. Several potential locations were identified for additional vaccination sites.ConclusionFine-scale variation in zero-dose prevalence and the impact of accessibility to healthcare facilities on vaccination coverage were identified. Geospatial modelling can aid targeted vaccination activities.

MONITORING OF MEASLES RUBELLA VACCINATION SESSIONS AT SCHOOLS IN PUNE CITY

Introduction: India with the support of WHO launched one of the world's largest vaccination campaigns against measles and rubella on 5 February 2017. The campaign was launched to vaccinate children in the age group of 9 months to 15 years with measles and rubella vaccine. In Maharashtra state the campaign started from 27th November 2018. All eligible children were vaccinated at the following session sites: Schools, Health sub-centers, Anganwadi centers, xed outreach sessions and mobile posts in villages and urban areas, Government health facilities will vaccinate on all days of campaign. Aim and objectives: To monitor vaccination injection practices, cold chain maintenance and safe needle disposal at measles rubella vaccination sessions at schools in Pune city. Material and methods: Study was a cross sectional study. 5 schools in each 5 Wards (Bibewadi, Kondwa, Hadapsar, Wanowri, and Dhankawadi) out of the 15 wards of Pune Municipal Corporation were MR vaccination campaign session will take place will be studied in 2nd week of the campaign. After obtaining permission from the WHO surveillance medical ofcer The above mentioned sites were visited on vaccination day. A structured Performa based on WHO checklist were lled on observation of all the sites selected. Results: 92% of the vaccinators have attended training sessions, 16% of the vaccinators were wearing gloves, Swabbing of the skin done by 52% , 80% of the vaccinators were administering vaccine through subcutaneous route, cold chain were maintained to 100% perfection and Safe needle disposal practices were maintained to 100%. Conclusion: Need for better training to healthcare workers about safe practices and proper implementation of vaccination campaign.

A Case of Rubella Caused by Rubella Vaccination

We present an extremely rare case of rubella that developed after rubella vaccine administration. A 54-year-old man complained of back and neck pain for some days. He presented with generalized rash and arthralgia that had persisted for two days before his visit. His vital signs were normal, and arthralgia had disappeared during an examination, but lymphadenopathy in the left posterior neck and pink papules were observed throughout the body. He had received his first Rubella vaccination 17 days before this visit and had attended a crowded festival. Owing to the rubella epidemic in that prefecture, we performed a rubella antibody test and polymerase chain reaction assay using blood, urine, and pharyngeal swab specimens. Rubella IgG and IgM antibody titers were 3 and 1.48, respectively. The pharyngeal swab yielded positive results for the 1a vaccine strain. Therefore, he was diagnosed with rubella due to rubella vaccination. His symptoms improved eventually. His clinical course was uncomplicated. Symptoms resolved within one week without specific treatment. The vaccine rubella strain is not as highly infectious as wild-type rubella strains. If rubella symptoms appear after vaccination, it must be investigated whether these are vaccine-specific adverse reactions, wild-strain rubella onset, or other eruptive viral infections.

Study of Congenital Malformation in a Tertiary Care Teaching Hospital

Objective: Congenital anomaly is one of the most important causes & being the 5th most common cause of neonatal mortality & morbidity. It may present as a structural or functional abnormality. These defects occur due to defective embryogenesis. Associated factors may be maternal age, maternal TORCH infection, drugs, genetic factors. Antenatal USG reduces the incidence.Materials and Methods: A cross-sectional study was done in the Pediatric department over 1 year. Diagnosis of all congenital anomalies was done by the concerned pediatrician& pediatric surgeon. Data was collected in the specified format.Results: A total of 10205 cases of age group 1 month to 5 years presented to the paediatric OPD, out of which 193 children were diagnosed as congenital anomalies in 1 year. Males were found to be affected the most. The most common system involved was found to be the genitourinary system (36.78%). The second most common system involved was the gastrointestinal system (33.67%). The least common system involved was the musculoskeletal system.Conclusion: Congenital anomalies are a major cause of neonatal & infantile mortality & morbidity. Routine screening with a level II targeted scan for all the pregnant mothers should be mandatory. Adequate nutrition, parental education & Rubella vaccination of the mother can decrease the prevalence of congenital anomalies to some extend.