Factors associated with participation in an ongoing national catch-up campaign against rubella: a cross-sectional internet survey among 1680 adult men in Japan

Background Since 2019, aiming to eliminate periodic rubella outbreaks, the Japanese government has provided a rubella immunization program targeting men born in fiscal years 1972 to 1978, who lacked the opportunity to be vaccinated against rubella in childhood. This study aimed to explore the factors associated with participation in the rubella vaccination program among the first-year target population in 2019. Methods A total of 11,754 adult men in Japan born in fiscal years 1972 to1978 living in seven rubella epidemic areas (Tokyo, Chiba, Kanagawa, Saitama, Aichi, Osaka, and Fukuoka) were selected from a list of a survey agency and invited to complete an Internet questionnaire in March 2020. Recruitment ended when the participants reached 1680 individuals. Multivariable log binomial regression analyses were performed to explore the association between awareness of rubella prevention and rubella antibody testing in fiscal year 2019, adjusting for social characteristics. Results Of the 1680 men aged 41–47 years who completed the survey, approximately half (51.3%) said that they had received a voucher for the rubella antibody testing and vaccination program. One-quarter (25.9%) of the respondents had used the voucher for rubella antibody testing in 2019, and 6.0% had used the voucher for rubella vaccination in fiscal year 2019. Respondents who understood the government recommendation for rubella antibody testing and vaccination for men of their generation (odds ratio [OR]: 5.50; 95% confidence interval [CI]: 4.01–7.53), those with acquaintances who had undergone rubella testing (OR: 1.39; 95% CI: 1.22–1.59), and those who knew that about their lack of opportunity for rubella vaccination (OR: 1.33; 95% CI: 1.11–1.60) tended to undergo rubella antibody testing. Receiving the most recent seasonal influenza vaccination (OR: 1.26; 95% CI: 1.10–1.43) and being able to confirm a rubella vaccination history (OR: 1.28; 95% CI: 1.13–1.46) were also associated with rubella antibody testing. Conclusions The ongoing Japanese test-and-vaccinate rubella program has yet to achieve its participation rate goal for 2019. Further dissemination of the government recommendation to the population is necessary, along with improvements in the accessibility of the rubella vaccination program.

Factors Associated With Participation in an Ongoing National Catch-up Campaign Against Rubella: A Cross-sectional Internet Survey Among 1,680 Adult Men in Japan

BackgroundSince 2019, aiming to eliminate periodic rubella outbreaks, the Japanese government has provided a rubella immunization program targeting men born in fiscal years 1972 to 1978, who lacked the opportunity to be vaccinated against rubella in childhood. This study aimed to explore the factors associated with participation in the rubella vaccination program among the first-year target population in 2019.MethodsA total of 11,754 adult men in Japan born in fiscal years 1972 to1978 living in seven rubella epidemic areas (Tokyo, Chiba, Kanagawa, Saitama, Aichi, Osaka, and Fukuoka) were selected from a list of a survey agency and invited to complete an Internet questionnaire in March 2020. Recruitment ended when the participants reached 1,680 individuals. Multivariable log binomial regression analyses were performed to explore the association between awareness of rubella prevention and rubella antibody testing in fiscal year 2019, adjusting for social characteristics.ResultsOf the 1,680 men aged 41–47 years who completed the survey, approximately half (51.3%) said that they had received a voucher for the rubella antibody testing and vaccination program. One-quarter (25.9%) of the respondents had used the voucher for rubella antibody testing in 2019, and 6.0% had used the voucher for rubella vaccination in fiscal year 2019. Respondents who understood the government recommendation for rubella antibody testing and vaccination for men of their generation (odds ratio [OR]: 5.50; 95% confidence interval [CI]: 4.01–7.53), those with acquaintances who had undergone rubella testing (OR: 1.39; 95% CI: 1.22–1.59), and those who knew that about their lack of opportunity for rubella vaccination (OR: 1.33; 95% CI: 1.11–1.60) tended to undergo rubella antibody testing. Receiving the most recent seasonal influenza vaccination (OR: 1.26; 95% CI: 1.10–1.43) and being able to confirm a rubella vaccination history (OR: 1.28; 95% CI: 1.13–1.46) were also associated with rubella antibody testing.ConclusionsThe ongoing Japanese test-and-vaccinate rubella program has yet to achieve its participation rate goal for 2019. Further dissemination of the government recommendation to the population is necessary, along with improvements in the accessibility of the rubella vaccination program.

Rubella Antibody Prevalence and Immunogenicity of Single Dose Rubella Vaccine Among 16 – 25 Years Girls from Bangladesh

Rubella virus infection during pregnancy is an important cause of blindness, deafness, congenital heart disease, and mental retardation of the foetus. Multiple sero-surveys of rubella antibody among reproductive aged females of Bangladesh showed that 20-30% of them remain susceptible to rubella as rubella vaccination is yet not included in our national immunization program for adolescent and adult girls. The present study was designed to conduct a sero-survey among unmarried girls of 16 to 25 years to assess their serological status in terms of natural rubella infection and vaccinate the rubella susceptible individuals with a single dose of rubella vaccine to evaluate the immunogenicity of the vaccine. A total of 344 randomly selected unmarried, apparently healthy college students were enrolled and investigated for rubella IgG and IgM antibodies at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Girls who were found to be negative for both rubella IgG and IgM were vaccinated with a single dose of rubella vaccine and tested for rubella antibody after four to six weeks of vaccination. Quantitative analysis of rubella IgG showed that a total of 68.87% study population had protective rubella antibody, 29.36% were susceptible to rubella and 1.74% experienced recent rubella infection. After vaccination, rubella antibody positivity was found to be 100% among 99 (98.02%) of 101 vaccinated girls who were tested for anti rubella IgG. There was statistically significant increase (p <0.001, Paired t Test) in anti-Rubella IgG titres among pre-vaccination and post-vaccination sera. The findings of the study showed that it is mandatory to include young girls in the national immunization programme and immunize them with a single dose of rubella vaccine which was found to be 100% effective.

Measles, Mumps, and Rubella Antibody: Patterns of Persistence and Rate of Decline Following the Second Dose of the MMR Vaccine

Background Antibodies to measles, mumps, and rubella decline an estimated average of 3% per year, and have a high degree of variation among individuals. Yet, this variation and differences in individual-level response to the 3 antigens are not well understood. To better understand potential implications on individual and population-level susceptibility, we reanalyzed existing longitudinal data to identify patterns of seropositivity and antibody persistence. Methods Wisconsin children given the second dose of measles, mumps, and rubella vaccine (MMR2) at age 4–6 years were followed up to 12 years postvaccination. The rate of antibody decline and factors associated with the rate of decline were assessed using regression models that accounted for differences between and among subjects. Results Most of the 302 participants were seropositive throughout follow-up (96% measles, 88% mumps, 79% rubella). The rate of antibody decline was associated with MMR2 response and baseline titer for measles and age at first dose of MMR (MMR1) for rubella. None of the demographic or clinical factors examined were associated with rate of decline for mumps. One month after MMR2, geometric mean titer (GMT) to measles was high (3892 mIU/mL), but declined on average 9.7% per year among subjects with the same baseline titer and &lt;2-fold increase in antibody titer after MMR2. Subjects with ≥2-fold increase experienced a slower decline (≤7.4%). GMT to rubella was 149 IU/mL one month after MMR2 and declined 2.6% and 5.9% per year among those who received MMR1 at 12–15 months and &gt;15 months, respectively. GMT to mumps one month after MMR2 was 151 and declined 9.2% per year. Only 14% of participants had the same trends in antibody persistence for all 3 antigens. Conclusion The rate of antibody decay varied substantially among individuals and among the 3 antigens. Despite waning titers, measles and rubella antibody levels remained high 12 years post MMR2. However, a fast rate of decline and high degree of variation was observed for mumps, yet no predictors of the decline were identified. Future research should focus on better understanding waning antibody titers to mumps and its impact on community protection and individual susceptibility, in light of recent mumps outbreaks in vaccinated populations. Disclosures All authors: No reported disclosures.