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Reported measles immunisation and serological immunity in children attending general practitioners
Insights
Many vaccinated children lack measles immunity, as indicated by serological testing. This challenges the effectiveness of reported immunization history and single-dose measles vaccination strategies.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Measles vaccination is crucial for public health.
- Assessing vaccine effectiveness relies on accurate immunity status determination.
- Reported immunization history is commonly used but may not reflect true immunity.
Purpose of the Study:
- To evaluate the feasibility of serological testing for measles immunity in children.
- To compare the accuracy of reported immunization history against serological results.
- To assess the adequacy of current measles immunization programs.
Main Methods:
- A cross-sectional descriptive study was conducted.
- 234 children under 15 years attending general practices were enrolled.
- Enzyme-linked immunosorbent assay (ELISA) was used for serological testing on finger-prick blood samples.
Main Results:
- 87% of children had a reported measles immunization history.
- Despite reported vaccination, 46% of these children were seronegative for measles antibodies.
- Inaccurate reporting did not explain the discrepancy; failure to seroconvert is suspected.
Conclusions:
- Serological testing is feasible for assessing measles immunity in children.
- Reported immunization history is unreliable for confirming measles immunity.
- The efficacy of single-dose measles vaccination requires further investigation and may be insufficient for public health goals.
Abstract:
To determine the feasibility of serological testing for measles immunity in children attending general practitioners and to assess the validity of establishing immune status by reported immunisation history compared with serology, a cross-sectional descriptive study was conducted in general practices in the Illawarra area south of Sydney, New South Wales. Participants were 234 children under 15 years attending general practitioners. 87 per cent of children were reported to have been immunised against measles, but 46 per cent of these children were seronegative for measles antibody using an ELISA test on finger-prick blood. This could not be explained by inaccurate reporting of immunisation. No causes other than failure to seroconvert or inadequate specificity of the test on the blood samples were evident. Failure to seroconvert as a result of inadequate adherence to cold chain requirements is a possibility that needs further investigation. The results further question whether a single vaccination is adequate to achieve the public health aims of measles immunisation programs.