Rubella immunity and vaccination coverage among medical students in Catalonia: a multicentre seroprevalence study

Rubella is a vaccine-preventable exanthematous viral infection whose most severe complication is congenital rubella syndrome. In countries such as Spain, most medical students are women, a group in which maintaining vaccination coverage is particularly relevant. This study aims to describe vaccination coverage and seroprevalence of protective antibody titres against rubella among medical students in Catalonia, as well as their perceptions, attitudes, and knowledge regarding vaccination.

A multicentre cross-sectional study was conducted in four university teaching units in Catalonia, Spain, during 2023-2025. Participants completed an adapted European Joint Action on Vaccination (EU-JAV) student survey, and blood samples were obtained to determine anti-rubella IgG titres. Factors associated with seropositivity and vaccination status were analysed using logistic regression. A sensitivity analysis restricted to women was also performed.

Of 235 participants, 189 (80.4%) were women, 216 (91.9%) were aged 19-24 years and 222 (94.5%) reported complete vaccination against rubella. Prevalence of protective anti-rubella IgG titres was 84.7%, with 6.0% indeterminate and 9.4% negative titres results. After adjustment for age, sex, and academic year, complete vaccination was significantly associated with positive serology (aOR 4.02; 95% CI 1.14-13.11), which was also confirmed in the women-only analysis (aOR 8.15; 95% CI 2.01-35.26). Nearly all participants considered the MMR vaccine safe, important, and would recommend it.

Our study shows a high proportion of Catalan medical students correctly vaccinated with a two-dose rubella-containing vaccine schedule and a high prevalence of protective antibody titres against rubella. Attitudes and perception regarding vaccination were highly favourable.