Increasing seroprevalence but waning herd immunity against measles after elimination: Longitudinal seroepidemiology of measles in Osaka Prefecture, Japan, 2003?2020
Increasing seroprevalence but waning herd immunity against measles after elimination: Longitudinal seroepidemiology of measles in Osaka Prefecture, Japan, 2003?2020
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消除麻疹后血清阳性率增加，但群体免疫力减弱：2003 年至 2020 年日本大阪府麻疹纵向血清流行病学
DOI：
10.1016/j.vaccine.2022.07.025
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发表时间：
2022
期刊：
影响因子：
5.5
通讯作者：
Motomura Kazushi
中科院分区：
文献类型：
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作者：
Kurata Takako;Miyama Takeshi;Kanbayashi Daiki;Kaida Yuko;Aoyama Ikuko;Ikemori Ryo;Banno Fumiya;Kawahata Takuya;Mori Haruyo;Motomura Kazushi
日本是对疫苗可预防疾病进行纵向血清监测的国家之一。我们对当地麻疹特异性抗体滴度进行了监测，计算了有效繁殖数（Re），并比较了四个学期的数据：第1学期，2003-2006年（推出第二针麻疹疫苗之前）；第1学期，2003-2006年（推出第二针麻疹疫苗之前）；第二学期，2007-2010 年（消除麻疹的早期阶段）；第三学期，2011-2014 年（后期致力于消除麻疹）；以及第 4 学期，2015 年至 2020 年（日本消除麻疹后）。从 2003 年到 2020 年，每年收集 0 至 ≥ 40 岁志愿者的大约 250 份血清，并使用明胶颗粒凝集 (PA) 方法检查麻疹特异性 IgG。按学期检查血清阳性率和 PA 抗体滴度的几何平均值。使用每个学期的年龄依赖性比例免疫和接触矩阵计算 Re 值。在 4,716 份血清中，收集了第 1 期 886 份、第 2 期 1,217 份、第 3 期 1,069 份和第 4 期 1,544 份血清。血清阳性率从第1期（88.3% CI 86.0–90.3）到第4期（95.7% CI 94.6–96.7）逐渐升高，且第1期的血清阳性率显着低于其他期（Fisher精确检验，p < 0.001），PA滴度≥16为阳性。相比之下，PA 抗体滴度从第 1 期（中位数 1,024）到第 4 期（中位数 256）显着下降（Mann–WhitneyUtest，p < 0.001）。以保护水平（PA滴度≥128和≥256）为阳性，从第1期（1.8和2.3）逐渐增加到第4期（分别为2.5和4.8）。麻疹抗体水平下降可能会增加日本大阪的麻疹易感性。这一趋势可能意味着，在消除麻疹后，在缺乏针对野生毒株的天然加强剂的情况下，疫苗诱导的免疫力受到限制。这项研究为未来维持麻疹持续消除状态提供了线索。
Japan is one of the countries conducting longitudinal serosurveillance of vaccine-preventable diseases. We conducted surveillance of the local measles-specific antibody titer, calculated the effective reproduction number (Re), and compared data of four terms: term 1, 2003–2006 (before the introduction of the second shot of measles-containing vaccine); term 2, 2007–2010 (early term toward measles elimination); term 3, 2011–2014 (later term toward measles elimination); and term 4, 2015–2020 (after elimination of measles in Japan). Approximately 250 sera from volunteers aged 0 to ≥ 40 years were collected and examined for measles-specific IgG using the gelatin particle agglutination (PA) method annually from 2003 to 2020. Seroprevalence and the geometric mean of the PA antibody titer were examined by term.Rewas calculated using the age-dependent proportion immune and contact matrix for each term. Of the 4,716 sera, 886 in term 1, 1,217 in term 2, 1,069 in term 3, and 1,544 in term 4 were collected. The seroprevalence gradually increased from term 1 (88.3% CI 86.0–90.3) to term 4 (95.7% CI 94.6–96.7), and the seroprevalence of term 1 was significantly lower than those of other terms (Fisher’s exact test,p < 0.001), with PA titer ≥ 16 as positive. By contrast, PA antibody titers significantly decreased from term 1 (median 1,024) to term 4 (median 256) (Mann–WhitneyUtest,p < 0.001). With the protection level (PA titer ≥ 128 and ≥ 256) as positive,Regradually increased from term 1 (1.8 and 2.3) to term 4 (2.5 and 4.8, respectively). Waning levels of measles antibodies potentially increase the measles susceptibility in Osaka, Japan. This trend might imply a limitation of vaccine-induced immunity in the absence of a natural booster for wild strains after measles elimination. This study provides a cue for maintaining continuous measles elimination status in the future.