title: Rubella immunity levels in the United States population: has the threshold of viral elimination been reached?
abstract: After the 1989-1991 rubella resurgence, rubella vaccination efforts targeted children and women of childbearing age. Utilizing National Health and Nutrition Examination Survey data collected during 1988-1994 and 1999-2004, we assessed whether US levels of rubella seropositivity are consistent with rubella elimination and whether changes are consistent with immunization efforts. Serum samples with rubella antibody levels > or =10 IU tested by rubella immunoglobulin G enzyme immunoassay were considered to be positive. In 1999-2004, the overall age-adjusted rubella seropositivity level was 91.3% (95% confidence interval [CI], 90.5%-92.1%), a significant increase from 88.1% (95% CI, 86.9%-89.1%) in 1988-1994 (P<.001). Among children, seropositivity was highest in children 6-11 years of age (96.2%), followed by adolescents 12-19 years of age (93.7%). Both groups showed significant increases in immunity levels, in comparison with those in 1988-1994 (P<.001). Among adults, seropositivity among women increased (from 88.9% to 91.5%; P=.015), and there was no change among men (from 87.8% to 88.0%; P=.84). In 1999-2004, population rubella immunity levels were at or above the modeled threshold for elimination of rubella virus transmission. Increases in immunity levels are consistent with vaccination efforts.
authors.affiliation: National Center for Immunization and Respiratory Diseases (proposed), Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. thyde@cdc.gov
authors.forename: Terri B
authors.initials: TB
authors.lastname: Hyde
authors.forename: Deanna
authors.initials: D
authors.lastname: Kruszon-Moran
authors.forename: Geraldine M
authors.initials: GM
authors.lastname: McQuillan
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cossen
authors.forename: Bagher
authors.initials: B
authors.lastname: Forghani
authors.forename: Susan E
authors.initials: SE
authors.lastname: Reef
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012409:Rubella / Q000453:epidemiology* / Q000276:immunology* / Q000821:virology; D012411:Rubella Vaccine / Q000008:administration & dosage / Q000276:immunology*; D012412:Rubella virus / Q000276:immunology* / Q000302:isolation & purification*; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology
chemical_list: D012411:Rubella Vaccine