Characterization of Measles, Diphtheria and Pertussis Pathogen-Specific Immunity in Fully Vaccinated Schoolchildren

Introduction: Waning specific immunity and the growing number of people susceptible to vaccine-preventable diseases increase the risk of deterioration of the epidemiological situation.

Objective: To characterize the intensity of specific immunity against measles, diphtheria and whooping cough in fully vaccinated schoolchildren to identify groups at increased risk of infection in the development of preventive measures.

Materials and methods: We used the enzyme-linked immunosorbent assay (ELISA) to detect and count antibodies in 1,709 serum samples from children who were fully and timely vaccinated against measles, pertussis, and diphtheria. In order to establish herd immunity, the children were divided into three age groups of 6 to 9, 10 to 13, and 14 to 17 years.

Results: We established that only 63.5 % to 88.5 % of the schoolchildren had a protective measles virus-specific antibody level; 15.7 % and 27.1 % of the children aged 10–13 years and 14–17 years, respectively, were seronegative. The protective level of immunity against diphtheria was observed in 91.8 % to 99.4 % in the children under examination. The proportions of children seronegative for diphtheria were 8.1 % and 8.2 % in the first and second age groups, respectively, while 41.4 % of the children aged 6–9 years and 60.6 % of those aged 14–17 years demonstrated high antibody titers. Protective pertussis antibody levels were found in 46.2 % to 68.2 % of the schoolchildren; yet, the number of seronegative cases among children aged 6–9 years was 1.6 times higher (37.8 %) than that among adolescents aged 14–17 years (23.4 %).

Conclusions: Our findings showed insufficient levels of immune protection against measles and pertussis in the schoolage children, especially those aged 14–17 years and 6–9 years, respectively. As for diphtheria, the absence of protective antibodies was detected in 8 % of the children aged 6 to 13 years who had been fully vaccinated against this bacterial infection by receiving the vaccine a total of five times.

1. Yunasova TN, Gorenkov DV, Rukavishnikov AV, Movsesyants AA, Merkulov VA. Analysis of measles incidence in Russia and problems of measles prevention at the elimination stage. Biopreparaty. Profilaktika, Diagnostika, Lechenie. 2019;19(3):154-160. (In Russ.) doi: 10.30895/2221-996X-2019-19-3-154-160

2. Olenkova OM, Kovtun OP, Kharitonov AN, Beikin YaB, Rybinskova EA. Evaluation of the level of collective immunity in children living in the city of Yekaterinburg to vaccine-preventable infections against the backdrop of the spread of the COVID-19 pandemic. Pediatriya. Zhurnal im. G.N. Speranskogo. 2022;101(4):88-96. (In Russ.) doi: 10.24110/0031-403X-2022-101-4-88-96

3. Semenenko TA, Nozdracheva AV. Analysis and outlook for the development of measles epidemic situation during the COVID-19 pandemic. Epidemiologiya i Vaktsinoprofilaktika. 2021;20(5):21-31. (In Russ.) doi: 10.31631/2073-3046-2021-20-5-21-31

4. Dinleyici EC, Borrow R, Safadi MAP, van Damme P, Munoz FM. Vaccines and routine immunization strategies during the COVID-19 pandemic. Hum Vaccin Immunother. 2020;17(2):400-407. doi: 10.1080/21645515.2020. 1804776

5. Tsvirkun OV, Tikhonova NT, Turaeva NV, Ezhlova EB, Melnikova AA, Gerasimova AG. Population immunity and structure of measles cases in the Russian Federation. Epidemiologiya i Vaktsinoprofilaktika. 2020;19(4):6-13. (In Russ.) doi: 10.31631/2073-3046-2020-19-4-6-13

6. Anichini G, Gandolfo C, Fabrizi S, et al. Seroprevalence to measles virus after vaccination or natural infection in an adult population, in Italy. Vaccines (Basel). 2020;8(1):66. doi: 10.3390/vaccines8010066

7. Quach HQ, Ovsyannikova IG, Grill DE, Warner ND, Poland GA, Kennedy RB. Seroprevalence of measles antibodies in a highly MMR-vaccinated population. Vaccines (Basel). 2022;10(11):1859. doi: 10.3390/vaccines10111859

8. Basov AA, Vysochanskaya SO, Tsvirkun OV, et al. Criteria for assessing the epidemiological situation of pertussis in Russian Federation. Epidemiologiya i Vaktsinoprofilaktika. 2024;23(1):4-13. (In Russ.) doi: 10.31631/2073-3046-2024-23-1-4-13

9. Sutovskaya DV, Burlutskaya AV, Dubova LV, Krylova DR. Immunological protection of individuals aged 3 to 25 years against pertussis: Regional cross-sectional study. Voprosy Sovremennoy Pediatrii. 2021;20(1):62-66. (In Russ.) doi: 10.15690/vsp.v20i1.2237

10. Subbotina KA, Feldblium IV, Kochergina EA, Lechtina NA. Epidemiological rationale for changing the strategy and tactics of vaccination of pertussis in current conditions. Epidemiologiya i Vaktsinoprofilaktika. 2019;18(2):27-33. (In Russ.) doi: 10.31631/2073-3046-2019-18-2-27-33

11. Sharma NC, Efstratiou A, Mokrousov I, Mutreja A, Das B, Ramamurthy T. Diphtheria. Nat Rev Dis Primers. 2019;5(1):81. doi: 10.1038/s41572-019-0131-y

12. Clarke KEN, MacNeil A, Hadler S, Scott C, Tiwari TSP, Cherian T. Global epidemiology of diphtheria, 2000–2017. Emerg Infect Dis. 2019;25(10):1834-1842. doi: 10.3201/eid2510.190271

13. Murhekar MV, Kamaraj P, Kumar MS, et al. Immunity against diphtheria among children aged 5–17 years in India, 2017–18: A cross-sectional, population-based serosurvey. Lancet Infect Dis. 2021;21(6):868-875. doi: 10.1016/S1473-3099(20)30595-8

14. Demurcheva IV, Bezrodnova SM, Baturin VA, Kravchenko OO. Changes in tension of immunity to pertussis by time of immunization. Saratovskiy Nauchno-Meditsinskiy Zhurnal. 2023;19(1):51-56. (In Russ.) doi: 10.15275/ssmj1901051

15. Xu J, Doyon-Plourde P, Tunis M, Quach C. Effect of early measles vaccination on long-term protection: A systematic review. Vaccine. 2021;39(22):2929-2937. doi: 10.1016/j.vaccine.2021.04.012

16. Nilova LJu, Orishak EA, Fomenko VO. Measles: Global diagnostics programm and heard immunity. Problemy Meditsinskoy Mikologii. 2022;24(2):108. (In Russ.)

17. Basov AA, Maksimova NM, Vysochanskaya SO, Tsvirkun OV, Yatskovsky KA, Aduguzelov SE. Аssessment of the state of antidiphtheria immunity in different age groups of the population of the Russian Federation based on seromonitoring data for 2015–2021. Epidemiologiya i Vaktsinoprofilaktika. 2023;22(5):63-73. (In Russ.) doi: 10.31631/2073-3046-2023-22-5-63-73

18. Nozdracheva AV, Semenenko TA. The status of herd immunity to measles in Russia: A systematic review and meta-analysis of epidemiological studies. Zhurnal Mikrobiologii, Epidemiologii i Immunobiologii. 2020;97(5):445457. (In Russ.) doi: 10.36233/0372-9311-2020-97-5-7

19. Béraud G, Abrams S, Beutels P, Dervaux B, Hens N. Resurgence risk for measles, mumps and rubella in France in 2018 and 2020. Euro Surveill. 2018;23(25):1700796. doi: 10.2807/1560-7917.ES.2018.23.25.1700796

20. Lee YC, Lee YH, Lu CW, Cheng SY, Yang KC, Huang KC. Measles immunity gaps in an era of high vaccination coverage: A serology study from Taiwan. Travel Med Infect Dis. 2020;36:101804. doi: 10.1016/j.tmaid.2020.101804

21. Hanvatananukul P, Prasarakee C, Sarachai S, et al. Seroprevalence of antibodies against diphtheria, tetanus, and pertussis among healthy Thai adolescents. Int J Infect Dis. 2020; 96:422-430. doi: 10.1016/j.ijid.2020.04.088

22. Mayansky NA, Mukozheva RA, Kulichenko TV, et al. Serological monitoring of levels of antibodies to pathogens of tetanus, diphtheria and pertussis in schoolchildren aged of 11-17 years in seven regions of the Russian Federation. Rossiyskiy Pediatricheskiy Zhurnal. 2019;22(2):81-87. (In Russ.) doi: 10.18821/1560-95612019-22-2-81-87