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Open Access Highly Accessed Research article

Effects of campaign for postpartum vaccination on seronegative rate against rubella among Japanese women

Takahiro Yamada1*, Junko Mochizuki2, Masachi Hanaoka3, Eriko Hashimoto4, Akihide Ohkuchi5, Mika Ito6, Takahiko Kubo2, Akihito Nakai4, Shigeru Saito6, Nobuya Unno3, Shigeki Matsubara5 and Hisanori Minakami1

Author Affiliations

1 Department of Obstetrics, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo 060-8638, Japan

2 Department of Obstetric and Gynecology, School of Medicine, Kitasato University, Sagamihara, Japan

3 Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan

4 Department of Obstetric and Gynecology, Nippon Medical School, Tokyo, Japan

5 Department of Obstetric and Gynecology, Jichi Medical University School of Medicine, Shimotsuke, Japan

6 Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Sugitani, Japan

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BMC Infectious Diseases 2014, 14:152  doi:10.1186/1471-2334-14-152

Published: 21 March 2014

Abstract

Background

Japan experienced two rubella outbreaks in the past decade (2004 and 2012 – 2013), resulting in 10 and 20 infants with congenital rubella syndrome (CRS), respectively. This study was performed to determine whether the seronegative rate was lower in multiparous women than in primiparous women in Japan.

Methods

Hemagglutination inhibition (HI) test results during pregnancy were analyzed retrospectively in 11048 primiparous and 9315 multiparous women who gave birth at six hospitals in northern Japan in the 5-year study period (January 2008 through December 2012). Women with HI titer <  1:8 were defined as susceptible to rubella.

Results

The seronegative rate was significantly lower in multiparous than primiparous women aged 30 – 31 years (2.3% [22/967] vs. 4.5% [66/1454], P  =  0.0036), 36 – 37 years (3.4% [55/1601] vs. 5.7% [79/1389], P  =  0.0030), and overall women (3.8% [350/9315] aged 34.7  ±  5.2 vs. 5.4% [597/11048] for 33.2  ±  5.9, P  <  0.001). The susceptible fraction size did not differ largely according to hospital, ranging from 3.5% to 6.3%. Those for each year did not change markedly; 4.5% [150/3369], 5.2% [221/4268], 4.4% [195/4412], 4.6% [186/4056], and 4.6% [195/4258] for 2008, 2009, 2010, 2011, and 2012, respectively. Those for teenagers were consistently high: 22.7% [5/22], 20.7% [6/29], 20.6% [7/34], 13.0% [3/23], and 23.5% [4/17] for 2008, 2009, 2010, 2011, and 2012, respectively.

Conclusions

The seronegative rate was significantly lower in multiparous than primiparous women. However, Japanese rubella vaccination programs were insufficient to eliminate CRS.

Keywords:
Congenital rubella syndrome; Outbreak; Vaccine