Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis.

BACKGROUND: Rubella containing vaccines (RCV) prevent rubella virus infection and subsequent congenital rubella syndrome (CRS). To update the evidence on immunogenicity, duration of protection, effectiveness and safety of RCV, we conducted a systematic literature review. METHODS: We searched EMBASE and SCOPUS, using keywords for rubella vaccine in combination with immunogenicity (seroconversion and seropositivity), duration of protection, efficacy/effectiveness, and safety. Original research papers involving at least one dose of RCV (at any age), published between 1-1-2010 and 17-5-2019 were included. Where appropriate, meta-analyses were performed. Quality of included studies was assessed using GRADE methodology. RESULTS: We included 36 papers (32 randomized controlled trials (RCTs) and 4 observational studies) on immunogenicity (RA27/3 strain) in children and adolescent girls, 14 papers (5 RCTs and 9 observational studies) on duration of protection, one paper on vaccine effectiveness (VE) (BRDII strain), and 74 studies on safety, including three on safety in pregnancy. Meta-analysis of immunogenicity data showed 99% seroconversion (95% CI: 98-99%) after a single dose of RCV in children, independent of co-administration with other vaccines. Seroconversion after RCV1 below 9 months of age (BRDII strain, at 8 months) was 93% (95% CI: 92-95%). For duration of protection, the included studies showed a seropositivity of 88%-100% measured 1-20 years after one or two RCV doses. The single study on VE of BRDII strain, reported 100% VE after one and two doses. Among 34,332 individuals participating in the RCTs, 140 severe adverse events (SAEs) were reported as possibly related to RCV. Among the case reports on SAEs, the association with RCV was confirmed in one report (on fulminant encephalitis). Among 3,000 pregnant women who were inadvertently vaccinated, no SAEs were reported. CONCLUSIONS: One and two doses of RCV are highly immunogenic for a long period of time, effective in preventing rubella and CRS, and safe.

Occupation- and age-associated risk of SARS-CoV-2 test positivity, the Netherlands, June to October 2020.

High coronavirus incidence has prompted the Netherlands to implement a second lockdown. To elucidate the epidemic's development preceding this second wave, we analysed weekly test positivity in public test locations by population subgroup between 1 June and 17 October 2020. Hospitality and public transport workers, driving instructors, hairdressers and aestheticians had higher test positivity compared with a reference group of individuals without a close-contact occupation. Workers in childcare, education and healthcare showed lower test positivity.

MenACWY vaccination campaign for adolescents in the Netherlands: Uptake and its determinants.

BACKGROUND: Between 2015 and 2018 the incidence of meningococcal disease serogroup W increased tenfold in the Netherlands with the highest case fatality among adolescents and young adults. In 2018-2019 a national mass vaccination campaign, with recall after non-attendance, was implemented targeting 14-18-years old adolescents. This study estimated the MenACWY-vaccine uptake and investigated its determinants. METHODS: The uptake before the start of the vaccination campaign was estimated from the number of vaccines administered by Municipal Health Services and dispensed by public pharmacies, and within the campaign from the national vaccination register. Possible determinants of uptake after the first invitation and recall were investigated among the first group invited for vaccination (born in May-December 2004) using random forest classification analysis. RESULTS: The uptake was 86% (of which 1.9% before the campaign) among all eligible adolescents and 88% among the first group invited, including 5% uptake achieved after the recall. The most important predictor of vaccination after the first invitation was parents' country of birth (lower uptake when parents were born abroad, range: 52%-Morocco to 88%-Netherlands). The most important predictors among those recalled were, respectively, distance to vaccination location (lower uptake with larger distance, range: 4-6%), percentage of votes for the conservative Christian (reformed) party in the municipality (lower uptake with higher percentage, range: 4-5%) and parents' country of birth (higher uptake when parents were born abroad, range: 4%-Netherlands to 11%-Syria). CONCLUSIONS: The MenACWY vaccination campaign for adolescents achieved a high uptake, with little vaccine use before the campaign. Parents' country of birth, votes for the conservative reformed political party and distance to the vaccination location were the most important predictors of vaccination. The recall strategy enhanced the uptake and was valuable to diminish immunization disparities. Future vaccination campaigns should put more effort into reaching adolescents with immigrant parents.