评估卫生保健工作者的麻疹免疫，同行评议文献的系统综述（2013 - 2023）。我们从这里往哪里走？

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-05-12 DOI:10.1016/j.vaccine.2025.127214

Yuen Fung Ng (Dave) , Karen Lockhart , Meena Dawar , David Vigor , Annalee Yassi

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引用次数: 0

摘要

麻疹是一种高度传染性疾病，目前正在全球范围内死灰复燃，因职业接触给卫生保健工作者带来重大风险。虽然以前的研究主要使用血清阳性率来评估HCW免疫，但没有研究通过纳入其他广泛使用的定义来全面评估免疫，包括免疫的文献证据、出生队列的自然免疫和自我报告的免疫。方法对2013年1月至2024年2月在同行评审期刊上发表的英文HCW免疫监测研究进行系统回顾。数据提取于(1)国家，(2)作者和年份，(3)免疫评估类型，(4)研究类型，(5)数据收集期，(6)免疫覆盖结果，(7)HCW计数，(8)年龄范围，(9)工作角色，（10）血清患病率方法和阈值（如适用）。结果共纳入98项研究，免疫覆盖率为57.1% ~ 99.2%。免疫评估基于血清阳性率、文献证据、出生队列的自然免疫和自我报告的免疫。在研究人群、免疫评估方法和情境背景中观察到相当大的异质性，包括在疫情期间进行的研究。包括的研究表明，召回可能低估了免疫力，因为在不记得接种过疫苗或患过麻疹的参与者中观察到较高的血清阳性率。结论与以往的研究结果相比，本研究突出了HCW免疫覆盖率的积极趋势。然而，评估麻疹免疫的方法差异很大，限制了进行综合全球分析的能力。仅使用一种方法评估免疫的研究导致人们认为免疫覆盖率低于预期，因为这种有限的方法可能无法全面或准确地反映实际免疫水平。今后的研究应优先考虑开发标准化工具和方法，以实现数据协调并促进强有力的全球免疫评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Assessing measles immunity among healthcare workers, a systematic review of peer-reviewed literature (2013−2023). Where do we go from here?

Background

Measles, a highly contagious disease, is experiencing a global resurgence, posing significant risks to healthcare workers (HCWs) due to occupational exposure. While previous studies have primarily evaluated HCW immunity using seroprevalence, no study has comprehensively assessed immunity by incorporating other widely used definitions, including documented evidence of immunity, natural immunity by birth cohort, and self-reported immunity.

Methods

A systematic review was conducted of HCW immunity surveillance studies published in English in peer-reviewed journals from January 2013 to February 2024. Data were extracted on (1) country, (2) author and year, (3) immunity assessment type, (4) study type, (5) data collection period, (6) immunity coverage results, (7) HCW count, (8) age ranges, (9) job roles, and (10) seroprevalence methodology and threshold values, where applicable.

Results

A total of 98 studies were included, with immunity coverage ranging from 57.1 % to 99.2 %. Immunity assessments were based on seroprevalence, documented evidence, natural immunity by birth cohort, and self-reported immunity. Considerable heterogeneity was observed across study populations, immunity assessment methodologies, and situational contexts, including studies conducted during outbreaks. Studies included demonstrated that recall may underestimate immunity, as a high rate of seropositivity was observed among participants who did not remember being vaccinated or having measles.

Conclusion

This study highlights a positive trend in HCW immunity coverage compared to previous findings. However, significant methodological variability in assessing measles immunity limits the ability to perform aggregated global analyses. Studies using only one method to assess immunity contribute to the perception of lower-than-expected immunity coverage, as this limited approach may not provide a complete or accurate picture of actual immunity levels. Future research should prioritize the development of standardized tools and methodologies to enable data harmonization and facilitate robust global immunity assessments.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.