Promouvoir la vaccination de rattrapage avec le vaccin contre la rougeole, la rubéole et les oreillons (RRO) chez les femmes des milieux défavorisés et chez les immigrantes

Un article intitulé Seroprevalence of rubella antibodies and determinants of susceptibility to rubella in a cohort of pregnant women in Canada, 2008–2011, signé par Nicolas Gilbert (membre du RRSPQ) et collègues, publié dans Vaccine. L'article décrit une étude menée par Centre de l’immunisation et des maladies respiratoires (CIMRI) de l’Agence de la santé publique du Canada.

Résumé:

Les anticorps IgG contre la rubéole ont été mesurés dans des échantillons de plasma obtenus de 1752 femmes enceintes de 2008 à 2011. L’analyse des résultats a démontré que :

  • Les titres d’anticorps IgG étaient plus bas chez les participantes plus jeunes;
  • La susceptibilité à la rubéole était plus fréquente chez les femmes qui n’avaient jamais eu d’enfant;
  • La susceptibilité était plus fréquente chez les femmes les moins scolarisées et chez les immigrantes.

En conclusion, davantage d’efforts seraient nécessaires pour promouvoir la vaccination de rattrapage avec le vaccin contre la rougeole, la rubéole et les oreillons (RRO) chez les femmes des milieux défavorisés et chez les immigrantes.

 

Authors' abstract: Long term control of rubella and congenital rubella syndrome relies on high population-level immunity against rubella, particularly among women of childbearing age. In Canada, all pregnant women should be screened so that susceptible new mothers can be offered vaccination for rubella before discharge. This study was undertaken to estimate rubella susceptibility in a cohort of pregnant women in Canada and to identify associated socio-economic and demographic factors. Biobanked plasma samples were obtained from the Maternal-Infant Research on Environmental Chemicals (MIREC) study, in which pregnant women were recruited between 2008 and 2011. Socio-demographic characteristics and obstetric histories were collected. Second trimester plasma samples (n = 1,752) were tested for rubella-specific IgG using an in-house enzyme-linked immunosorbent assay. The percentage of women with IgG titers <5 IU/mL, 5–10 IU/mL, and ≥10 IU/mL were 2.3%, 10.1%, and 87.6%, respectively. Rates of seronegativity, defined as <5 IU/mL, were 3.1% in women who had no previous live birth and 1.6% in women who had given birth previously. Among the latter group, seronegativity was higher in women with high school education or less (adjusted OR (aOR) 5.93, 95% CI 2.08–16.96) or with a college or trade school diploma (aOR 3.82, 95% CI 1.45–10.12), compared to university graduates, and those born outside Canada (aOR 2.60, 95% CI 1.07–6.31). In conclusion, a large majority of pregnant women were found to be immune to rubella. Further research is needed to understand inequalities in vaccine uptake or access, and more effort is needed to promote catch-up measles-mumps-rubella vaccination among socioeconomically disadvantaged and immigrant women of childbearing age.