The Susceptibility of Young Adult Americans to Vaccine-Preventable Infections

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Abstract
Objective. —Due to recent resurgences of measles, mumps, and rubella among young US adults, we sought to generate antibody prevalence data for national and military immunization policy evaluations. Design. —We used a questionnaire and serological survey of Army recruits to assess antibody status to measles, mumps, rubella, and varicella by enzymelinked immunosorbent assay and to poliovirus types 1,2, and 3 by microneutralization assay. Setting. —Basic training reception centers at Fort Benning, Ga, and Fort Jackson, SC. Patients. —The study included 1547 US Army recruits who were inducted during September and October 1989. Outcome Measures. —Seronegativity by various demographic factors. Results. —Seronegativity rates, directly adjusted to the 15- to 24-year-old US population in 1980, were 20.7% for measles, 15.6% for mumps, 17.5% for rubella, and 6.9% for varicella. For measles, mumps, and rubella, susceptibility was less in females, blacks, and college-educated recruits, and varicella susceptibility was greater in females and blacks. Recruits who were born after 1969 lacked measles, mumps, and rubella antibodies more often than older recruits. The adjusted seronegativity rates for poliovirus types 1, 2, and 3 were 2.3%, 0.6%, and 14.6%, respectively; trends by age, sex, and race-ethnicity were generally unremarkable. Conclusions. —Among young adult Americans, susceptibility to measles, mumps, and rubella is unevenly distributed and may be substantial. Our findings support national objectives to further improve immunization coverage in schoolage and adult populations and provide further impetus for legislation requiring college entrants to present evidence of having received at least two doses of measles vaccine, with one on or after entry into elementary school. (JAMA. 1991;266:2724-2729)

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