Seroprevalence of Pandemic A(H1N1) pmd09 Virus Antibodies in Mexican Health Care Workers Before and After Vaccination

Arch Med Res. 2015 Feb;46(2):154-63. doi: 10.1016/j.arcmed.2015.03.001. Epub 2015 Mar 18.

Abstract

Background and aims: In April 2009, a new strain of influenza A(H1N1) was identified in Mexico and in the U.S. In June 2009, WHO declared this a pandemic. Health care workers constituted a risk group for their close contact with infected individuals. The aim was to estimate seropositivity for A(H1N1)pdm09 in health staff at the Instituto Mexicano del Seguro Social.

Methods: A two-stage cross-sectional study, before and after vaccination in the same workers, was performed on a random sample of health-care workers. A socio-occupational questionnaire was applied and serum antibodies against influenza A(H1N1)pdm09 were determined through neutralization of retroviral pseudotypes; two logistic regression models for both were constructed.

Results: The average (median/mean) age of 1378 participants from 13 work centers was 41.7 years and 68.7% (947) were women. Seroprevalence for the first stage was 26.5% (365) (7.4-43%) vs. 20.8% (11) in a control group from the blood bank; for the second stage, the vaccinated group was 33% (215) (18.2-47%) and 27% (196) (11.6-50%) for the unvaccinated group. In regression models, seropositivity was associated with occupational exposure to suspected influenza infected patients, being physicians, and being vaccinated.

Conclusions: Seropositivity against pandemic virus is similar to what was reported, both for vaccinated (2.8-40.9%) and unvaccinated (18.8-64.7%). Low seroprevalence in the vaccinated group indicates that between 67% and 73% were susceptible to infection. Given the relatively low vaccine-induced seropositivity, it is imperative to increase, hygiene and safety for health staff and at-risk populations, and strengthen epidemiological surveillance.

Keywords: Health care workers; Influenza A(H1N1)pdm09; Retroviral pseudotypes; Seroprevalence; Vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral / blood*
  • Blood Banks
  • Cross-Sectional Studies
  • Female
  • Health Personnel
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology*
  • Influenza A Virus, H1N1 Subtype / isolation & purification
  • Influenza Vaccines / immunology*
  • Influenza, Human / epidemiology*
  • Logistic Models
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Occupational Exposure
  • Physicians
  • Seroepidemiologic Studies
  • Surveys and Questionnaires
  • Vaccination
  • Young Adult

Substances

  • Antibodies, Viral
  • Influenza Vaccines