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August 30, 2026Vaccine XOpen Access

Age- and program-related heterogeneity in rubella IgG antibody titers among adults undergoing municipal antibody testing in Japan

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Key result

Municipal rubella testing reveals ~26% of adults have IgG titers below 20 IU/mL.

  • n=221

Why the study?

Preventing rubella and congenital rubella syndrome requires understanding adult immunity patterns shaped by historical vaccination policy changes and varying municipal program thresholds.

Population

221 adults aged 20–64 years undergoing municipal rubella antibody testing at a Japanese outpatient clinic

Comparison

Phase 5 rubella vaccination program vs CRS prevention program

Design

Retrospective study

Authors

MYMasamichi YoshikaOsaka Nishi Clinic

Discussion

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Implication

May indicate waning adult rubella immunity; leaves open need for prospective serosurveys before changing vaccination policy.

Key Points

  • To evaluate age- and program-related heterogeneity in rubella IgG antibody titer distributions among adults undergoing municipal screening in Japan.
  • Retrospective analysis of N=221 adults aged 20–64 years tested at a community-based outpatient clinic in Japan.
  • Rubella IgG antibody titers were quantified using chemiluminescent enzyme immunoassay (CLEIA) across two municipal screening cohorts: Phase 5 vaccination program men (n=156) and congenital rubella syndrome (CRS) prevention program participants (n=65).
  • The overall median rubella IgG titer was 62.0 IU/mL, with the lowest median titers observed in participants aged 25–29 years and the highest in those aged 60–64 years.
  • Applying program-specific thresholds across all participants, 25.8% (57/221) had titers <20 IU/mL (Phase 5 threshold) and 40.3% (89/221) had titers <45 IU/mL (CRS prevention threshold).
  • Sub-threshold rates were higher in the CRS prevention group (33.8% <20 IU/mL; 63.1% <45 IU/mL) than in the Phase 5 group (22.4% <20 IU/mL; 30.8% <45 IU/mL), while only 0.9% (2/221) fell below the serological cutoff of <10 IU/mL.

Study Design

Type

Observational (n=221)

Multicenter

No

Structured PICO

P
Population
221 adults aged 20-64 years undergoing municipal rubella antibody testing at a community-based outpatient clinic in Japan.
E
Exposure
Municipal rubella antibody testing (retrospective analysis of rubella IgG antibody titers measured by chemiluminescent enzyme immunoassay [CLEIA]).
O
Outcome
Rubella IgG antibody titers and proportion of participants below programmatic thresholds (<20 IU/mL and <45 IU/mL).surrogate

There is significant age- and program-related heterogeneity in rubella IgG antibody titer distributions among adults undergoing municipal testing in Japan.

Cite This Study

Masamichi Yoshika (2026) conducted an observational in Rubella immunity (n=221). Municipal rubella antibody testing programs was evaluated on Rubella IgG antibody titers and proportion below programmatic thresholds. Among adults undergoing municipal rubella antibody testing, the overall median IgG titer was 62.0 IU/mL, with 25.8% having titers <20 IU/mL and 40.3% having titers <45 IU/mL.

synapsesocial.com/papers/6a93f02f6c1a8fb52e79c3dchttps://doi.org/10.1016/j.jvacx.2026.100895
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1How to Prevent Rubella Epidemics and Congenital Rubella Syndrome: Lessons From 42 Years of Longitudinal Epidemiology in Osaka Prefecture, Japan (1982–2023)2024 · 7 citations
  2. 2The cost of dichotomising continuous variables2006 · 2,718 citations
  3. 3Rubella Immunity:Defining the Level of Protective Antibody1996 · 180 citations
  4. 4Assessing Immunity to Rubella Virus: a Plea for Standardization of IgG (Immuno)assays2016 · 48 citations