Measles is a highly contagious viral illness associated with significant global mortality, despite the availability of an effective vaccine. As vaccine hesitancy continues to increase following the COVID-19 pandemic, combined with a lack of measles-specific antiviral agents, the risk of outbreaks and epidemics remains elevated. Immunocompromised individuals have a higher risk of serious complications from measles, especially because the live-attenuated measles, mumps, and rubella vaccine may be contraindicated in severely immunocompromised patients. As such, these individuals depend on herd immunity. This scoping review aims to identify the potential need for a measles booster dose among immunocompromised adults in the United States by providing an overview of current vaccine indications and outcomes. EMBASE, Web of Science, and Ovid MEDLINE were searched using search terms specific to measles booster doses and immunocompromised adults. In total, 2,335 articles were imported to Rayyan, and after a two-tiered review, seven articles met the full inclusion criteria. The results revealed that individuals with chronic immunocompromising illnesses were often not fully protected against measles, leaving them vulnerable to infection. The findings from this review suggest that clinicians may consider a booster dose of vaccine for immunocompromised individuals to help restore their protection against measles. Meanwhile, further research utilizing larger sample sizes and diverse patient populations is warranted based on these findings. We believe that additional studies should aim to clarify current guidelines to improve the care of immunocompromised patients who may be exposed to measles.

Measles virus remains a significant global health threat, and despite the availability of an effective vaccine, measles cases continue to increase worldwide in recent years. Genomic surveillance has become an essential tool for monitoring virus circulation and investigating outbreaks. Here, we describe a wet laboratory method for whole‑genome sequencing of measles virus using a tiled amplicon approach and Illumina sequencing technology. A previously published Oxford Nanopore based tiled primer scheme was adapted to include both circulating measles genotypes and for use on the Illumina platform. Two Illumina library preparation kits, Illumina DNA Prep (IDP) and Nextera XT (XT), were evaluated for performance. The IDP kit demonstrated more complete genomes and consistent genome coverage compared with XT. Using quantified reference genomes, the limit of detection was determined to be 10,000 genome copies for genotype B3 and D8. Sequence accuracy was evaluated using previously characterized clinical samples and showed high concordance. This method provides a reliable and sensitive approach for measles virus whole genome sequencing using Illumina platforms and is suitable for genomic surveillance applications.

Florida's proposal to remove vaccine mandates in the state raises urgent questions about the state's vulnerability to measles resurgence. We develop and analyze an age-structured measles transmission model with heterogeneous contact patterns between children and adults, calibrated using data from the 2025 measles outbreak in Gaines County, Texas, and applied to Florida using state-specific demographic structure and measles-mumps-rubella (MMR) vaccination coverage. Using Florida-specific mixing patterns and demographic composition, we estimate the state's vaccine-induced herd immunity threshold and find that current MMR coverage already falls below the level required to prevent sustained measles transmission. Simulated declines in MMR vaccination coverage following removal of school-entry requirements further increase outbreak potential, producing epidemic sizes not seen since prevaccine eras and projecting a significant number of pediatric deaths within five years. Sensitivity analyses highlight that small reductions in child vaccination rates yield disproportionately large increases in outbreak magnitude, especially under strong assortative mixing among children. These findings indicate that Florida's vaccination policies are approaching a critical tipping point: Maintaining or improving MMR vaccination coverage is essential to prevent measles from reestablishing endemic circulation within the state and potentially spreading to the broader United States.

Free-text narratives in vaccine adverse event reports contain symptom descriptions and contextual wording that can be characterized using text mining. However, lexicon-based sentiment scores in medical narratives should be interpreted as vocabulary patterns rather than direct measures of patients' emotional states. We evaluated sex-specific and vaccine-specific patterns in sentiment-scored and emotion-category assignment vocabulary in Vaccine Adverse Event Reporting System (VAERS) narratives for coronavirus disease 2019 (COVID-19), influenza, human papillomavirus (HPV), and measles-mumps-rubella (MMR) vaccines. Public VAERS reports received from 2010 to 2024 were analyzed. VAERSDATA, VAERSVAX, and VAERSSYMPTOMS were linked by VAERS_ID, with duplicate records removed. Report-level AFINN scores were normalized per 100 words. Sensitivity analyses excluded common clinical and symptom-related terms. Effect sizes, 95% confidence intervals, adjusted linear regression models with HC3 robust standard errors, and NRC emotion-category assignment profiles were evaluated. After duplicate handling, 1022460 COVID-19, 148489 influenza, 41212 HPV, and 47459 MMR reports were analyzed. Female-associated reports generally showed slightly lower primary AFINN scores than male-associated reports, although effect sizes were negligible. Excluding clinical and symptom-related terms attenuated or reversed these differences. Adjusted regression models showed only small associations between sex and AFINN scores. NRC analyses demonstrated clearer vaccine-specific than sex-specific vocabulary patterns. VAERS narratives showed only small sex-related differences but distinct vaccine-specific patterns in sentiment-scored and emotion-category assignment vocabulary. These findings should be interpreted as lexicon-derived vocabulary patterns rather than direct measures of psychological responses, vaccine perceptions, or clinical outcomes.

TORCH infections (toxoplasmosis, other [syphilis, varicella-zoster, parvovirus B19], rubella, cytomegalovirus, herpes) constitute the classic group of congenital infections that may result in severe fetal and neonatal consequences. Transplacentally transmitted infections have been a critical component of prenatal care for decades. Although screening for this group of infections has been performed in Hungary since 1971, diagnostic approaches and screening strategies have undergone significant transformation. Current international recommendations, as well as national professional guidelines, no longer support the routine use of non-indicated TORCH panels in the presence of non-specific ultrasound findings, as their diagnostic value is extremely limited. The aim of this paper is to present the clinical significance of TORCH infections, the most recent evidence-based diagnostic algorithms (including serology, avidity testing, and polymerase chain reaction), and emerging therapeutic options (e.g., valacyclovir in cytomegalovirus infection), while emphasizing the importance of targeted diagnostic evaluation and prevention. The manuscript provides an overview of the Hungarian aspects of the diagnosis and management of TORCH infections during pregnancy, including current national screening recommendations, practices and the organization of reference care pathways. The diagnostic approach to TORCH infections has undergone a paradigm shift; therefore, routine TORCH panel testing is no longer recommended. The use of a targeted diagnostic strategy improves diagnostic efficiency and reduces unnecessary interventions. Orv Hetil. 2026; 167(39): 1535-1551.

Background and Objectives: Despite long-standing MMR vaccination programmes, outbreaks of vaccine-preventable diseases continue to occur worldwide, raising concerns regarding waning immunity and susceptibility gaps in adult populations. Between 2017 and 2019 alone, WHO reported over 880,000 measles cases globally-a fourfold increase over the preceding two years-with outbreaks in both low- and high-income countries despite high childhood vaccination coverage. This study evaluated the seroepidemiology of measles, mumps, and rubella among adults in Türkiye over a nine-year period. Materials and Methods: A retrospective laboratory-based study was conducted using ELISA IgM and IgG results obtained between 2014 and 2022 at a tertiary-care university hospital. Seropositivity rates were analysed by year, age group, and sex. Temporal trends were assessed using the Cochran-Armitage trend test; factors associated with IgG seropositivity were assessed using multivariable logistic regression. Results: Among 10,407 adult test records, overall IgG seropositivity was 75.8% for measles, 94.9% for rubella, and 86.3% for mumps; IgM positivity remained low throughout (0.9%, 0.4%, and 1.9%, respectively). Measles IgG declined significantly from 78.4% in 2014-2019 to 62.6% in 2022 (p < 0.001), whereas Rubella IgG remained stable (93.2-95.7%) and Mumps IgG showed no significant temporal change. Seropositivity increased markedly with age for measles (18-29 years: 70.2% vs. ≥50 years: 93.4%; p < 0.001) and mumps (p = 0.030). Multivariable analysis confirmed that Measles IgG seropositivity was substantially lower in 2022 than in the pooled 2014-2019 period (OR = 0.432, 95% CI: 0.319-0.584, p < 0.001). Rubella seroprotection among women of reproductive age was 94.7% (95% CI: 93.9-95.5%), close to but not statistically distinguishable from the 95% population immunity benchmark used in rubella elimination frameworks. Conclusions: A significant measles immunity gap exists among younger adults in Türkiye, with Measles IgG seropositivity declining from 78.4% in 2014-2019 to 62.6% in 2022, consistent with a cohort effect whereby vaccine-era cohorts exhibit lower protection than older adults with naturally acquired immunity. Rubella immunity, by contrast, remained close to the 95% elimination benchmark throughout. These findings underscore the importance of targeted serological surveillance and evidence-based booster vaccination strategies.

Background/Objectives: Vaccine hesitancy has intensified worldwide, and measles and pertussis have resurged across the WHO European Region. In Türkiye, a regulation introduced in May 2024 made documentation of every parental refusal mandatory, rendering 2025 the first calendar year for which provincial refusal data can be considered systematically ascertained. Methods: We conducted a retrospective, registry-based cross-sectional study of all vaccine refusal notifications submitted to the Batman Provincial Health Directorate between 1 January and 31 December 2025, covering all six districts of the province. Sociodemographic data were extracted from the notification database, and reasons for refusal were obtained using a structured questionnaire administered by primary healthcare personnel. Parents could endorse more than one reason. Results: A total of 4118 notifications were analysed. Mothers completed 62.4% of notifications; 44.2% of parents had primary education only and 58.3% belonged to low-income households. The diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b (DTaP-IPV-Hib) combination vaccine (28.4%) and measles-mumps-rubella (MMR) vaccine (22.1%) were the most frequently refused vaccines. Exposure to media or community reports was the most frequently endorsed reason (71.3%), followed by concern about adverse effects (68.9%) and doubts about vaccine safety (65.4%). Parents endorsed a mean of 3.6 reasons each. Doubts about safety predominated in lower socioeconomic strata, whereas the perception that vaccination is unnecessary predominated in higher strata. Conclusions: Refusal in this setting rests on a cluster of mutually reinforcing beliefs rather than a single misconception, and the concerns reported differ systematically by socioeconomic position. Differentiated rather than uniform communication strategies are required.

Background: Measles, mumps, and rubella outbreaks continue to occur despite high vaccination coverage, raising concerns about long-term vaccine-induced immunity. This study assessed serological protection against measles, mumps, rubella, and varicella in fully vaccinated Russian adolescents to identify immunity gaps and inform revaccination strategies. Methods: Serum IgG was quantified by commercial ELISA. Analytical cut-offs were: measles ≥ 0.18 IU/mL, rubella ≥ 30 IU/mL, mumps index ≥ 1.0 (index = OD/0.467), and varicella ≥ 1.0 IU/mL; equivocal results were classified as negative in the primary analysis and as positive in a sensitivity analysis. Geometric mean concentrations (GMC) were computed on the natural-logarithm scale. Results: Seropositivity differed markedly between infections (χ[2] 55.1; p < 0.001): rubella 81.4% (95% CI 74.6-86.7), varicella 57.7% (95% CI 49.8-65.2), mumps 53.2% (95% CI 45.4-60.9) and measles 41.0% (95% CI 33.6-48.9). GMC was lowest for measles (0.132; 95% CI 0.111-0.158) and highest for rubella (61.9; 95% CI 55.3-69.2). The measles estimate was sensitive to the treatment of equivocal results, rising to 53.2% (95% CI 45.4-60.9) at the manufacturer's cut-off of ≥0.12 IU/mL; rubella rose to 94.9% at ≥16 IU/mL. Conclusions: Lower seropositivity rates for measles and mumps were identified among fully vaccinated adolescents, which fall below standard epidemiological benchmarks. In contrast, rubella seropositivity was robust at 81.4%. Because the measles estimate depended strongly on the assay cut-off applied, and because enzyme immunoassays are known to underestimate seroprevalence relative to neutralization testing, these findings describe the distribution of circulating antibody rather than the prevalence of susceptibility and warrant confirmation in larger representative samples with neutralization testing.

We assessed the risk of Idiopathic thrombocytopenic purpura (ITP) after Measles Mumps Rubella vaccine (MMR) doses 1 and 2 in children in England born from 2000 to 2019. After linking hospitalised ITP episodes to MMR vaccine records, we used the self-control case-series method to assess the relative incidence in the 6-week period post vaccination. We also assessed the risk of ITP after dose 2 in those who had ITP after dose 1. We found an increased risk of ITP after dose 1 (relative incidence 2.38 (95% CI: 2.12-2.67)) with an attributable risk of 1 in 42,900 doses. We found no evidence of an increased risk after dose 2 (relative incidence 0.96 (95% CI: 0.81-1.13)). Furthermore, we found that the 336 children with ITP after dose 1 who had MMR dose 2 had no increased risk in the 6-weeks after this dose and that it is therefore safe to vaccinate these children.