{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:01:56Z","timestamp":1784869316556,"version":"3.55.0"},"reference-count":51,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coalition for Operational Research on Neglected Tropical Diseases","award":["OPP1053230"],"award-info":[{"award-number":["OPP1053230"]}]},{"DOI":"10.13039\/501100001794","name":"University of Queensland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian National Health and Medical Research Council Fellowship","award":["1193826"],"award-info":[{"award-number":["1193826"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Introduction: Seroprevalence of antibodies for vaccine-preventable diseases (VPDs), due to vaccination or previous infection, can provide a more accurate estimate of immunity compared to vaccination coverage data alone. This study aimed to examine the seroepidemiology and spatial distribution of VPD seroprevalence in Samoa in 2018 and 2019. Methods: Dried blood spot (DBS) samples were collected from two nationally representative community-based surveys of participants aged \u22655 years from the Surveillance and Monitoring to Eliminate Lymphatic Filariasis and Scabies from Samoa (SaMELFS) project. DBSs were tested using multiplex bead assays (MBAs) to detect antibodies against measles, rubella, diphtheria, and tetanus. Seroprevalence was estimated at the national and primary sampling unit (PSU) levels, and cluster analysis was completed using SaTScan. Results: Overall, 8394 valid MBA results were analysed across 35 PSUs. The highest overall seroprevalence was observed for tetanus (91.0%; 95% CI: 90.2\u201391.7), followed by diphtheria (83.7%; 95% CI: 82.7\u201384.7), rubella (79.3%; 95% CI: 78.2\u201380.3), and measles (45.8%; 95% CI: 44.8\u201346.9) with substantial heterogeneity across PSUs. Clusters of seronegativity to measles (relative risk [RR]: 1.16, p &lt; 0.001) and diphtheria (RR: 1.16, p &lt; 0.001) were also identified. Conclusions: These findings demonstrate significant variation in seroprevalence and pockets of low population immunity to multiple VPDs, highlighting the key advantage of an integrated rather than siloed approach. The relatively high seroprevalence to rubella suggests potential community transmission, emphasising the need to strengthen congenital rubella surveillance and improve vaccination coverage. Identifying low immunity to VPDs can provide an early warning to potential outbreak risk and support the Ministry of Health to target public health interventions in higher-risk areas.<\/jats:p>","DOI":"10.3390\/tropicalmed11010009","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T08:47:27Z","timestamp":1766998047000},"page":"9","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Finding the Gaps: Integrated Serosurveillance and Spatial Clustering of Vaccine Preventable Diseases in Samoa, 2018\u20132019"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-8419","authenticated-orcid":false,"given":"Selina","family":"Ward","sequence":"first","affiliation":[{"name":"Faculty of Health, Medicine, and Behavioural Sciences, Center for Clinical Research, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-8201","authenticated-orcid":false,"given":"Harriet L. S.","family":"Lawford","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Behavioural Sciences, Center for Clinical Research, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6761-2325","authenticated-orcid":false,"given":"Benn","family":"Sartorius","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Behavioural Sciences, Center for Clinical Research, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-4324","authenticated-orcid":false,"given":"Helen J.","family":"Mayfield","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Behavioural Sciences, Center for Clinical Research, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4314-0615","authenticated-orcid":false,"given":"Filipina","family":"Amosa-Lei Sam","sequence":"additional","affiliation":[{"name":"School of Medicine, National University of Samoa, Lepapaigalagala Campus, Toomatagi, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-3027","authenticated-orcid":false,"given":"Sarah Louise","family":"Sheridan","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance\u2014Sydney Children\u2019s Hospitals Network, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Samoa Ministry of Health, Moto\u2019otua, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4829-8403","authenticated-orcid":false,"given":"Satupaitea","family":"Viali","sequence":"additional","affiliation":[{"name":"Oceania University of Medicine, Moto\u2019otua, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8288-4169","authenticated-orcid":false,"given":"Colleen L.","family":"Lau","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Behavioural Sciences, Center for Clinical Research, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1111\/tmi.12737","article-title":"Seroepidemiology: An underused tool for designing and monitoring vaccination programmes in low-and middle-income countries","volume":"21","author":"Cutts","year":"2016","journal-title":"Trop. 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