State health departments are integral to providing guidance on specimen collection, transport, and testing of vaccine-reportable diseases. The CDC is the definitive organization to gather such information.
A number of different tests are used to identify Vaccine-Preventable Diseases. Many are beyond the testing capability of any one clinical lab, which is why they are often sent to state reference labs or the CDC. Table 1 is provided by the CDC and lists the types of tests performed on VPDs.8
Table 1. Confirmatory and Other Tests for VPDs.| Disease | Confirmatory Tests | Other Useful Tests |
| Diphtheria | Culture
Toxigenicity testing | PCR
MALDI-TOF |
| Haemophilus influenzae | Culture
Real-time PCR | Serotyping slide agglutination or PCR
(identification of capsular type of encapsulated strains)
Antigen detection
Molecular typing |
| Hepatitis A | IgM anti-HAV (positive) | Total anti-HAV
IgG anti-HAV (markers of immunity)
PCR for HAV RNA (marker of current infection) |
| Hepatitis B | IgM anti-HBc (acute infection)
HBsAg (acute or chronic infection)* | Anti-HBs (marker of immunity)
Total anti-HBc (marker of past or present infection)
PCR for HBV DNA (marker of current infection) |
| Influenza | Culture
Antigen detection (EIA, IFA, EM)
RT-PCR | |
| Measles | IgM
RT-PCR
Virus isolation | IgG
IgG for seroconversion or 4-fold titer rise
Avidity (case classification) |
| Meningococcal disease | Culture | Serogrouping
Slide agglutination or PCR
(identification of capsular type of encapsulated strains)
Antigen detection
Molecular typing |
| Mumps | Virus isolation
RT-PCR | IgG for seroconversion or 4-fold titer rise
(not recommended) |
| Pertussis | Culture
PCR | Serology |
| Pneumococcal disease | Culture
PCR | WGS-based deduction of all strain features (serotype, antimicrobial resistance, MLST genotype)
- Serotyping
- PCR deduction of serotypes
- Strain identification (MLST, PFGE)
|
| Poliomyelitis | Culture from stool, pharynx, or CSF | Intratypic differentiation (wild vs. vaccine type)
Paired serology
CSF analysis |
| Rotavirus |
| RT-PCR/qRT-PCR |
| Rubella | Paired sera for IgG
IgM | Culture |
| Tetanus | There are no lab findings characteristic of tetanus | Serology (for immunity testing) |
| Varicella | PCR | DFA
Culture
Serology
Genotyping |
Abbreviations: EIA, enzyme-linked immunosorbent assay; IFA, indirect fluorescent antibody; EM, electron microscopy; PCR, polymerase chain reaction; MLST, multilocus sequence typing; PFGE, pulsed field gel electrophoresis; CSF, cerebral spinal fluid; IgG, immunoglobulin G; IgM, immunoglobulin M; HAV, hepatitis A virus; HBV, hepatitis B virus; anti-HBc, hepatitis B core antibody; HBsAg, hepatitis B surface antigen; qRT-PCR, quantitative reverse transcription polymerase chain reaction
*Confirmation of HBsAg positive results by HBsAg neutralization assay should be performed as specified in the test package insert.
