Spatial disparities in perfluoroalkyl and polyfluoroalkyl substances exposure and immunosuppressive effects on vaccine induced antibody levels in Guangzhou children.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are persistent environmental pollutants that are widely detected in human serum worldwide, and are associated with reduced vaccine-induced antibody responses. However, existing research has primarily focused on the effects of prenatal and adolescent PFAS exposures on antibody levels or disease incidence. A critical gap remains in understanding the association between serum PFAS concentrations and antibody levels in children. In this study, we assessed the association of serum PFAS concentrations and antibody levels against measles, mumps, rubella, and varicella in children aged 3-12 years across all 11 administrative districts of Guangzhou, China. We compared the spatial distribution of serum PFAS concentrations across 11 administrative districts to reveal regional differences. We further evaluated both the individual and combined effects of PFAS on antibody levels, and employed interaction terms and stratified analyses to examine the modifying roles of age and sex. Children in Nansha District exhibited the highest total PFAS concentrations, with a noticeable decrease from south to north. We observed significant negative associations between perfluorobutanesulfonic acid and varicella antibody levels, as well as between perfluorooctanoic acid/6:2 chlorinated polyfluoroalkyl ether sulfonic acid and rubella antibody levels. In contrast, perfluoroheptanesulfonate showed significant positive associations with measles and rubella antibody levels. Trend analyses indicated a significant negative association between quartiles of total PFAS concentrations and rubella antibody levels, and Bayesian Kernel Machine Regression further demonstrated a gradual, significant decline in rubella antibody levels with increasing PFAS concentrations. Notably, these associations were more pronounced in girls and in younger age groups. Overall, our findings reveal marked spatial disparities in PFAS exposure and highlight a humoral immunosuppressive effect, particularly among younger children and girls.