Inadequate Measles, Mumps, Rubella, and Varicella Immunity Among Employees.

OBJECTIVES: The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center. METHODS: Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application. RESULTS: Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity. CONCLUSION: Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.

An Employer-Sponsored Musculoskeletal Care Coordination Service Can Improve Clinical Outcomes and Self-Reported Productivity.

OBJECTIVE: To evaluate the effects of participation with a novel musculoskeletal care coordination service on clinical outcomes, self-reported productivity, and satisfaction. METHODS: Prospective analysis of participants using the service from January 1, 2019 to December 31, 2019. RESULTS: One hundred eighty nine participants were enrolled; 54 participants completed their recommended clinical pathway. Low back pain was the most common musculoskeletal issue (N = 86, 46%). 88 participants (47%) were triaged to home exercise and 59 (31%) to physical therapy. Behavioral health issues were common: 47 participants (25%) were referred to their EAP. Only 30 participants (16%) required a medical referral. Engagement was associated with improvements in pain, physical function, mood, and self-reported productivity (P < 0.01). The net promotor score for this service was 95. CONCLUSIONS: Employers with populations for whom musculoskeletal complaints are common might benefit from integrating a musculoskeletal care coordination service in their benefits offering.