The Clinical and Economic Impact of Measles-Mumps-Rubella Vaccinations to Prevent Measles Importations From US Pediatric Travelers Returning From Abroad.
J Pediatric Infect Dis Soc
; 11(6): 257-266, 2022 Jun 22.
Article
em En
| MEDLINE
| ID: mdl-35333347
ABSTRACT
BACKGROUND:
Pediatric international travelers account for nearly half of measles importations in the United States. Over one third of pediatric international travelers depart the United States without the recommended measles-mumps-rubella (MMR) vaccinations 2 doses for travelers ≥12 months and 1 dose for travelers 6 to <12 months.METHODS:
We developed a model to compare 2 strategies among a simulated cohort of international travelers (6 months to <6 years) (1) No pretravel health encounter (PHE) travelers depart with baseline MMR vaccination status; (2) PHE MMR-eligible travelers are offered vaccination. All pediatric travelers experience a destination-specific risk of measles exposure (mean, 30 exposures/million travelers). If exposed to measles, travelers' age and MMR vaccination status determine the risk of infection (range, 3%-90%). We included costs of medical care, contact tracing, and lost wages from the societal perspective. We varied inputs in sensitivity analyses. Model outcomes included projected measles cases, costs, and incremental cost-effectiveness ratios ($/quality-adjusted life year [QALY], cost-effectiveness threshold ≤$100 000/QALY).RESULTS:
Compared with no PHE, PHE would avert 57 measles cases at $9.2 million/QALY among infant travelers and 7 measles cases at $15.0 million/QALY among preschool-aged travelers. Clinical benefits of PHE would be greatest for infants but cost-effective only for travelers to destinations with higher risk for measles exposure (ie, ≥160 exposures/million travelers) or if more US-acquired cases resulted from an infected traveler, such as in communities with limited MMR coverage.CONCLUSIONS:
Pretravel MMR vaccination provides the greatest clinical benefit for infant travelers and can be cost-effective before travel to destinations with high risk for measles exposure or from communities with low MMR vaccination coverage.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Rubéola (Sarampo Alemão)
/
Sarampo
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Caxumba
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article