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Missed opportunities for MMR vaccination among departing U.S. adult travelers receiving pretravel health consultations
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7 18 2017
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Source: Ann Intern Med. 167(2):77-84
[PDF-312.20 KB]
Details:
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Alternative Title:Ann Intern Med
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Personal Author:
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Description:Background
Measles outbreaks continue to occur in the United States and are mostly due to infections in returning travelers.
Objective
We described how providers assessed the measles immunity status of departing U.S. adult travelers seeking pretravel consultation and assessed reasons given for nonvaccination among those considered eligible to receive the measles-mumps-rubella (MMR) vaccine.
Design
Observational study in U.S. pretravel clinics.
Setting
24 sites associated with Global TravEpiNet (GTEN), a Centers for Disease Control and Prevention-funded consortium.
Patients
Adults (born in or after 1957) attending pre-travel consultations at GTEN sites (2009-2014).
Measurements
Structured questionnaire completed by traveler and provider during pretravel consultation.
Results
We included 40,810 adult travelers; providers considered 6,612 (16%) to be eligible for MMR vaccine at the time of pretravel consultation. Of the MMR-eligible, 3,477 (53%) were not vaccinated at the visit; of these, 1,689 (48%) were not vaccinated due to traveler refusal, 966 (28%) due to provider decision, and 822 (24%) due to health systems barriers. Most MMR-eligible travelers who were not vaccinated were evaluated in the South (2,262 travelers, 65%) or at nonacademic centers (1,777 travelers, 51%). Nonvaccination due to traveler refusal was most frequent in the South (1,432 travelers, 63%) or at nonacademic centers (1,178 travelers, 66%).
Limitations
Our estimates could underrepresent the opportunities for MMR vaccination, as providers accepted verbal histories of disease and vaccination as evidence of immunity.
Conclusions
Sixteen percent of U.S. adult travelers who presented for pretravel consultation at GTEN sites met criteria for MMR vaccination according to the provider's assessment, but fewer than half of these travelers were vaccinated. An increase in MMR vaccination of eligible U.S. adult travelers could reduce the likelihood of measles importations and transmissions.
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Source:
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Pubmed ID:28505632
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Pubmed Central ID:PMC5513758
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Document Type:
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Funding:
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Volume:167
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Issue:2
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