BOSTON, Mass. — More than half of U.S. adults recommended to receive vaccination against measles prior to traveling abroad didn’t do so at health clinics, a new study finds.
Researchers from Massachusetts General Hospital and Harvard Medical School found that 53 percent of eligible adults examined from 2009 to 2014 didn’t receive the measles vaccine — with about half refusing the recommended vaccination because they weren’t worried.
The new study of more than 40,800 patients born after 1956 and seen for pre-travel consultation at health clinics also found that 84 percent were determined to be immune to the disease after having gone through two MMR vaccinations in the past.
Travelers eligible for the vaccine were least likely to receive immunization at clinics in the Southern U.S. or at nonacademic medical centers.
“Measles has been eliminated in the U.S. since 2000, which means that all measles cases in the country can be traced back to an imported case – either a foreign visitor or a U.S. resident returning from international travel,” says lead author Dr. Emily Hyle, of the MGH Division of Infectious Diseases, in a hospital press release.
Nearly one-quarter (24 percent) of providers referred travelers over to another healthcare provider for vaccination, while 28 percent of consultations saw providers deciding not even suggesting MMR vaccinations.
“It was surprising to see such a high number of missed opportunities for MMR vaccination, even at these specialized pre-travel consultations, but our results also suggest ways to improve the rate of MMR immunization among eligible travelers,” says Hyle.
According to the Centers for Disease Control and Prevention, measles starts with a fever, runny nose, cough, red eyes, and a sore throat. It is then followed by a rash that spreads over the body. The virus is highly contagious virus and spreads through the air through coughing and sneezing.
For those without evidence of measles immunity, the Advisory Committee on Immunization Practices recommends two documented doses of the MMR vaccine for adult travelers. Positive tests showing antibodies to the virus as well as a documented previous case of measles are sufficient evidence, the experts say.
Worldwide, it’s estimated that more than 300 children die from measles complications each day. In the United States, 667 cases were reported to CDC in 2014—the largest number of cases in a year since 1994. These cases resulted from people infected overseas bringing the virus into the United States.
“Since more than 60 percent of the measles importations into the country are due to returning U.S. travelers, increasing the number of travelers who are immune to measles will reduce the number of measles cases,” adds Hyle. “We can definitely improve how often providers specializing in pre-travel medical advice offer MMR vaccine to eligible travelers and encourage clear discussions with patients about the risks of contracting measles and of spreading the disease after their return to the U.S.”
The researchers caution that even singular cases of measles can trigger a major outbreak, particularly in communities or areas where there is a high number of people that never received immunization or are not immune. Although the virus may just cause fever-like reactions and symptoms, it can lead to more serious health consequences and hospitalization among children.
“Measles is one of the most infectious diseases known – 90 percent of people who are not immune will contract measles from an even-minimal exposure to someone who is infected,” says senior author Dr. Regina LaRocque, of Harvard Medical School.
This study was published in the May edition of the journal Annals of Internal Medicine.
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