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 The U.S. Centers for Disease Control and Prevention(CDC) recommends
two doses of the measles, mumps and rubella (MMR) vaccine for adults
traveling outside the U.S. who were born before 1957 and lack either
a documented measles infection, records of adequate vaccination or a
positive blood test for immunity to measles.
For the study, researchers examined data on adults who went to
clinics specializing in travel medicine from 2009 to 2014 and found
53 percent of the travelers who were eligible for the measles
vaccine didn’t get it.
And almost half of the eligible travelers didn’t get the vaccine
because they refused it when it was recommended, often because they
weren’t worried about getting measles, the study found.
“Many consider measles to be a mild illness characterized by fever,
rash and cough, but measles can also result in severe illness that
requires hospitalization,” said lead study author Dr. Emily Hyle, of
Harvard Medical School and Massachusetts General Hospital in Boston.
“The very young and immunocompromised are at particularly high risk
for severe or life-threatening illness with measles,” Hyle said by
email.
Even if travelers don’t get too sick themselves, they can still
transmit the illness to other people when they return to the U.S.
Most measles cases in the U.S. result from international travel,
according to the CDC.
It’s very contagious. Measles lives in mucus in the throat and nose
of an infected person and spreads when that person coughs and
sneezes. The virus can remain alive and contagious in the air for up
to two hours, according to the CDC.
About 90 percent of unvaccinated people exposed to measles by
entering a room where an infected person had been within the
previous two hours will be infected by measles, researchers note in
the Annals of Internal Medicine.
For the current study, researchers wanted to see how often
clinicians experienced in travel medicine got travelers who needed
the vaccine to have the shot.
Out of the 40,810 adult patients included in the study, 6,612, or 16
percent were eligible for the measles vaccine.
While most of the instances when eligible travelers didn’t get the
recommended vaccine happened because patients refused to do it,
about 28 percent of these cases occurred because clinicians decided
against it, the study found. Another 24 percent of cases involved
issues with access to care and the main barrier was referrals to
another provider for vaccination.
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Travelers eligible for the vaccine were less likely to receive it at
clinics in the South or at nonacademic medical centers.
One limitation of the study is its reliance on travelers to recall
their own vaccination history; another is that clinicians accepted
this as evidence of sufficient protection against measles, the
authors note.
Still, the findings highlight the need to educate travelers about
the importance of vaccination, said Dr. Lori Handy, a physician at
the Vaccine Education Center at the Children’s Hospital of
Philadelphia and co-author of an accompanying editorial.
“Most individuals in the United States have never known an
individual who has measles and do not realize that prior to the
introduction of a vaccine, 500,000 cases occurred each year in the
United States resulting in 500 deaths, 48,000 hospitalizations, and
1,000 cases of permanent brain damage from encephalitis,” Handy said
by email.
“As there are many people who cannot be vaccinated, such as pregnant
women, infants less than 6 months of age and immunocompromised
individuals, everyone else who can safely receive the vaccine should
receive it,” Handy added.
SOURCE: http://bit.ly/2fazTFW Annals of Internal Medicine, online
May 15, 2017.
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