|
 Nearly 60% of children who could have benefited from the MMR
(measles, mumps and rubella) vaccination did not get it during
pre-travel doctor's appointments, researchers found.
While nearly 40% of those children did not get vaccinated because
their parents or guardians declined, an equal number missed
vaccinations because they weren't offered by the clinician,
according to the study in JAMA Pediatrics.
"The main message is that providers should consider MMR vaccination
for children traveling internationally if they are eligible for it,"
said the study's lead author, Dr. Emily Hyle, an infectious disease
physician at Massachusetts General Hospital in Boston.
"Those traveling internationally are at a higher risk of being
infected because there is more measles circulating globally than
there is in the U.S., Hyle said. "Kids going to areas that are
higher risk can easily be infected just by breathing because measles
is spread through droplets in the air that last up to 2.2 hours."
The results were not what Hyle and her colleagues expected. "We were
really, really surprised," she said. "We anticipated that guardians
would refuse, but we didn't expect that nearly 40% of eligible kids
didn't get vaccinated because the provider didn't recommend it."
To take a closer look at measles vaccinations among children who
were going to be traveling internationally, Hyle and her colleagues
turned to data from the Global TravEpiNet, a consortium of U.S.
travel medicine clinics supported by the Centers for Disease Control
and Prevention (CDC). Data for the new study came from 29 sites
across the country from 2009 through 2018.
The researchers focused on 2,864 children who were deemed to be
eligible for vaccination. That included children between 6 and 12
months old who had not yet been vaccinated (unless the risk of
exposure is high, children aren't usually vaccinated until they are
a year old) and older children who had not yet received two doses of
the MMR vaccine.
[to top of second column] |
Just 41.3% of eligible children received vaccinations during their
visits. Among those who did not, the reason for 36.9% of kids was
that it was not offered by the clinician, and for 36.4% because the
guardian refused it. Another 25.7% were referred to the child's
regular provider, and for 1% of cases, the vaccine was unavailable.
The most common reason clinicians didn't recommend vaccination is
that they concluded, incorrectly, the child was not eligible.
Guardians most commonly reported not being concerned about measles.
The U.S. experienced more than 1,000 measles cases in the first half
of 2019, the study team notes, the majority originating with
travelers returning home infected. And while children represent less
than 10% of international travelers from the U.S., they accounted
for 47% of measles importations.
The study illustrates "one more missed opportunity for measles
vaccination," said Dr. Albert Wu, an internist and professor of
health policy and management at the Johns Hopkins Bloomberg School
of Public Health in Baltimore, Maryland. "It's surprising and
disappointing that the clinicians involved failed to recommend
vaccination as often as they did. Clearly there is still a need for
better education and knowledge among both doctors and patients to
reduce the risk of serious travel-related illnesses like this."
SOURCE: https://bit.ly/2RzEKUj JAMA Pediatrics, online December 9,
2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content.
 |
