Many missed MMR vaccinations


According to a recent study by Massachusetts General Hospital (MGH) investigators, 53 per cent of individuals seeking pre-travel consultations at clinics across the country who were eligible to receive the measles, mumps, rubella (MMR) vaccine were not vaccinated during the clinic visit.

“Measles has been eliminated in the US 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 US resident returning from international travel,” commented Dr Emily Hyle of the MGH Division of Infectious Diseases, who is lead and corresponding author of the report in Annals of Internal Medicine. “Since more than 60 per cent of the measles importations into the country are due to returning US travellers, increasing the number of travellers who are immune to measles will reduce the number of measles cases.”

The study analysed data from 24 Global TravEpiNet clinics that provide pre-travel health advice and vaccinations said MGH. These consultations use online questionnaires through which travellers indicate information on their current health, medical history and destination, and providers indicate the advice and services that were provided, including vaccinations.

Findings were that among more than 40,800 patients born after 1956 and seen for pre-travel consultations at Global TravEpiNet clinics from 2009 through 2014, 84 per cent were found to be immune to measles, primarily because of a history of two MMR vaccinations.

Of the 6,612 remaining vaccine-eligible individuals, 3,477 (53 per cent) were not vaccinated during the clinic visit. In 48 per cent of those instances, the traveller refused vaccination. In 28 per cent of consultations, providers decided not to suggest MMR vaccination; and in 24 per cent, they referred the traveller to another provider for vaccination.

Those travellers who refused the MMR vaccine indicated a lack of concern about measles 74 per cent of the time, concerns about vaccine safety 20 per cent of the time, and concerns about costs six per cent of the time, found the MGH investigators.

“It was surprising to see such a high number of missed opportunities for MMR vaccination, even at these specialised pre-travel consultations, but our results also suggest ways to improve the rate of MMR immunisation among eligible travellers,” said Dr Hyle. “We can definitely improve how often providers specialising in pre-travel medical advice offer MMR vaccine to eligible travellers and encourage clear discussions with patients about the risks of contracting measles and of spreading the disease after their return to the US.”