投稿分類 防護措施

主委發表種類: 口頭

投稿標題(中): 醫院中麻疹抗體檢測與疫苗接種之成本效益分析

投稿標題(英): Cost-benefit analysis of measles prevention strategies in a healthcare setting

投稿摘要: Background: In light of recent measles epidemic and hospital-associated clusters, strategies for measles prevention in healthcare settings have been strengthened. Evaluation of immunity against measles is suggested for all healthcare workers (HCWs) and any staff who are in contact with patients, and measles, mumps, and rubella (MMR) vaccination is advised for those without immunity. We aimed to evaluate the costs and benefits of strengthened strategies.
Methods: The immune and vaccination status of measles were retrospectively collected at a regional hospital. Since 2014, free-of-charge single-dose MMR vaccination has been provided to newly recruited HCWs born after 1981 and at-risk HCWs aged ≤40 years without pre-vaccination antibody testing. In October 2019, anti-measles IgG was included in the routine health screening for all employees. All measles seronegative HCWs and staff having contact with patients were advised to receive free-of-charge one dose of MMR vaccine.
Results: Of 155 employees, the overall measles seropositivity rate was 78.7% (122/155): 79.4% (27/34), 67.2% (41/61) and 90.0% (54/60) for those aged 20-29, 30-39 and ≥40 years, respectively. Among 33 employees tested negative for measles, 11 had previously received single-dose MMR booster vaccination, 16 had previously declined vaccination, 6 were not eligible for vaccination under the previous strategy. According to the strategy without pre-vaccination antibody testing, 74 employees were eligible for vaccination and the total cost of vaccination was New Taiwan Dollar (NTD) $ 62,234. With pre-vaccination antibody testing, 26 employees were eligible for vaccination and the cost of vaccination decreased to NTD $ 21,866. An additional expense of antibody screening for all HCWs and staff having contact with patients was NTD $ 39,624.
Conclusion: Implementation of measles prevention strategies including pre-vaccination antibody screening and subsequent vaccination helped lower the cost and vaccine demand.

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