A study led by Massachusetts General Hospital investigators found that many U.S adults travel abroad without first getting the full recommended course of measles vaccines. Researchers are now looking to find ways to increase the vaccination rate in order to protect travelers and the people they come in contact with back home.
The measles virus is a highly contagious disease that spreads through the air via coughing and sneezing. Even though a case of measles can be limited to fever, rash and cough, many cases can be severe and require hospitalization. The virus has been contained in the United States thanks to the introduction of the measles vaccination in the 1960s, but it remains a common disease in many parts of the world. Right now there are outbreaks in Germany, Italy and Romania.
“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,” says Emily Hyle, MD, MSc, of the MGH Division of Infectious Diseases, lead and corresponding author of the report in Annals of Internal Medicine. “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.”
The Advisory Committee on Immunization Practices recommends two documented doses of the measles, mumps, rubella (MMR) vaccine for adults traveling outside the U.S. who were born after 1956 and don’t have documented evidence of either two prior vaccinations, a previous measles infection or protective anti-measles antibodies in their blood.
Researchers gathered data from questionnaires filled out by 40,810 patients at 24 clinics nationwide that provide pre-travel health advice and vaccinations. Of the 6,612 respondents who were vaccine-eligible, approximately 1,730 refused a vaccination when offered one during the pre-travel clinical visit. The top reason for refusal was a lack of concern about measles; other reasons included concerns about vaccine safety and concerns about costs.
“Our results also suggest ways to improve the rate of MMR immunization among eligible travelers,” says 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.”
Hyle is as an infectious disease clinician investigator at Mass General exploring ways to improve outcomes for patients with HIV and to measure the effectiveness of medical interventions to prevent disease transmission during international travel. Read more about her work in a recent interview with the Research Institute.
Regina C. LaRocque, MD, MPH, of the MGH Division of Infectious Diseases, is senior author of the paper. Drs. Edward Ryan, MD, and Rochelle Walensky, MD, MPH, both of the MGH Division of Infectious Diseases, are co-authors.