Impact of Nonmedical Vaccine Exemption Policies on the Health and Economic Burden of Measles (original) (raw)
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Under Ontario legislation, for select vaccine-preventable diseases nonimmunized or under-immunized students must undergo vaccination or provide a statement of exemption, or risk suspension from school. At the time of this assessment, these diseases included measles, mumps, rubella, diphtheria, tetanus and polio. Exemptions data for the school years 2002/03 to 2012/13 were obtained from the Immunization Records Information System used in Ontario. Temporal trends were expressed for 7- and 17-year-old students by exemption classification (medical, prior immunity, religious or conscientious belief, total) at the provincial level, by school year and by birth cohort. Regional analysis was conducted for the 2012/13 school year. A temporal trend analysis of exemptions for measles-containing vaccines was performed by using a Poisson distribution with a 2-sided test (α = 5%). For both 7- and 17-year-old students, religious or conscientious exemptions for measles-containing vaccines significan...
The cost of measles in industrialised countries
Vaccine, 2003
The aim of this study is to estimate the costs of measles and measles control in 11 industrialised countries with varying levels of measles vaccine coverage. Country-specific annual incidence of measles, measles immunization policy, coverage and costs data were collected. The average societal costs of measles cases and immunisation programme per capita were calculated. These 11 countries spend together over US$ 151 million every year to treat and control measles. Per capita costs of measles control tend to be higher in countries with poorer measles control programmes (for instance, Italy has the highest incidence and highest overall costs), though many other factors, such as the number of antigens given per clinic visit and the local price of MMR also affect the efficiency of the programme. The costs estimates presented here can be used to estimate potential savings that might accrue from changes to measles control programmes.
BMC Public …, 2002
Background: Even though the annual incidence rate of measles has dramatically decreased in industrialised countries since the implementation of universal immunisation programmes, cases continue to occur in countries where endemic measles transmission has been interrupted and in countries where adequate levels of immunisation coverage have not been maintained. The objective of this study is to develop a model to estimate the average cost per measles case and per adverse event following measles immunisation using the Netherlands (NL), the United Kingdom (UK) and Canada as examples.
Journal of Shifa Tameer-e-Millat University, 2021
Introduction: Measles is a highly contagious viral infection, vaccine-preventable diseases claim the lives of nearly 30 million people each year around the world, including 17% of children under the age of 5. Methodology: This was a descriptive and cross-sectional investigation. Retrospective data collection was used. We looked at medical centers that provided EPI administrations. Results: Around 8% of the youngsters in the study were found to have measles, according to the health center's records. There are an undetermined number of measles-infected children. Only 12% of those surveyed had received the measles vaccine, and the vast majority (88%) had never received the shot. According to statistical analysis, the study's r square value is r=0.35, which is considered to be an intermediate direct relationship (Wastage of vaccine and total cost). It illustrates that if there is no system of checks and balances on vaccine waste, it could have an impact on the overall cost of th...
Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting
Vaccines, 2019
Despite efforts to improve surveillance and vaccination coverage, measles virus (MeV) continues to cause outbreaks also in high-income countries. As the reference laboratory of the Veneto Region, Italy, we analyzed changes in population immunity, described measles outbreaks, investigated MeV genetic diversity, and evaluated cross-protection of measles vaccination against MeV epidemic strains. Like most European areas, the Veneto Region has suboptimal measles vaccination coverage and is facing a growing public mistrust of vaccination. A progressive decline of measles vaccine uptake was observed during the last decade in the Veneto Region, leading to immunity gaps in children and young adults. Measles outbreaks were caused by the same MeV genotype B3, D4, and D8 strains that were circulating in other European countries. Eleven cases of measles were observed in immunized subjects. These cases were not associated with particular MeV genotypes nor with mutations in epitopes recognized by...
Measles lessons in an anti-vaccination era: public health is a social duty, not a political option
Italian Journal of Pediatrics
Background: Measles virus, member of the genus Morbillivirus in the family Paramyxoviridae, is a highly contagious human pathogen. An effective live-attenuated vaccine is available and its use has the potential to eradicate the disease from the human population. Although the vaccine was introduced in national vaccination schedules, several measles outbreaks have occurred because of insufficient vaccination coverage. Since early January 2017, a new outbreak of measles in Italy has been observed. Methods: We analyzed all the patients admitted to the Emergency Department of Bambino Gesù Children Hospital of Rome from the 1st of January 2017 to the end of May 2017 and discharged with diagnosis of suspected or confirmed measles or admitted to the Pediatric and Infectious Disease Unit. For each confirmed case, demographic data, vaccination history, exposure to source case, clinical presentation, date of onset of symptoms, hospitalization, laboratory test results, complications and therapy were collected. Results: From the 1st of January 2017 to the 31st of May 2017, we enrolled 139 patients who were conducted to the Emergency Department of Bambino Gesù Children's Hospital because of measles: 33 patients were discharged with the diagnosis of suspected measles by clinical manifestations; 33 discharged with the diagnosis of confirmed measles by laboratory tests and 73 were admitted to the Pediatric and Infectious Disease Unit. Seven patients, who were exposed to mothers with measles, were admitted to receive treatment with Measles Immune Globulin intravenously. Among the 66 patients admitted to the hospital with measles, 31 cases (47%) occurred in unvaccinated individuals who were age-eligible for measles vaccination; 29 (44%) were infants too young to be vaccinated; only five patients (8%) received one dose of measles-containing vaccine. Out of the 66 patients, 35 (53%) developed complications. Acute respiratory failure was the most reported complications (20%). Death, due to multiorgan failure by measles, occurred in one 9-girl-year-age patient with genetic disorders who was unvaccinated. Conclusions: Measles still represents a serious public health problem worldwide. Vaccination against measles is safe, effective, and cost-effective. High vaccination coverage (>95%) with two doses of measles vaccine is crucial to elimination. Health care professionals play an important role in vaccination uptake and prevention of measles spread during an outbreak.
The Journal of Infectious Diseases, 2004
To evaluate the economic impact of the current 2-dose measles-mumps-rubella (MMR) vaccination program in the United States, a decision tree-based analysis was conducted with population-based vaccination coverage and disease incidence data. All costs were estimated for a hypothetical US birth cohort of 3,803,295 infants born in 2001. The 2-dose MMR vaccination program was cost-saving from both the direct cost and societal perspectives compared with the absence of MMR vaccination, with net savings (net present value) from the direct cost and societal perspectives of 3.5billionand3.5 billion and 3.5billionand7.6 billion, respectively. The direct and societal benefitcost ratios for the MMR vaccination program were 14.2 and 26.0. Analysis of the incremental benefit-cost of the second dose showed that direct and societal benefit-cost ratios were 0.31 and 0.49, respectively. Varying the proportion of vaccines purchased and administered in the public versus the private sector had little effect on the results. From both perspectives under even the most conservative assumptions, the national 2-dose MMR vaccination program is highly cost-beneficial and results in substantial cost savings. Endemic measles has been eliminated from the United States [1], and rubella and mumps are reported at record low incidences. These significant public health achievements have been realized through a 2-dose measles-mumps-rubella (MMR) vaccination program. Two previous measles elimination programs in the United States, started in 1966 and 1978, relied on a 1-dose vaccination strategy and did not achieve elimination of endemic measles, although they did reduce the incidence of measles substantially. The successful elimination of endemic measles with the 2-dose MMR strategy prompted us to perform an economic analysis of the 2-dose MMR vaccination program. In the prevaccine era, ∼4 million persons-the size of 1 birth cohort-were infected with measles each year. These cases were associated with a reported 500 deaths, 48,000 hospitalizations, and 4000 cases of encephalitis