1. Over half of patients eligible for the MMR were not vaccinated at their pre-travel consultation.
2. The majority of MMR-eligible travelers who were not vaccinated were evaluated in the South of the U.S. or at nonacademic centers.
Evidence Rating Level: 2 (Good)
Study Rundown: Although measles has been eliminated in many parts of the Western world, such as the United States and Canada, measles remains a significant infectious disease in many countries and measles outbreaks have occurred in the United States due to imported cases. Considering these outbreaks, and increased risk for measles outside the United States, it is highly recommended that travelers have received two documented doses of the measles, mumps, rubella (MMR) vaccine. In this study, the authors aimed to describe how providers assessed the measles immunity status of departing U.S. adult travelers seeking pre-travel consultation. Additionally, they aimed to evaluate reasons given for non-vaccination among those eligible to receive the MMR vaccine. Generally, the results of the study suggest that over half of eligible U.S. travelers skip their pre-trip measles vaccine. This study has several limitations. Mainly, the clinical practice at GTEN sites may not be representative of all pre-travel health consultations or patient populations. Overall, the results from this study highlight the importance of patient education regarding pre-trip measles vaccination in order to increase immunity among U.S. international travelers.
In-Depth [prospective cohort]: The authors conducted a retrospective, observational study based in U.S. pre-travel clinics (Global TravEpiNet [GTEN]). The study included adults attending pre-travel consultations at GTEN sites from 2009 to 2014. To assess MMR vaccination and reasons for non-vaccination, study participants were provided with a structured questionnaire to capture relevant study end points. In general, 6612 (16%) of the 40 810 adult travelers included in the study were considered eligible for MMR vaccination at the time of their pre-travel consultation. However, only 47% of those patients were vaccinated at their visit. Of the 53% of patients not vaccinated, 1689 (48%) were not vaccinated due to traveler refusal, 966 (28%) due to provider decision, and 822 (24%) due to health systems barriers.
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