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Measles Immunity in a Population of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Mary E. Willy
Affiliation:
Hospital Epidemiology Service, National Institutes of Health, Bethesda, Maryland
Deloris E. Koziol
Affiliation:
Hospital Epidemiology Service, National Institutes of Health, Bethesda, Maryland
Thomas Fleisher
Affiliation:
Immunology Service, National Institutes of Health, Bethesda, Maryland
Sylvia Koo
Affiliation:
Immunology Service, National Institutes of Health, Bethesda, Maryland
Henry McFarland
Affiliation:
Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland
James Schmitt
Affiliation:
Occupational Medical Service, National Institutes of Health, Bethesda, Maryland
Robert Wesley
Affiliation:
Information Systems Department, National Institutes of Health, Bethesda, Maryland
Eugene S. Hurwitz
Affiliation:
Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland Centers for Disease Control and Prevention, Atlanta, Georgia
David K. Henderson*
Affiliation:
Hospital Epidemiology Service, National Institutes of Health, Bethesda, Maryland Office of the Director of the Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland
*
Magnuson Clinical Center, National Institutes of Health, Building 10, Room 2C146, Bethesda, MD 20892

Abstract

Objectives:

To evaluate measles seroprev-among cohorts of new employees and to evaluate vaccine responses of susceptible adult healthcare workers.

Design:

New employees were screened for measles susceptibility as part of employee evaluations. Anti-IgG measles antibody tests were completed on 2,473 workers. Demographic, measles history, and measles vaccination information was collected using a short questionnaire. Susceptible workers were vaccinated and screened for vaccine responses following vaccination.

Results:

Ninety-three workers (4%) were seronegative, and 56 (2%) were equivocal. Individuals in the youngest cohort (born after 1956) were significantly more likely to be susceptible than those in the middle cohort (born 1951 to 1956) and those in the oldest cohort (born before 1951) (P<0.01). The middle cohort included eight (5%) of the 149 seronegative or equivocal workers. Among the members of the youngest cohort, those from the United States were more likely to be susceptible (P<0.01) than those from outside the United States.

Of the 106 vaccinated susceptible workers whose follow-up serologies were determined, 90 (85%) developed positive IgG serologies, six had equivocal results, and 10 were seronegative. Eleven of the 16 non- or hyporesponders were revaccinated and re-evaluated; nine developed low positive IgG antimeasles levels, one exhibited an equivocal response, and one failed to respond.

Conclusions:

A small but important proportion of healthcare workers are susceptible to measles. Whenever feasible, measles immunity programs for healthcare workers should include workers born before 1957. Of workers born after 1956, those from outside the United States are more likely to be immune than workers from inside the United States. Using the currently available vaccine, revaccination of initial non- or hyporesponders appears to be effective.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994 

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