{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T02:52:36Z","timestamp":1771901556299,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U19CI000514"],"award-info":[{"award-number":["U19CI000514"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000490"],"award-info":[{"award-number":["U01CK000490"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000633"],"award-info":[{"award-number":["U01CK000633"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pediatric international travelers account for nearly half of measles importations in the United States. Over one third of pediatric international travelers depart the United States without the recommended measles-mumps-rubella (MMR) vaccinations: 2 doses for travelers \u226512 months and 1 dose for travelers 6 to &amp;lt;12 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a model to compare 2 strategies among a simulated cohort of international travelers (6 months to &amp;lt;6 years): (1) No pretravel health encounter (PHE): travelers depart with baseline MMR vaccination status; (2) PHE: MMR-eligible travelers are offered vaccination. All pediatric travelers experience a destination-specific risk of measles exposure (mean, 30 exposures\/million travelers). If exposed to measles, travelers\u2019 age and MMR vaccination status determine the risk of infection (range, 3%-90%). We included costs of medical care, contact tracing, and lost wages from the societal perspective. We varied inputs in sensitivity analyses. Model outcomes included projected measles cases, costs, and incremental cost-effectiveness ratios ($\/quality-adjusted life year [QALY], cost-effectiveness threshold \u2264$100 000\/QALY).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with no PHE, PHE would avert 57 measles cases at $9.2 million\/QALY among infant travelers and 7 measles cases at $15.0 million\/QALY among preschool-aged travelers. Clinical benefits of PHE would be greatest for infants but cost-effective only for travelers to destinations with higher risk for measles exposure (ie, \u2265160 exposures\/million travelers) or if more US-acquired cases resulted from an infected traveler, such as in communities with limited MMR coverage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Pretravel MMR vaccination provides the greatest clinical benefit for infant travelers and can be cost-effective before travel to destinations with high risk for measles exposure or from communities with low MMR vaccination coverage.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piac011","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T20:11:17Z","timestamp":1643746277000},"page":"257-266","source":"Crossref","is-referenced-by-count":2,"title":["The Clinical and Economic Impact of Measles-Mumps-Rubella Vaccinations to Prevent Measles Importations From US Pediatric Travelers Returning From Abroad"],"prefix":"10.1093","volume":"11","author":[{"given":"Audrey C","family":"Bangs","sequence":"first","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Gasta\u00f1aduy","sequence":"additional","affiliation":[{"name":"Division of Viral Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7915-4974","authenticated-orcid":false,"given":"Anne M","family":"Neilan","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of General Academic Pediatrics, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy Parker","family":"Fiebelkorn","sequence":"additional","affiliation":[{"name":"Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison Taylor","family":"Walker","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sowmya R","family":"Rao","sequence":"additional","affiliation":[{"name":"MGH Biostatistics Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Global Health, Boston University School of Public Health , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward T","family":"Ryan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts , USA"},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health , Boston, Massachusetts , USA"},{"name":"Travelers' Advice and Immunization Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina C","family":"LaRocque","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts , USA"},{"name":"Travelers' Advice and Immunization Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-379X","authenticated-orcid":false,"given":"Rochelle P","family":"Walensky","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8721-106X","authenticated-orcid":false,"given":"Emily P","family":"Hyle","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts , USA"},{"name":"Travelers' Advice and Immunization Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"2022062210153468700_CIT0001","article-title":"Measles (Rubeola)","volume-title":"CDC Yellow Book 2018 Health 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2016\u20132017.","volume":"66","author":"Marx","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022062210153468700_CIT0005","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1001\/jamapediatrics.2013.4342","article-title":"Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience.","volume":"168","author":"Papania","year":"2014","journal-title":"JAMA Pediatr"},{"key":"2022062210153468700_CIT0006","first-page":"40","article-title":"A comparison of post-elimination measles epidemiology in the United States, 2009\u22122014 versus 2001\u22122008.","volume":"6","author":"Fiebelkorn","year":"2017","journal-title":"J Pediatr Infect Dis Soc"},{"key":"2022062210153468700_CIT0007","first-page":"1","article-title":"Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP).","volume":"62","author":"McLean","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022062210153468700_CIT0008","first-page":"1","article-title":"Measles prevention","volume":"38","author":"Centers for Disease Control (CDC).","year":"1989","journal-title":"MMWR Suppl"},{"key":"2022062210153468700_CIT0009","doi-asserted-by":"crossref","first-page":"e194515","DOI":"10.1001\/jamapediatrics.2019.4515","article-title":"Clinical practices for measles-mumps-rubella vaccination among US pediatric international travelers.","volume":"174","author":"Hyle","year":"2019","journal-title":"JAMA Pediatr"},{"key":"2022062210153468700_CIT0010","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/jamapediatrics.2018.1024","article-title":"Public health consequences of a 2013 measles outbreak in New York City.","volume":"172","author":"Rosen","year":"2018","journal-title":"JAMA 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