{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:42:28Z","timestamp":1777858948266,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Crossover Health"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501327211005902","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T03:33:40Z","timestamp":1617420820000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inadequate Measles, Mumps, Rubella, and Varicella Immunity Among Employees"],"prefix":"10.1177","volume":"12","author":[{"given":"Stephen","family":"Ezeji-Okoye","sequence":"first","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittney L.","family":"Bilodeau","sequence":"additional","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya K.","family":"Madhusudhan","sequence":"additional","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen","family":"Pruett","sequence":"additional","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujith","family":"Thokala","sequence":"additional","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-8279","authenticated-orcid":false,"given":"Dena M.","family":"Bravata","sequence":"additional","affiliation":[{"name":"Crossover Health, San Clemente, CA, USA"},{"name":"Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"bibr1-21501327211005902","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(52)91357-3"},{"key":"bibr2-21501327211005902","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6945a6"},{"key":"bibr3-21501327211005902","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa070"},{"key":"bibr4-21501327211005902","unstructured":"Centers for Disease Control and Prevention. Monitoring the Impact of Varicella Vaccination. Accessed November 11, 2020. https:\/\/www.cdc.gov\/chickenpox\/surveillance\/monitoring-varicella.html."},{"key":"bibr5-21501327211005902","unstructured":"Gastanaduy P, Haber P, Rota PA, Patel M. Epidemiology and prevention of vaccine-preventable diseases: measles. December 2020. Report of the centers of disease control and prevention. Accessed March 1, 2021. https:\/\/www.cdc.gov\/vaccines\/pubs\/pinkbook\/meas.html#secular."},{"key":"bibr6-21501327211005902","doi-asserted-by":"publisher","DOI":"10.1086\/377713"},{"key":"bibr7-21501327211005902","unstructured":"Lopez A, Harrington T, Marin M. Epidemiology and prevention of vaccine-preventable diseases: varicella. December 2020. Report of the centers of disease control and prevention. Accessed March 1, 2021. https:\/\/www.cdc.gov\/vaccines\/pubs\/pinkbook\/meas.html#secular."},{"key":"bibr8-21501327211005902","unstructured":"Measles, Mumps, and Rubella (MMR) Vaccinations: what everyone should know. Accessed December 5, 2020. https:\/\/www.cdc.gov\/vaccines\/vpd\/mmr\/public\/index.html."},{"key":"bibr9-21501327211005902","unstructured":"Centers for Disease Control and Prevention. Adult vaccine price list. Accessed December 12, 2020. https:\/\/www.cdc.gov\/vaccines\/programs\/vfc\/awardees\/vaccine-management\/price-list\/index.html#adult."},{"key":"bibr10-21501327211005902","unstructured":"Budiman A, Tamir C, Mora L, Noe-Bustamante L. Facts on U.S. immigrants, 2018. Statistical portrait of the foreign-born population of the United States. Pew Research Center Report. August 20, 2020. Accessed December 10, 2020. https:\/\/www.pewresearch.org\/hispanic\/2020\/08\/20\/facts-on-u-s-immigrants-current-data\/."},{"key":"bibr11-21501327211005902","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.24984"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501327211005902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501327211005902","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501327211005902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:22:37Z","timestamp":1777508557000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501327211005902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":11,"alternative-id":["10.1177\/21501327211005902"],"URL":"https:\/\/doi.org\/10.1177\/21501327211005902","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"21501327211005902"}}