{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:42:34Z","timestamp":1760236954266,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003056","name":"Ente Cassa di Risparmio di Firenze","doi-asserted-by":"publisher","award":["24151"],"award-info":[{"award-number":["24151"]}],"id":[{"id":"10.13039\/501100003056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The appropriate immunization of internationally adopted children (IAC) is currently under debate and different approaches have been suggested. The aim of this study is to evaluate the clinical and economic impact of different strategies of measles, mumps, rubella, and varicella (MMRV) immunization in IAC in Italy. A decision analysis model was developed to compare three strategies: presumptive immunization, pre-vaccination serotesting and vaccination based on documentation of previous immunization. Main outcomes were the cost of strategy, number of protected IAC, and cost per child protected against MMRV. Moreover, the incremental cost-effectiveness ratio (ICER) was calculated. The strategy currently recommended in Italy (immunize based on documentation) is less expensive. On the other hand, the pre-vaccination serotesting strategy against MMRV together, improves outcomes with a minimum cost increase, compared with the presumptive immunization strategy and compared with the comparator strategy. From a cost-effectiveness point of view, vaccination based on serotesting results in being the most advantageous strategy compared to presumptive vaccination. By applying a chemiluminescent immunoassay test, the serology strategy resulted to be clinically and economically advantageous. Similar results were obtained excluding children aged &lt;1 year for both serology methods. In conclusion, based on our analyses, considering MMRV vaccine, serotesting strategy appears to be the preferred option in IAC.<\/jats:p>","DOI":"10.3390\/vaccines8010060","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T11:28:31Z","timestamp":1580729311000},"page":"60","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of the Clinical and Economic Impact of Different Immunization Protocols of Measles, Mumps, Rubella and Varicella in Internationally Adopted Children"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-7549","authenticated-orcid":false,"given":"Sara","family":"Boccalini","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6013-8779","authenticated-orcid":false,"given":"Angela","family":"Bechini","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia Maria","family":"Alimenti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2875-3744","authenticated-orcid":false,"given":"Paolo","family":"Bonanni","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-3366","authenticated-orcid":false,"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"},{"name":"Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Chiappini","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy"},{"name":"Meyer Children\u2019s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MD.0000000000006300","article-title":"Infectious diseases prevalence, vaccination coverage, and diagnostic challenges in a population of internationally adopted children referred to a Tertiary Care Children\u2019s Hospital from 2009 to 2015","volume":"96","author":"Sollai","year":"2017","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1111\/apa.14237","article-title":"Italian multicentre study found infectious and vaccine-preventable diseases in children adopted from Africa and recommends prompt medical screening","volume":"107","author":"Chiappini","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1086\/605430","article-title":"Immunization Programs for Infants, Children, Adolescents, and Adults: Clinical Practice Guidelines by the Infectious Diseases Society of America","volume":"49","author":"Pickering","year":"2009","journal-title":"CID"},{"key":"ref_4","unstructured":"Centers for Disease Control and Prevention (2019, September 08). 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