COST-EFFECTIVENESS OF PREVACCINATION SCREENING OF HEALTH-CARE WORKERS FOR IMMUNITY TO MEASLES, RUBELLA AND MUMPS
COST-EFFECTIVENESS OF PREVACCINATION SCREENING OF HEALTH-CARE WORKERS FOR IMMUNITY TO MEASLES, RUBELLA AND MUMPS
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DOI：
10.5694/j.1326-5377.1994.tb138311.x
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发表时间：
1994-04-18
影响因子：
11.4
通讯作者：
WHYBIN, LR
中科院分区：
文献类型：
--
作者：
FERSON, MJ;ROBERTSON, PW;WHYBIN, LR
目的：确定感染和疫苗接种史作为麻疹、风疹和腮腺炎免疫力预测因子的价值，并比较各种筛查策略的成本与卫生保健工作者普遍接种疫苗的成本。麻疹病史，将风疹和腮腺炎感染或疫苗接种与血清学检测结果进行比较，以确定哪些历史陈述具有高阳性预测值（PPV）免疫。利用这一点，我们设计了三种疫苗接种前筛查策略，并比较其成本与普及工作人员vaccination.Results的成本：235名参与者中，98.3%的血清免疫麻疹，96.6%的风疹和83.0%的腮腺炎。表明PPV大于95%的免疫力的历史陈述是麻疹或风疹疫苗接种史以及腮腺炎感染的个人回忆。策略使用历史筛选比普及疫苗接种，这反过来又比使用血清学screenings.Conclusions便宜：在职业麻疹，风疹和腮腺炎的卫生保健工作者，需要接种疫苗，可以减少结合历史和血清学筛查。如果筛查被认为是一种行政负担，那么普遍的疫苗接种策略比使用历史筛查的策略多花费30%-50%。
Objectives: To determine the value of infection and vaccination histories as predictors of immunity to measles, rubella and mumps, and to compare the costs of various screening strategies with the cost of universal vaccination of health care workers.Setting: Staff employed by a Sydney children's hospital.Methods: Histories of measles, rubella and mumps infection or vaccination were compared with the results of serological testing to determine which historical statements had high positive predictive Values (PPV) for immunity. Using this, we devised three prevaccination screening strategies and compared their costs with the cost of universal staff vaccination.Results: Of 235 participants, 98.3% were serologically immune to measles, 96.6% to rubella and 83.0% to mumps. Historical statements indicating immunity with a PPV of more than 95% were histories of measles or of rubella vaccination, and personal recollection of mumps infection. Strategies using historical screening were cheaper than universal vaccination, which in turn was cheaper than using serological screening alone.Conclusions: Among health care workers at occupational measles, rubella and mumps, need for vaccination can be reduced by combining historical and serological screening. Where screening is felt to impose an administrative burden, a universal vaccination strategy costs 30%-50% more than strategies which use historical screening.