Cost-effectiveness analysis of MMR immunization in health care workers

摘要

Background: Assessment of measles, mumps and rubella (MMR) status is an essential part of occupational health clearance for new health care workers (HCWs). At the time of this study the policy at Sheffield Occupational Health Service (SOHS) was to perform serological testing of HCWs without evidence of previous immunization prior to MMR vaccination. Aims: To identify the cost implications of changing policy to offer vaccination without prior serological testing to HCWs without evidence of previous immunization. Methods: A retrospective cohort analysis of all MMR serological results from individuals attending SOHS for pre-placement assessment between 1 April 2010 and 31 March 2012. Results Seven thousand five hundred and sixty-nine individuals attended SOHS for pre-placement screening. Of these, 52 (3921) had no evidence of prior vaccination to at least one MMR disease and underwent serological testing. Thirty-three per cent (1204) of these HCWs were sero-negative to at least one condition requiring vaccination. With the suggested change in policy, our data indicate a cost-saving of over ￡105 000 per year may currently be achieved at SOHS. Conclusions: Our findings highlight significant savings through offering vaccination without prior serology for HCWs with no evidence of prior immunization to MMR. An awareness of costs associated with serology, vaccination and staffclinics, as well as the wider impact of population vaccination campaigns, are important factors determining the most cost-effective strategy in this area.