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      Risk of Absence of Measles Antibody in Healthcare Personnel and Efficacy of Booster Vaccination

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          Abstract

          We aimed to identify the presence of the measles IgG antibody (mIgG-Ab) in healthcare personnel and finding out who needs the measles vaccination. The history of measles vaccination was obtained from the national vaccine registry. A baseline mIgG-Ab test was performed, and the measles vaccine was administered to participants who tested negative or equivocal for mIgG-Abs. During the study, 2885 (87.3%) of the 3303 employees were tested for measles serostatus. The baseline seropositivity rate for mIgG-Abs was 91.9%. Among the 234 seronegative cases, 82.9% were born after 1985. The seroprevalence rate was lower in those who received the measles–mumps–rubella (MMR) vaccine >10 years before the testing time, especially if they were born after 1985 and if there was only one previous record of vaccination. Among the 234 seronegative cases, MMR vaccination was administered in 174 cases, of which serostatus was evaluated in 146 cases. After the first dose, positive seroconversion was achieved in 126 participants (86.3%). After a second dose, 15 achieved (75.0%) positive seroconversion. In healthcare personnel born after the period when measles incidence significantly decreased, it may be necessary to reassess their immune status for measles if more than 10 years have elapsed since the last vaccination.

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          The basic reproduction number (R 0 ) of measles: a systematic review

          The basic reproduction number, R nought (R0), is defined as the average number of secondary cases of an infectious disease arising from a typical case in a totally susceptible population, and can be estimated in populations if pre-existing immunity can be accounted for in the calculation. R0 determines the herd immunity threshold and therefore the immunisation coverage required to achieve elimination of an infectious disease. As R0 increases, higher immunisation coverage is required to achieve herd immunity. In July, 2010, a panel of experts convened by WHO concluded that measles can and should be eradicated. Despite the existence of an effective vaccine, regions have had varying success in measles control, in part because measles is one of the most contagious infections. For measles, R0 is often cited to be 12-18, which means that each person with measles would, on average, infect 12-18 other people in a totally susceptible population. We did a systematic review to find studies reporting rigorous estimates and determinants of measles R0. Studies were included if they were a primary source of R0, addressed pre-existing immunity, and accounted for pre-existing immunity in their calculation of R0. A search of key databases was done in January, 2015, and repeated in November, 2016, and yielded 10 883 unique citations. After screening for relevancy and quality, 18 studies met inclusion criteria, providing 58 R0 estimates. We calculated median measles R0 values stratified by key covariates. We found that R0 estimates vary more than the often cited range of 12-18. Our results highlight the importance of countries calculating R0 using locally derived data or, if this is not possible, using parameter estimates from similar settings. Additional data and agreed review methods are needed to strengthen the evidence base for measles elimination modelling.
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            Measles

            Measles is a highly contagious disease that results from infection with measles virus and is still responsible for more than 100 000 deaths every year, down from more than 2 million deaths annually before the introduction and widespread use of measles vaccine. Measles virus is transmitted by the respiratory route and illness begins with fever, cough, coryza, and conjunctivitis followed by a characteristic rash. Complications of measles affect most organ systems, with pneumonia accounting for most measles-associated morbidity and mortality. The management of patients with measles includes provision of vitamin A. Measles is best prevented through vaccination, and the major reductions in measles incidence and mortality have renewed interest in regional elimination and global eradication. However, urgent efforts are needed to increase stagnating global coverage with two doses of measles vaccine through advocacy, education, and the strengthening of routine immunisation systems. Use of combined measles-rubella vaccines provides an opportunity to eliminate rubella and congenital rubella syndrome. Ongoing research efforts, including the development of point-of-care diagnostics and microneedle patches, will facilitate progress towards measles elimination and eradication.
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              Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP).

              , (2011)
              This report updates the previously published summary of recommendations for vaccinating health-care personnel (HCP) in the United States (CDC. Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices [ACIP] and the Hospital Infection Control Practices Advisory Committee [HICPAC]. MMWR 1997;46[No. RR-18]). This report was reviewed by and includes input from the Healthcare (formerly Hospital) Infection Control Practices Advisory Committee. These updated recommendations can assist hospital administrators, infection-control practitioners, employee health clinicians, and HCP in optimizing infection prevention and control programs. The recommendations for vaccinating HCP are presented by disease in two categories: 1) those diseases for which vaccination or documentation of immunity is recommended because of risks to HCP in their work settings for acquiring disease or transmitting to patients and 2) those for which vaccination might be indicated in certain circumstances. Background information for each vaccine-preventable disease and specific recommendations for use of each vaccine are presented. Certain infection-control measures that relate to vaccination also are included in this report. In addition, ACIP recommendations for the remaining vaccines that are recommended for certain or all adults are summarized, as are considerations for catch-up and travel vaccinations and for work restrictions. This report summarizes all current ACIP recommendations for vaccination of HCP and does not contain any new recommendations or policies. The recommendations provided in this report apply, but are not limited, to HCP in acute-care hospitals; long-term-care facilities (e.g., nursing homes and skilled nursing facilities); physician's offices; rehabilitation centers; urgent care centers, and outpatient clinics as well as to persons who provide home health care and emergency medical services.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Vaccines (Basel)
                Vaccines (Basel)
                vaccines
                Vaccines
                MDPI
                2076-393X
                12 May 2021
                May 2021
                : 9
                : 5
                : 501
                Affiliations
                [1 ]Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Korea; jki342@ 123456gmail.com
                [2 ]Ewha Education and Research Center for Infection, Seoul 07985, Korea; jiyunbae@ 123456gmail.com (J.-Y.B.); sunny0521.chung@ 123456ewha.ac.kr (H.-S.C.); miae@ 123456ewha.ac.kr (M.L.); heechoi@ 123456ewha.ac.kr (H.-J.C.)
                [3 ]Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
                [4 ]Department of Laboratory Medicine, Ewha Womans University Seoul Hospital, Seoul 07804, Korea
                [5 ]Office of Infection Control, Ewha Womans University Seoul Hospital, Seoul 07804, Korea; 41808s@ 123456eumc.ac.kr (A.K.); 41121s@ 123456eumc.ac.kr (J.K.)
                [6 ]Office of Infection Control, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea; 40757@ 123456eumc.ac.kr
                [7 ]Department of Laboratory Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
                Author notes
                [* ]Correspondence: cj.kim.id@ 123456gmail.com ; Tel.: +82-2-6986-1643
                Author information
                https://orcid.org/0000-0002-7475-4564
                https://orcid.org/0000-0002-6019-1238
                https://orcid.org/0000-0001-6382-4099
                Article
                vaccines-09-00501
                10.3390/vaccines9050501
                8151488
                34066145
                e06b85f0-9d65-4e31-bb5a-421034c6860c
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 08 April 2021
                : 08 May 2021
                Categories
                Article

                measles,health personnel,vaccination
                measles, health personnel, vaccination

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