Human Vaccines & Immunotherapeutics (May 2017)

Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia

  • Margaret S. Coleman,
  • Heather M. Burke,
  • Bethany L. Welstead,
  • Tarissa Mitchell,
  • Eboni M. Taylor,
  • Dmitry Shapovalov,
  • Brian A. Maskery,
  • Heesoo Joo,
  • Michelle Weinberg

DOI
https://doi.org/10.1080/21645515.2016.1271518
Journal volume & issue
Vol. 13, no. 5
pp. 1084 – 1090

Abstract

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Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.

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