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Hum Vaccin Immunother. 2017 Jan 9:0. doi: 10.1080/21645515.2016.1271518. [Epub ahead of print]
Cost Analysis of Measles in Refugees Arriving at Los Angeles International Airport from Malaysia.
Coleman MS1 Burke HM1 Welstead BL1 Mitchell T1 Taylor EM12 Shapovalov D3 Maskery BA1 Joo H1 Weinberg M1.
Abstract
Background On August 24 2011 31 U.S.-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 nine 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 U.S.-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 $35115. The total of domestic and IOM Malaysia reported costs for U.S.-bound refugees were $137505 [range: $134531 - $142777 from a sensitivity analysis]. Had all U.S.-bound refugees been vaccinated while in Malaysia it would have cost approximately $19646 and could have prevented 8 measles cases.
Conclusion A vaccination program for U.S.-bound refugees supporting a complete vaccination for U.S.-bound refugees could improve refugees health reduce importations of vaccine-preventable diseases in the United States and avert measles response activities and costs.