Ismael R. Ortega-Sanchez1, Laura Zimmerman
1, Kelly Saldana
2, Sheree Smith
2, Beth Rowe-West
2, Richard Carney
2, and Susan Reef
3. (1) National Immunization Program, ESD, OD, Center for Disease Control, 1600 Corporate Square Boulevard, M/S E-61, Atlanta, GA, USA, (2) WOMEN&CHD HLTH, NC: Department of Health and Human Services, 1916 Mail Service Center, Raleigh, NC, USA, (3) Centers for Disease Control and Prevention, National Immunization Program, Rubella/Mumps Activity Chief, 1600 Clifton Road, NE, MS E-61, Atlanta, Georgia, USA
BACKGROUND:
From 1996 to 2000, North Carolina (NC) accounted for 24% of the 1221 reported rubella cases in the U.S. Despite vaccination efforts, repeated rubella outbreaks occurred in NC, primarily among foreign born Hispanics in workplace environments such as plants and factories. The high employee turnover rate in these environments creates difficulties in ensuring rubella immunity among employees.
OBJECTIVE:
To evaluate the economic impact of rubella screening and vaccination of Hispanic immigrants in the workplace.
METHOD:
We conducted a cost-effectiveness analysis based on rubella serologic results and workplace vaccination. A hypothetical population is defined based on rates of susceptible individuals, employee turnover and socio-demographic characteristics. Costs associated with screening and vaccinating are projected along with the costs of the disease. We considered a routine rubella vaccination of all new employees and incrementally compared this strategy with providing rubella vaccine to only those who are susceptible based on serologic analysis. We conducted sensitivity analysis and assessed the frequency and type of interventions. Results are measured in costs per case of rubella and associated congenital rubella syndrome (CRS) prevented.
RESULT:
Preliminary observations show that workplace screening and vaccination of immigrants will prevent a considerable number of rubella and potential CRS cases. Among individuals with high levels of susceptibility, vaccinating all workers would be cost saving. Screening and vaccinating only susceptible individuals may be cost-effective but would depend on the rates of employee turnover and the frequency of interventions.
CONCLUSION:
Workplace screening and vaccinating Hispanic immigrants has the potential to be cost-effective.
LEARNING OBJECTIVES:
After this presentation participants will understand important components of a cost-effective analysis in Rubella and be able to evaluate combine strategies for screening and vaccination to prevent outbreaks in susceptible groups.