Screening hospital employees for measles immunity is more cost effective than blind immunization.

Abstract

To examine alternative strategies in developing a cost-effective program to assure measles immunity among hospital employees. Observational. Referral teaching hospital. Eighteen hundred "established" hospital employees with potential patient contact and 630 newly hired hospital employees. Established employees born after 1 January 1957 and all newly hired employees were screened for serologic evidence of measles immunity and immunized if necessary. Cost analysis. The cost of screening and directed immunization of established employees was $3.98 per employee compared with a potential cost of $10.03 to $42.80 per employee if all employees were "blindly" immunized with monovalent measles vaccine or trivalent mumps-measles-rubella vaccine. The cost of the screening and directed immunization of new employees was $2.42 per employee compared with potential costs of $8.30 to $39.34 per employee for blind immunization. These analyses assumed that varying percentages of employees would be able to produce documentation of having received a previous dose of vaccine or of having had measles. In a large referral hospital, screening for measles immunity followed by directed immunization was considerably less expensive than immunizing all potentially susceptible employees.