Vaccine
Volume 36, Issue 20, 2018, Pages 2902-2909

Vaccine delivery to newly arrived refugees and estimated costs in selected U.S. clinics, 2015 (Article)

Pezzi C. , McCulloch A. , Joo H. , Cochran J. , Smock L. , Frerich E. , Mamo B. , Urban K. , Hughes S. , Payton C. , Scott K. , Maskery B. , Lee D.*
  • a Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, United States
  • b Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, United States
  • c Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, United States
  • d Massachusetts Department of Public Health, Division of Global Populations and Infectious Disease Prevention, Boston, MA, United States
  • e Massachusetts Department of Public Health, Division of Global Populations and Infectious Disease Prevention, Boston, MA, United States
  • f Minnesota Department of Health, Saint Paul, MN, United States
  • g Minnesota Department of Health, Saint Paul, MN, United States
  • h Minnesota Department of Health, Saint Paul, MN, United States
  • i New York State Department of Health, Albany, NY, United States
  • j Thomas Jefferson University, Philadelphia, PA, United States
  • k Thomas Jefferson University, Philadelphia, PA, United States
  • l Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, United States
  • m Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA, United States

Abstract

Background: Newly arrived refugees are offered vaccinations during domestic medical examinations. Vaccination practices and costs for refugees have not been described with recent implementation of the overseas Vaccination Program for U.S.-bound Refugees (VPR). We describe refugee vaccination during the domestic medical examination and the estimated vaccination costs from the US government perspective in selected U.S. clinics. Methods: Site-specific vaccination processes and costs were collected from 16 clinics by refugee health partners in three states and one private academic institution. Vaccination costs were estimated from the U.S. Vaccines for Children Program and Medicaid reimbursement rates during fiscal year 2015. Results: All clinics reviewed overseas vaccination records before vaccinating, but all records were not transferred into state immunization systems. Average vaccination costs per refugee varied from $120 to $211 by site. The total average cost of domestic vaccination was 15% less among refugees arriving from VPR- vs. nonVPR-participating countries during a single domestic visit. Conclusion: Our findings indicate that immunization practices and costs vary between clinics, and that clinics adapted their vaccination practices to accommodate VPR doses, yielding potential cost savings. © 2018

Author Keywords

Cost-benefit Vaccine preventable diseases Refugee health Refugee immunizations Vaccine costs

Index Keywords

medical record review Vaccines clinical protocol refugee Cost benefit analysis economics medical examination human Refugees priority journal sensitivity analysis clinical practice United States health care cost Health Care Costs Humans Article health care organization adult medicaid health care facility vaccination public policy immunization clinical decision making health care delivery vaccine
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85040976632&doi=10.1016%2fj.vaccine.2017.12.023&partnerID=40&md5=9233505ba1e86d6bfa176c567663b5f5
DOI: 10.1016/j.vaccine.2017.12.023
ISSN: 0264410X
Original Language: English