Prevaccination serologic screening for measles in health care workers.

A model was developed from which the cost-effectiveness of prevaccination serologic screening for measles could be estimated, for any combination of antibody screening costs and prevalence of antibody to measles. This model was tested using sera obtained prospectively from 222 health care workers, including 181 born in or after 1957 who had no history of measles, no measles vaccine after 1980, and no documentation of immunity to measles. In addition, 41 subjects born before 1957 who had no history of measles were studied. A rapid, reliable, and inexpensive ($5 per test) commercial ELISA was used to test for antibodies to measles; its seroprevalence in the subject population was 86%. From the model, it was estimated that prevaccination serologic testing would be cost-effective if antibody screening cost less than or equal to $12.75 per test. In this subject population, prevaccination serologic screening for measles was cost-effective.