[MCOH-EH] Measles IVIG for severely immunocompromised HCWs with presumptive immunity?

[Haq, Farah]

In the event of a measles exposure, do any of your institutions plan to offer IVIG to severely immunocompromised healthcare workers regardless of measles vaccine/immunity status?

Our hospital is considering offering IVIG and furloughing severely immunocompromised HCWs who are exposed to measles, even if they have documentation of presumptive immunity to measles, which virtually all our HCWs do

The rationale is the following MMWR CDC guidance for measles-exposed immunocompromised patients (but which could presumably include exposed immunocompromised HCWs as well):

Immunocompromised patients. Severely immunocompromised patients who are exposed to measles should receive IGIV prophylaxis regardless of immunologic or vaccination status because they might not be protected by the vaccine. Severely immunocompromised patients include patients with severe primary immunodeficiency; patients who have received a bone marrow transplant until at least 12 months after finishing all immunosuppressive treatment, or longer in patients who have developed graft-versus-host disease; patients on treatment for ALL within and until at least 6 months after completion of immunosuppressive chemotherapy; and patients with a diagnosis of AIDS or HIV-infected persons with severe immunosuppression defined as CD4 percent <15% (all ages) or CD4 count <200 lymphocytes/mm3 (aged >5 years) and those who have not received MMR vaccine since receiving effective ART. Some experts include HIV-infected persons who lack recent confirmation of immunologic status or measles immunity.

https://www.cdc.gov/infectioncontrol/pdf/guidelines/IC-Guidelines-HCP-H.pdf

I am interested to know if any other hospitals are considering this?

Thank you,



Farah Haq MD, MPH

Division Head, Occupational, Environmental and Clinical Preventive Medicine

Clinical Assistant Professor

Dept. of Family, Population and Preventive Medicine

Stony Brook Medicine


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