24 December 2019
Measles, a disease that was declared eradicated in the United States in 2000, has made a huge comeback in 2019
Since the beginning of 2019, there has been a surge in the number of reported measles cases in the U.S. The CDC reports that from January 1 to November 7, 2019, 1,261 individual cases of measles were confirmed in 31 states (Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Virginia and Washington). This is the greatest number of cases reported in the U.S. since 1992, with the majority of cases in people who were not vaccinated against measles.
courtesy of the CDC
However, measles is almost entirely preventable with two doses of the MMR (measles-mumps-rubella) vaccine — a safe and highly effective vaccine.
Measles can cause serious complications, even death
From January 1 to November 7, 2019 in the U.S., 123 of the people who developed measles were hospitalized, and 61 reported having complications including pneumonia and encephalitis.
A measles outbreak can also lead to death. According to a Nov. 18th article in The New York Times, schools in the Pacific island nation of Samoa are closed indefinitely and children are barred from public gatherings amid a measles epidemic that has killed at least 16 people, many of them younger than age 2.
Who should get the MMR vaccine?
According to the CDC, the following children and adults should get the MMR vaccine to protect against measles, mumps and rubella.
The CDC recommends that all children get two doses of the MMR vaccine, starting with the first dose between 12-15 months of age, and the second dose between 4-6 years of age. They can receive the second dose earlier as long as it is at least 28 days after the first dose.
The MMR vaccine is given later than some other childhood vaccines because antibodies transferred from the mother to the baby can provide some protection from disease and therefore make the MMR vaccine less effective until about 1 year of age.
Students at post-high school educational institutions
Students at post-high school educational institutions who do not have presumptive evidence of immunity need two doses of the MMR vaccine, separated by at least 28 days.
Presumptive evidence of immunity can be established in any of the following ways:
- Written documentation of one or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children and non-high-risk adults
- Written documentation of two doses of measles-containing vaccine for school-age children and adults at high risk, including students at post-high school secondary educational institutions, healthcare personnel and international travelers
- Laboratory evidence of immunity
- Laboratory confirmation of disease
- Being born before 1957
Adults who do not have presumptive evidence of immunity should get at least one dose of the MMR vaccine, and if they are in a setting that poses a high risk for measles or mumps transmission, they need 2 doses separated by at least 28 days. These adults include:
- students at post-high school education institutions
- healthcare personnel
- international travelers
- people who public health authorities determine are at increased risk during an outbreak
People 6 months of age and older who will be traveling internationally should be protected against measles. These include:
- Infants 6-11 months of age should receive one dose of the MMR vaccine. Infants who get one dose of the MMR vaccine before their first birthday should get two more doses (one dose between 12-15 months of age and another dose separated by at least 28 days).
- Children 12 months of age and older should receive two doses of the MMR vaccine, separated by at least 28 days.
- Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of the MMR vaccine separated by at least 28 days.
Healthcare personnel should have documented presumptive evidence of immunity. Otherwise, they should get two doses of the MMR vaccine, separated by at least 28 days.
Women of childbearing age
Women of childbearing age should check with their doctor to make sure they are vaccinated before they get pregnant. Those who are not pregnant and do not have presumptive evidence of immunity should get at least one dose of the MMR vaccine.
NOTE: It is safe for breastfeeding women to receive the MMR vaccine. Breastfeeding does not interfere with the response to the vaccine, and the baby will not be affected by the vaccine through breast milk.
Who should NOT get the MMR vaccine?
You should not get the MMR vaccine or should wait until your healthcare provider gives consent if you:
- Have any severe, life-threatening allergies. A person who has ever had a life-threatening allergic reaction after a dose of the MMR vaccine, or has a severe allergy to any part of this vaccine, may be advised not to be vaccinated.
- Are pregnant, or think you might be pregnant. Pregnant women should wait to get the MMR vaccine until after they are no longer pregnant. In addition, women should avoid getting pregnant for at least 1 month after getting the MMR vaccine.
- Have a weakened immune system due to disease (such as cancer or HIV/AIDS) or medical treatments (such as radiation, immunotherapy, steroids or chemotherapy).
- Have a parent or sibling with a history of immune system problems.
- Have ever had a condition that makes you bruise or bleed easily.
- Have recently had a blood transfusion or received other blood products. You might be advised to postpone the MMR vaccination for 3 months or more.
- Have tuberculosis.
- Have gotten any other vaccines in the past 4 weeks. Live vaccines given too close together might not work as well.
- Are not feeling well. A mild illness, such as a cold, is usually not a reason to postpone a vaccination, but someone who is moderately or severely ill (with a sinus infection or the flu, for instance) should wait.
Are vaccinations safe? Yes.
Before being approved, all vaccines administered in the U.S. must be tested by the Food and Drug Administration (FDA). The FDA will not allow a vaccine to be given unless it has been proven to be safe and to actually work. This data is then reviewed again by the Centers for Disease Control and Prevention (CDC) and the American Academy of Family Physicians before a vaccine is officially permitted to be administered. The FDA also monitors where and how vaccines are made. Laboratories manufacturing vaccines must be licensed and are regularly inspected. Plus, each vaccine lot is safety-tested.
No link between measles vaccine and autism
There is a lot of misinformation regarding vaccinations that has caused some parents to choose not to vaccinate their children. Many of these parents arrive at this decision because they think there is a link between the measles vaccine and autism. Although this theory (known as the Wakefield study) has been disproven many times over, many parents still believe it. However, a recent study by the Center for Disease Control supports the research stating that vaccines do not cause autism. In addition, a recently-published study of more than 600,000 children who were tracked for more than 10 years found no association between the measles vaccine and autism.
Herd immunity helps everyone stay well
When someone has been vaccinated against a particular disease, he/she is then immune to that disease and cannot infect others. Therefore, the greater the number of people who are vaccinated, the fewer opportunities there are for a disease to spread, with the result that the community surrounding that person is less likely to get the disease. This is known as herd immunity.
When enough people in a community are vaccinated, everyone — including those who are too young or too sick to be immunized — receives some protection from the spread of diseases, even those who are unvaccinated. This is why it’s so important for as many people as possible to get vaccinated, every year.
Blogs we’ve written on this subject
- What You Need To Know About Measles
- Do Vaccinations Cause Autism? No, And Here’s Why
- Is There A Reason NOT To Vaccinate Your Child?
- White paper: Immunization: The Incredible Intervention That Continues to Save Millions of Lives
To learn more about the importance of immunizations:
- American Academy of Pediatrics: Immunization
- Centers for Disease Control and Prevention: Vaccines and Immunizations
- National Network for Immunization Information
- Department of Health & Human Services
You’ve got questions, we’ve got answers.
At any age, count on the pediatricians of Westchester Health and Northwell Physician Partners for vital information to help you raise happy, healthy kids. Whether you have teenagers, adolescents, toddlers or newborns, we’ve got years of experience helping parents take care of their children and we’re here to help you with yours. Please call us at (914) 228-0330.
Want to know more about the measles vaccine or vaccines in general? Come talk to us.
The subject of immunizing your child can be confusing and emotional, with different people having different (often opposite) views. At Westchester Health Pediatrics, we welcome the opportunity to explain why we feel so strongly about vaccinations. Please come in and talk with any of our pediatricians who will take all the time you need to answer your questions and address your concerns. Our #1 goal is to help you as a parent make the best possible decision for your child to keep him/her healthy. Whenever, wherever you need us, we’re here for you.
By Maria P. McKenna, MD, FAAP, Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners