Although vaccination discussions are typically most focused around children due to the dramatic lifelong benefits of childhood immunization, I have had many recent inquiries from adults about Measles vaccination due to the recent outbreaks. Below is some information that should be most helpful for my adult patients based on these inquiries. The majority of this information is directly from the Centers for Disease Control (CDC) as they have the experts dedicated to continually researching and updating the information. If you want further detail you can access much more at CDC.gov.
Up to 90% of unvaccinated individuals exposed to measles will get it compared to only about 3% of those who have had the standard 2 dose vaccination.
From January 1 to April 19, 2019, 626** individual cases of measles have been confirmed in 22 states. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000, second only to the 667 cases reported during all of 2014. In the coming weeks, 2019 confirmed case numbers will likely surpass 2014 levels.
*Cases as of December 29, 2018. Case count is preliminary and subject to change.
**Cases as of April 19, 2019. Case count is preliminary and subject to change. Data are updated every Monday.
Recent areas of Measles outbreaks in the US include New York State, Rockland County, New York City, Washington, New Jersey, California, Butte County, and Michigan. These are linked to travelers who brought measles back from other countries where large measles outbreaks are occurring. A significant outbreak can occur when a traveler bringing measles into the country then exposes a pocket of unvaccinated people.
Complications of Measles:
It is important to consider the potentially severe complications of measles infection. Awareness has faded due to successful immunization campaigns over the years leading to most people fortunately not having to experience themselves or a loved one suffering or dying from this.
● Ear infections,
● Permanent hearing loss,
● Encephalitis (brain swelling),
● Brain damage,
What Adults Can Do:
1. Make sure your children obtain immunizations at the optimal recommended schedule.
2. Generally if you received your childhood immunizations appropriately you would NOT need additional immunization or testing for immunity. But, there are a couple of special considerations:
a. Birth before 1957 provides only presumptive evidence for measles, mumps, and rubella. Before vaccines were available, nearly everyone was infected with measles, mumps, and rubella viruses during childhood. The majority of people born before 1957 are likely to have been infected naturally and therefore are presumed to be protected against measles, mumps, and rubella. Healthcare personnel born before 1957 without laboratory evidence of immunity or disease should consider getting two doses of MMR vaccine.
b. If you were vaccinated between 1963 and 1968 you may have received a “killed measles vaccine” which was an earlier formulation that is no longer used and was not as effective as the current MMR vaccine. Fortunately, this involves a relatively small number of people.
c. If you have direct, close contact (sharing sport equipment, drinks, kissing, living in close quarters) with someone diagnosed with measles.
d. International travelers without evidence of measles immunity.
3. If you have concern for any of the above circumstances or otherwise then you can schedule an appointment with us to discuss the best preventive measures for you. If appropriate you can have a blood test to determine if you are immune or to get a dose of the MMR vaccination. There is no specific additional harm in getting another dose of the MMR vaccine if you may already be immune to measles, mumps, or rubella. You should check with your insurance to understand your coverage for testing or immunization so there is no surprise if insurance passes the cost directly to you.
4. If you do not have immunity and are exposed to measles you may get some protection if you get the MMR vaccine within 72 hours of your exposure. Clearly this is a last resort.
5. There are some individuals who should not get the MMR vaccine and it is important to discuss preventive measures with your doctor.
6. If you think you have the measles then contact your doctor’s office with your concern PRIOR to going to the office. Most offices have extremely cautious protocols to minimize risk of spreading this highly contagious infection while still evaluating and treating you appropriately.
7. For more information: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html