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(HealthNewsDigest.com) – Measles has made another unexpected and unwelcome return this year, and nearly all of the cases have occurred in people who haven’t been vaccinated against the disease.
“Vaccines are the best ways to prevent certain diseases, some of which are life-threatening, including measles,” says Renee Slade, MD, a physician in the Rush Pediatric Primary Care Center. “It always disappoints me when parents choose not to vaccinate their children, because study after study after study has shown the safety of vaccinations.”
As of Aug. 11 (the most recent data available), 124 cases of measles in the United States had been confirmed, according to the federal Centers for Disease Control and Prevention. Cases have been confirmed in 22 states, including Illinois, and the District of Columbia.
“We have already surpassed the number of cases reported in 2017, including confirmed cases in Illinois,” says Melissa Kalensky, DNP, a nurse practitioner and assistant professor in the Rush University College of Nursing’s Department of Community, Systems and Mental Health Nursing. Last year, 118 cases were reported, according to the CDC.
‘Every year, unvaccinated people get measles’
The United States eradicated measles in 2000, but people who travel outside the country may be at risk of exposure to the measles virus if they’re not vaccinated. This week, for example, a toddler in Houston was diagnosed with measles after he traveled outside the U.S.
“Every year, unvaccinated people get measles while they are abroad then bring the disease into the United States and spread it to others. Make sure you and your family are protected with MMR vaccine,” the CDC warns.
The CDC recommends that all children receive a first dose of MMR (measles, mumps and rubella) vaccine at 12 to 15 months of age and a second dose between the ages of four and six. For travelers, the MMR vaccine is recommended for children as young as six months.
Infants less than 12 months old who receive the vaccine will need an additional dose after age 12 months as well as the booster dose, typically after age four years. Children over age 12 months who are traveling should have two doses, at least 28 days apart.
The CDC also recommends vaccination for adults born after 1956. Adults unsure of their vaccination status should be vaccinated, as well those who were vaccinated from 1963 to 1967 (when some vaccine being used were less effective), unless medical records show they received a live measles vaccination.
Despite these recommendations, some parents have chosen to keep their children from being vaccinated, in large part due to fears that the vaccine can harm the child. Here, Slade and other physicians at Rush share their knowledge and insights regarding measles, vaccination, and the intersection of private choice and public health.
What’s the risk for people who haven’t been vaccinated for measles?
Slade: If you haven’t been vaccinated and you come in contact with somebody who is infected with the measles, there’s a 90 percent chance of developing illness. That’s extremely contagious, and if somebody with measles coughs in the room, their respiratory secretions will hang in the air for hours.
If you get sick, you’re going to be very, very miserable for probably more than a week, with a runny nose, fevers, a rash. There’s also a chance of complications. The most common complications would be ear infection and pneumonia, but there’s a 0.1 to .2 percent chance of death. One or two in a thousand children who get the illness die. That’s a lot.
Jennifer Earvolino, MD, medical director of Earvolino and Associates, a primary care practice at Rush: We get lulled into a sense of security that we can treat all infections; but with measles there is no specific treatment. Infected individuals can have complications such as diarrhea, pneumonia and neurologic complications, and a small percent of patients will die. I strongly encourage parents to have their children vaccinated.
If I’m vaccinated and my kids are vaccinated, why does it matter if someone else doesn’t vaccinate their kids?
Slade: Babies less than 12 months old aren’t vaccinated. If there’s a baby in your family, there’s someone who’s not protected. You want all the people in your community to be protected. It’s why herd immunity [achieving a sufficient number of vaccinated people to prevent the illness from spreading] is important.
Paul Kent, MD, a Rush pediatric oncologist: A kid with cancer will die if he gets the measles. Even my cancer patients who are vaccinated for the measles are only somewhat protected if they are on chemotherapy, because their immune systems are so suppressed.
In my division, we followed all our patients the past three years to see who lost their immunity to measles due to chemotherapy, and we found that approximately 6 percent had lost their immunity to measles. Measles for any of my patients would be dangerous, but for those who had lost their immunity it would be fatal or cause permanent brain damage.
Can’t we just keep the sick kids at home?
Kent: Patients with measles are infectious for four days before they have symptoms, so we can’t just say ‘keep your unimmunized kids away if they have a fever or are sick.’ They may look and feel fine and still pass it to someone else.
What do you say to reassure parents who are worried about the side effects of vaccines?
Slade: I tell people I vaccinate my own children. I vaccinated both of my children according to the guidelines, because study after study demonstrate that vaccines are both safe and effective. The measles vaccine has been around for more than 50 years; it’s one of the vaccines that we have the most experience with. Immunization is a simple way to teach the immune system to recognize specific germs, so when that germ – such as measles – show up, the immune system knows how to fight it
Is there anyone who shouldn’t get the vaccine?
Slade: People can’t get the vaccine if they have a severe (anaphylactic) allergy to Neomycin, gelatin or any component of the vaccine. Also, anyone who is immunocompromised shouldn’t get it.
Earvolino: If you are a women of childbearing age, you cannot get the vaccine while you are pregnant. You must be vaccinated at least 28 days before you become pregnant or wait until after a pregnancy.
If it’s safe for all but those few people, why are so many people not allowing their children to be vaccinated?
Slade: There was one study that claimed a relationship between the vaccine and autism that studied a small sample population. After it was published, it was learned that the main author had a financial incentive for the study to be published, and after more was learned about the study the other authors took their names off of the study. It also was debunked by many other studies that used larger groups of children. In the scientific community, the vaccine is considered very, very safe. There’s no relationship between this vaccine — or any vaccine — and autism.
(Russian online meddling also may be a contributing factor. Study findings published last week by the American Journal of Public Health found that automated accounts and Russian trolls stoked both the pro- and anti-vaccine sides of the issue from 2014 to last year, possibly to cause social conflict in the U.S. “Accounts masquerading as legitimate users create false equivalency, eroding public consensus on vaccination,” the authors of the research paper wrote.)
Many of the people who were vaccinated between 1963 and 1967 can’t know for sure if they received the live measles vaccination, which is considered effective, or other forms of the vaccine that may be less effective. What do you recommend for them?
Earvolino: It is recommended that individuals born between 1963 and 1967 receive one to two doses of the MMR vaccine (the number of booster shots will be determined by their overall health history and potential risk of exposure). If an individual is concerned about receiving the vaccine, they can have blood drawn to check to see if they are immune to measles or not. If they are immune, they do not need to receive a booster shot.