Cases of measles in the United States, now topping 700, have climbed to their highest level in 25 years. The extremely-contagious disease was declared eliminated from the United States in 2000. So what explains the recent outbreaks?
According to Dr. John Bower, a pediatric infectious disease specialist at Akron Children’s Hospital, recent outbreaks in the U.S. can typically be traced to travelers who have visited other countries where the disease still occurs and then return home to communities in the United States where vaccination rates are low, such as in an Orthodox Jewish community in Brooklyn now or the Amish community in central Ohio in 2014. The vast majority of cases involve children who haven’t been vaccinated.
Dr. Bower said as concerned as he is about the measles outbreaks, it is part of a larger problem related to growing skepticism – and misinformation – about all childhood vaccines.
“The MMR [mumps, measles, rubella] vaccine is just one piece of the puzzle, one part of a bigger picture,” said Dr. Bower. “Infections, such as pertussis and pneumococcus are still common and are as dangerous as measles. Each year, scores of children die from the flu. Vaccines are safe and effective means to prevent these illnesses, and have been for decades.”
In light of the news coverage about measles, Dr. Bower and his colleagues have been getting lots of questions about measles and the MMR vaccine, and answers to those frequently-asked questions are below.
Public health officials say low vaccination rates in some U.S. communities can be attributed to the spread of bad information, including the debunked link between the MMR vaccine and autism.
“Some of this misinformation is now deeply embedded, and I don’t want to discount any parent’s concerns,” said Dr. Bower, “We must remember that parents are advocates for their child, and, if a vaccine is perceived to have a risk, they will naturally be cautious, especially when such infections are rare. But healthcare providers are advocates for all children. They strive to protect every child in every community against the very real dangers of vaccine-preventable childhood infection and ensure that every immunization given is both safe and effective. As health care providers, we must do a better job communicating the message that vaccines are necessary to protect all children and that everyone is part of public health.”
Measles: Frequently-Asked Questions
Am I protected against measles?
The CDC considers you protected from measles if you have written documentation showing at least one of the following:
- You received two doses of measles-containing vaccine, and you are a(n)
- School-aged child (K-12)
- Adult in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.
- You received one dose of measles-containing vaccine, and you are a(n)
- Pre-school-aged child.
- Adult who will not be in a high-risk setting for measles transmission.
- A laboratory confirmed you had measles at some point in your life.
- A laboratory confirmed you are immune to measles.
- You were born before 1957.
What should I do if I am unsure whether I’m immune to measles?
If you are unsure whether you’re immune to measles, you should first try to find your vaccination records. If you do not have documentation of measles immunity, you should get vaccinated with the MMR vaccine. Another option is to have a doctor test your blood to determine whether you’re immune. But this option is likely to cost more and will take two appointments. There is no harm in getting another dose of the MMR vaccine if you may already be immune to measles (or mumps or rubella).
Can I still get measles if I am fully vaccinated?
Very few people – about 3 in 100 – who get two doses of measles vaccines will still get measles if exposed to the virus.
What explains the current measles outbreaks in the United States?
Every year, unvaccinated U.S. residents get measles while they are abroad and bring the disease into the United States. While measles was considered eliminated in the United States in 2000, it is still common in other parts of the world, including countries in Europe, Asia, the Pacific Islands, and Africa. When people with measles travel in the United States, they can spread the disease to unvaccinated people, including children too young to be vaccinated. The current outbreak is a sign that vaccination rates, especially in some states, have fallen considerably in recent decades.
Is the MMR vaccine safe?
Yes, the MMR shot is very safe and effective at preventing measles (as well as mumps and rubella). Vaccines, like any medicine, can have side effects. But most children get the MMR vaccine have no side effects.
Is there a link between MMR shot and autism?
In 1998, Andrew Wakefield and his colleagues published a study linking the MMR vaccine to autism. Despite the small sample size (12 children), the poor study design and the speculative nature of the conclusions, the paper received wide publicity. Almost immediately, other studies were conducted, refuting the link. The original study was retracted and it was later disclosed that Wakefield had financial ties to lawyers and families who were pursuing the manufacturers of the vaccines in the courts and most of his research participants were litigants.
Do I ever need a booster vaccine?
No, the CDC considers people who received two doses of measles vaccine as children, according to the U.S. vaccination schedule, protected for life, and they do not ever need a booster. Adults need at least one dose of measles vaccine, unless they have proof of immunity. Adults who are going to be in a setting that poses a high risk for measles transmission (colleges, hospitals, international travel) should make sure they have had two doses separated by at least 28 days.
What are the symptoms of measles?
Measles starts with a fever that can get very high. Other symptoms include:
- Cough, runny nose and red eyes
- Rash of tiny, red spots that starts at the head and spread to the rest of the body
- Ear Infection
Measles is highly contagious. It is estimated that 90 percent of unvaccinated individuals who come into contact with an infected person will get the measles. It can be especially dangerous for babies and young children. Nearly 30 percent of children younger than 5 years who get the measles have to be treated in the hospital as it can lead to pneumonia, brain damage, deafness and death.
What is Akron Children’s Hospital’s policy on accepting patients when parents refuse to vaccinate?
It has always been Akron Children’s practice to accept and care for children whose parents refuse immunizations. We are obligated professionally to recommend immunizations and do so. Refusals are documented in the chart. The physician-patient relationship is based on trust, and we hope to keep the dialogue about the benefits of vaccines open with parents.