Tag: boosters

When Do You Get the Measles Vaccine?

With the rise in measles cases this year, folks are asking when they routinely get the measles vaccine to help make sure they are vaccinated and protected.

Do you know when you routinely get your measles vaccine?
Adults who aren’t high risk might be able to get away with simply having one dose of MMR or a measles containing vaccine since 1967.

Unfortunately, there isn’t an easy answer.

When Do You Get the Measles Vaccine?

Well, there kind of is.

Today, we routinely give:

  • the first dose of the measles vaccine (MMR) when toddlers are 12 to 15 months old, and
  • the second dose of MMR when they are 4 to 6 years old

However, if you are at high risk to get measles, especially if you are planning to travel out of the country or to specific areas with active outbreaks, you should get those doses early.

Early Doses of MMR

How early?

As early as age six months.

In fact, high-risk infants 6 through 11 months of age should receive one early dose of MMR vaccine, a dose that will have to be repeated when they are 12 months old. This early dose is mostly about international travel though and not travel within the United States, unless there is a specific recommendation in a local area.

“For outbreaks with sustained, community-wide transmission affecting infants <12 months of age and with ongoing risk of exposures to infants, health departments may consider vaccination of infants aged 6-11 months in these affected areas (including visitors) with 1 dose of MMR vaccine. This recommendation should be made following careful assessment of the benefit of early protection against measles during a period of increased transmission and exposure, and risk of decreased immune response following subsequent MMR doses in infants vaccinated at <12 months of age compared with infants vaccinated at ≥12 months of age.”

Manual for the Surveillance of Vaccine-Preventable Diseases

And children 1 to 3 years of age who are high-risk should receive two doses of MMR vaccine (instead of waiting to get the second dose when they are 4-6 years old), separated by at least 28 days.

This second dose doesn’t have to be repeated though.

When Did We Use to Give the Measles Vaccine?

Still, more than a review of the current immunization schedule, most folks want to know when we used to get vaccinated against measles. That’s what might help you figure out if you are vaccinated and protected.

Hopefully, you can just check your shot records too.

It might also help to know that we began:

  • giving the first measles vaccine in 1963. This doesn’t count as a dose of measles vaccine though, as it didn’t provide long-lasting protection.
  • giving the first improved, live measles vaccine in 1967.
  • using the combined MMR in 1971.
  • offering a second dose of MMR to kids in 1990.

So, how many doses have you had?

What to Know About Getting an MMR Vaccine

If you haven’t had two doses and are at high risk to get measles, get caught up and protected. Keep in mind that you don’t need to check your titers first and you won’t need a third dose of MMR. Titers might be a good idea if you were born before 1957 and aren’t sure if you had a natural case of measles.

“The best way to protect yourself and your loved ones from measles is by getting vaccinated. You should plan to be fully vaccinated at least 2 weeks before you depart. If your trip is less than 2 weeks away and you’re not protected against measles, you should still get a dose of MMR vaccine.”

Before international travel: Make sure you’re protected against measles

Lastly, if possible, try to get your second dose of MMR at least two weeks before your trip.

More on When We Give the Measles Vaccine

How Many Vaccines Did Kids Get in the 1950s?

I recently posted an immunization schedule from the 1960s to bust the myth that kids didn’t get many vaccines before the 1970 and 80s, even though they actually got multiple doses of DTP, polio, and smallpox vaccines.

But how about if we go back even earlier than that?

My uncle got polio around the time this vaccine schedule was released in 1951, but before the first polio vaccines were being routinely used.
My uncle got polio around the time this vaccine schedule was released in 1951, but before the first polio vaccines were being routinely used.

In 1951, infants got multiple doses of diphtheria, tetanus, and pertussis vaccines and the smallpox vaccine by the time they were 6 months old, with boosters through age 10 years.

Multiple doses with aluminum. And thimerosal. And far more antigens than kids are exposed to today, even though they now get many more vaccines.

“Tetanus toxoid recall injections should be continued every 3 years throughout life in dosage of 0.1cc to 0.2cc.”

AAP Report of the Committee on the Control of Infectious Diseases 1951

Oh, they also got revaccinated with the smallpox vaccine “every five years.”

And yes, most of the vaccines contained aluminum.

“The Committee recommends that all infants be immunized actively against diphtheria, pertussis, and tetanus with a course of injections of combined alum or aluminum phosphate precipitated, or aluminum hydroxide adsorbed diphtheria and tetanus toxoids containing H. pertussis vaccine. These products are considered preferable to fluid mixtures for the following reasons: (1) more prolonged antitoxic immunity produced by precipitated or adsorbed mixtures, (2) greater effectiveness as immunizers against pertussis in early infancy, and (3) less likelihood of producing systemic reactions because of lower protein content and slower absorption.”

AAP Report of the Committee on the Control of Infectious Diseases 1951

Other vaccines were also available for special situations, including rabies, typhoid, parathyphoid, and the BCG vaccine.

“Acetylsalicylic acid, 65 mg per year of age, should be given within an hour or two of injections and repeated 4 hours thereafter.”

AAP Report of the Committee on the Control of Infectious Diseases 1951

While it is likely a very big surprise to anti-vaccine folks that kids got multiple doses of DPT, tetanus, and smallpox vaccines back then, unfortunately, it means that they were susceptible to many diseases that are now vaccine-preventable.

Diseases that our kids don’t have to get, because they can be vaccinated and protected with vaccines that are safe, with few risks, and still necessary.

How Many Vaccines Did Kids Get in the 1950s?

What Percentage of Adults Are up to Date on Their Immunizations?

Are you up to date on your vaccines?

What about everyone else?

What Percentage of Adults Are up to Date on Their Immunizations?

Can you guess why this question comes up so often?

Yup.

There is no plan to force adults to get vaccinated...
There is no plan to force adults to get vaccinated…

It’s about herd immunity.

If most adults aren’t immune because they haven’t been vaccinated or don’t get boosters, then since we aren’t seeing that many outbreaks, herd immunity itself must be a myth.

The thing is though, adults were either born in the pre-vaccine era and likely earned their natural immunity or were born in the vaccine era and are vaccinated and immune.

It is also important to understand that herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if everyone has herd immunity levels of protection against hepatitis A or Hib.

And adults do get a few boosters and some vaccines that are only recommended for adults, including the shingles vaccine.

In addition, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated, because vaccinated kids are less likely to become infectious.

But back to the original question, how many adults are up to date on their immunizations?

“While modest gains occurred in vaccination coverage for pneumococcal, Tdap, hepatitis A (persons with chronic liver conditions), herpes zoster, and HPV vaccination, coverage did not improve for other vaccinations and many adults remained unvaccinated with recommended vaccines. “

Vaccination Coverage Among Adults in the United States, National Health Interview Survey, 2016

While most adults are immune to what were once common childhood diseases, like measles and mumps, because they were either vaccinated or had the disease naturally, many could do better with newer vaccines that weren’t available when they were kids.

More on Adult Vaccination Statistics

Can I Get a Second Flu Shot for Extra Protection?

If one flu shot is good, wouldn’t two be better?

Can I Get a Second Flu Shot for Extra Protection?

Some people do get a second flu shot.

In fact, all kids eight years and younger, if it is their first time getting a flu vaccine, get two doses of flu vaccine.

How many doses of flu vaccine will your kids need this year?
How many doses of flu vaccine will your kids need this year?

The first dose is a priming dose and the second, at least 28 days later, is a booster dose.

Why do we do it that way?

Because studies have shown that is the best way to do it.

We don’t need to use this same priming/booster strategy in older children and adults though.

But with recent talk that protection against the flu after a flu vaccine might wane before the end of a flu season, some folks are likely wondering if they should just get another flu shot later in the season.

“Revaccination later in the season of persons who have already been fully vaccinated is not recommended.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

And the official answer is no, except for younger children getting vaccinated for the first time, you should just get one dose per season.

Why not?

Mostly because a lot of studies haven’t been done to see what effect that second dose will have. And since some studies have even suggested that regular annual flu vaccines could actually lower vaccine effectiveness, you would want to know if getting an extra flu vaccine was safe and effective before we started to do it.

Not surprisingly, someone has looked into this already. One small study, Influenza revaccination of elderly travelers: antibody response to single influenza vaccination and revaccination at 12 weeks, actually showed that a second dose in the same season “did not enhance the immune response.”

So just one flu vaccine per season.

“Prior-season vaccination history was not associated with reduced vaccine effectiveness in children, supporting current recommendations for annual influenza vaccination of children.”

McLean et al on Association of Prior Vaccination With Influenza Vaccine Effectiveness in Children Receiving Live Attenuated or Inactivated Vaccine

But do get a flu vaccine every season.

Again, while there were some reports that an annual flu vaccine could lower vaccine effectiveness, other studies have disproven this.

More on Getting a Second Flu Shot