Tag: costs

What is the Natural Immunity Model?

It’s becoming a little clearer why some folks think it is safe to not vaccinate their kids, leaving them at risk to get vaccine-preventable diseases.

Who's calling the measles outbreaks a national emergency?
Who’s calling the measles outbreaks a national emergency?

Their idea of a natural immunity model of getting disease simply involves hiding in the herd and any outbreaks they trigger magically stopping.

What is the Natural Immunity Model?

Bob Sears thinks he has exposed some big news, that not everyone who gets measles dies.

Fortunately, that’s very true and something folks have always known.

With a death rate of about 1 in 1000 cases, you wouldn’t expect to have had any deaths after just 50 or 60 cases. But you never know. It’s not like every 1000th case dies. It could be the second case, the 562nd, or the 3043rd.

The hospitalization rates work the same way. They are statistical averages of what typically happens when people get measles.

That’s why measles was once called a “harmless killer.” It is often harmless, if you call having a high fever and feeling miserable for a week harmless, but it is sometimes a killer.

So is what we are seeing in Washington “what an outbreak looks like with the natural immunity model,” when no one is vaccinated and protected?

Of course not!

In a natural immunity model, up to 90% of the people who are exposed to someone with measles get sick!

In the pre-vaccine era, everyone got measles. That's the natural immunity model.
In the pre-vaccine era, everyone got measles. That’s the natural immunity model.

In a natural immunity model, everyone gets measles.

Not everyone survives having measles though.

Remember, the last measles death in the United States was during a 2015 outbreak in Washington. A immunocompromised women got caught up in an outbreak of mostly unvaccinated people, got measles, and died.

That’s the natural immunity model.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.

Not having a choice about getting measles.

That’s the natural immunity model.

Worry about your child with leukemia after an exposure to measles…

That’s the natural immunity model.

“Well, what does this mean? Much like the outbreak in 2014 in a large Amish community (around 400 cases), and the recent NY outbreak in an orthodox Jewish community (around 100 cases), these types of outbreaks are centralized and self-limiting—which means they don’t spread like wildfire. These cases are also almost exclusively in communities who are CHOOSING not to be vaccinated. In other words, they are not random people “victimized” by measles. #dontfeelsorryforthem”

Melissa Floyd

Do anti-vaccine folks really think that these outbreaks are self-limiting? That they just stop on their own?

Do they not understand that the only thing that keeps them from “spreading like wildfire” is the intensive work of the local and state health departments, efforts to get folks vaccinated, and quarantines?

The Disneyland measles outbreak, for example, was hardly centralized or self-limited. It spread to Arizona, Nebraska, Utah, Colorado, Washington, Oregon, Mexico, and Canada.

And like many other large outbreaks, it cost millions of dollars to contain.

“Measles outbreaks can be very costly to communities, a new report suggests. For example, the 2013 measles outbreak in New York City cost the city’s health department nearly $395,000 and more than 10,000 personnel hours, according to a report in JAMA Pediatrics. And there were other non-monetary costs, including the loss of a pregnancy, researchers reported.”

Measles outbreaks come with serious consequences

That hardly sounds like something that is harmless or self-limited.

“Now, the ACIP is preparing to add a 3rd dose for all college-age students to try to stop adults from getting and spreading measles—THAT’S how common adults cases are. Yet in Washington, there were only three??”

Melissa Floyd

Not only is there no call for a third dose of MMR to help stop the spread of measles, the CDC actually says a third dose isn’t necessary.

“In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity.”

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Any talk about a third dose of MMR has to do with outbreaks of mumps…

“Is this all a coincidence my friends? Is the panic generated because of motive rather than data? In other words, could the media actually be encouraged to shift public beliefs on an issue to help pass legislation with a vested interest? #HerdImmunityDoesntApplyToVaccines”

Melissa Floyd

It’s not a coincidence that we are seeing so much anti-vaccine measles panic and propaganda these days. Outbreaks always bring it out.

Why?

It becomes harder to justify your decision to leave your kids unvaccinated and unprotected when you actually start to see that intentionally unvaccinated kids are getting sick.

More on the Natural Immunity Model

Vaccines Statistics and Numbers

To help you get better educated about vaccines, it can help to learn some vaccine statistics and some other numbers behind vaccines.

Vaccine Court payouts come from an excise tax and are not taxpayer dollars...
Vaccine Court payouts come from an excise tax and are not taxpayer dollars…

Including the numbers that anti-vaccine folks throw around.

Vaccine Statistics

For all of the talk of some folks delaying or skipping vaccines, do you know how many vaccines are given each day?

According to the CDC, from 2006 to 2017, at least 3,454,269,356 doses of vaccines were distributed in the United States. These are the vaccines that are covered by the National Vaccine Injury Compensation Program, such as DTaP, MMR, Hepatitis A and B, HPV, and flu, etc.

That’s over 287 million doses each year!

The WHO reports that 85% of infants around the world receive vaccines against DTP, polio, measles, and hepatitis B.
The WHO reports that 85% of infants around the world receive vaccines against DTP, polio, measles, and hepatitis B.

How about worldwide?

That’s harder to know, but consider that the World Health Organization reports that 85% of infants worldwide, or almost 100 million infants, get at least:

  • 3 doses of DTP
  • 3 doses of hepatitis B
  • at least one doses of measles
  • 3 doses of polio

Plus, an increasing number are getting vaccines to protect them against Hib, pneumococcal disease, rotavirus, HPV, meningitis A, mumps, rubella, tetanus, and yellow fever.

“UNICEF supplies vaccines reaching 45 per cent of the world’s children under five years old as part of its commitment to improving child survival.”

How many vaccine doses are we talking about?

A lot. UNICEF alone buys 2.8 billion doses of vaccines each year! Those vaccines are then distributed to children in over 100 countries.

Vaccine-Preventable Disease Statistics

As impressive as the number of vaccines that are given each year are the numbers about what happens when we give vaccines:

  • there are 2 to 3 million fewer deaths in the world each year because people are vaccinated and protected
  • in the Unites States, every $1 spent on vaccines provides $3 in direct benefits and up to $10 in benefits if you include societal costs
  • in developing countries, every $1 spent on vaccines provides $16 in direct benefits, but that goes up to $44 when you take “into account the broader economic impact of illness”
  • for children born in the United States during “1994–2013, routine childhood immunization was estimated to prevent 322 million illnesses (averaging 4.1 illnesses per child) and 21 million hospitalizations (0.27 per child) over the course of their lifetimes and avert 732,000 premature deaths from vaccine-preventable illnesses,” and it also “will potentially avert $402 billion in direct costs and $1.5 trillion in societal costs because of illnesses prevented”
  • only two countries continue to have wild polio – Afghanistan and Pakistan – and together, they only had 21 cases in 2017

Still, only one vaccine-preventable disease, smallpox, has been eradicated.

And worldwide, more than 3 million people still die from vaccine-preventable diseases every year, many of them young children.

Other Vaccine Numbers

There are some other numbers about vaccines and vaccine-preventable diseases folks should know:

  • the number of pediatricians who got a $3 million vaccine bonus – zero
  • the number of doses of vaccines kids get today – 69 72 54 doses (including yearly flu shots) by age 18
  • the number of vaccines that contain antifreeze as an ingredient – zero
  • the number of vaccines that contain peanut oil as an ingredient – zero
  • the number of studies that link vaccines to autism – zero
  • the number of diseases that homeopathic vaccines can prevent – zero
  • the number of anti-vaccine sites that mention any benefits of vaccines – zero
  • the number of VAERS reports that are thought to be unrelated to a vaccine – 53%
  • the number of VAERS reports that are thought to be definitely caused by a vaccine – 3%
  • the number of definite VAERS reports that were serious – 1% (anaphylaxis)
  • the number of myths about vaccines that can scare you away from vaccinating and protecting your kids – 100s
  • the number of measles outbreaks that have been caused by a vaccine strain – zero
  • how long you have to stay in quarantine if you are unvaccinated and are exposed to someone with measles – at least 21 days
  • the number of new vaccines in the pipeline300

And yes, $4,060,857,713.42 has been paid by the Vaccine Court for 6,355 compensated claims for vaccine injuries since 1989, during which time billions of doses of vaccines were given.

“This means that for every 1 million doses of vaccine that were distributed, 1 individual was compensated.”

Vaccine Injury Compensation Data

And many of those claims were simply settled.

Vaccines work. Vaccines are safe. Vaccines are necessary.

Get vaccinated and protected.

What’s the biggest number you should be thinking about? Way too many people are still getting and dying from vaccine-preventable diseases.

What to Know About Vaccine Statistics

Although more work needs to be done to protect more people, vaccine statistics clearly show that vaccines work and that they are safe and necessary.

More on Vaccines Statistics

Updated February 2, 2019

The Value and Cost Savings of Getting Vaccinated

We often hear a lot about the benefits of vaccines.

Even the schools were closed in San Antonio when polio came to Texas in 1946.
How much would it cost to close all of the schools in a big city today?

Well, most of us do.

But can getting vaccinated really help save us money?

Cost Savings of Getting Vaccinated

Vaccines are expensive, so it probably doesn’t make a lot of sense to many people that saving money is one of the big benefits of getting vaccinated.

That’s just because vaccines work so well.

“Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42 000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively.”

Zhou et al on Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009

Few of us remember the pre-vaccine era when there were polio and diphtheria hospitals and “pest houses” at the edge of town.

We don’t remember when outbreaks of vaccine-preventable diseases would close schools and these diseases were more deadly, not because they were more severe, but simply because they were more common.

Costs Associated With Getting Sick

If we don’t remember these diseases and outbreaks, we certainly don’t remember how much it cost to control and treat them.

We should though.

Just look at how much it costs to control the recent measles outbreaks that continue to plague us.

“The estimated total number of personnel hours for the 16 outbreaks ranged from 42,635 to 83,133 and the corresponding total estimated costs for the public response accrued to local and state public health departments ranged from $2.7 million to $5.3 million US dollars.”

Ortega-Sanchez on The economic burden of sixteen measles outbreaks on United States public health departments in 2011

Not including the direct costs for outpatient visits and inpatient care, recent outbreaks have cost anywhere from $3,000 to $50,000 per case to contain. Why the difference? Localized outbreaks, like in a church group or among a single family, will be easier and less expensive to contain, as they will likely involve fewer contacts to track down to see if they were exposed and are already vaccinated.

Again, these costs don’t include the costs of going to your doctor or the ER because your child is sick, getting hospitalized, or lab tests, etc.

It also doesn’t include the costs associated with living under quarantine, which is happening in many of the recent outbreaks.

Getting sick is expensive.

How much is a liver transplant?

How much does it cost to treat someone with cervical cancer?

How much does it take to care for a child with congenital rubella syndrome?

How do anti-vax folks usually counter this important message?

They typically say that taking care of a vaccine-injured child is expensive too. While that can be true, the problem is with their idea of what constitutes a vaccine injury. While vaccines are not 100% safe and they can rarely cause serious or even life-threatening reactions, most of what they describe as vaccine-induced diseases, from autism to SIDS, are not actually associated with vaccines.

The Value of Vaccination

So yes, getting vaccinated is cost effective.

“Cost-effectiveness analysis has become a standard method to use in estimating how much value an intervention offers relative to its costs, and it has become an influential element in decision making. However, the application of cost-effectiveness analysis to vaccination programs fails to capture the full contribution such a program offers to the community. Recent literature has highlighted how cost-effectiveness analysis can neglect the broader economic impact of vaccines.”

Luyten et al on The Social Value Of Vaccination Programs: Beyond Cost- Effectiveness

The value of getting vaccinated goes way beyond saving money though.

Most of the ways this has been studied in the past still leaves out a lot of important things, including:

  • increased productivity later in life following vaccination
  • improved cognitive and educational outcomes
  • community-level health gains through herd effects
  • prevention of antibiotic resistance
  • vaccination-related benefits to macroeconomic factors and political stability
  • furthering moral, social, and ethical aims

Why are these important?

“Vaccination has greatly reduced the burden of infectious diseases. Only clean water, also considered to be a basic human right, performs better. Paradoxically, a vociferous antivaccine lobby thrives today in spite of the undeniable success of vaccination programmes against formerly fearsome diseases that are now rare in developed countries.”

Andre et al on Vaccination greatly reduces disease, disability, death and inequity worldwide

If you are making a decision to get vaccinated vs. trying to hide in the herd, you want to have all of the information about the benefits of vaccines, not just about the risks, or what you might think are risks.

Vaccines Are Expensive

Although getting vaccinated is certainly cost-effective, that doesn’t erase the fact that vaccines are expensive.

If they weren’t so expensive, then we likely still wouldn’t have so many deaths from vaccine-preventable diseases in the developing world, where the problem is access to vaccines, not vaccine-hesitant parents.

“We conclude that the vaccination portion of the business model for primary care pediatric practices that serve private-pay patients results in little or no profit from vaccine delivery. When losses from vaccinating publicly insured children are included, most practices lose money.”

Coleman on Net Financial Gain or Loss From Vaccination in Pediatric Medical Practices

Parents should also be aware that vaccines are expensive for the average pediatrician too, who no matter what anti-vax folks may claim about bonuses, aren’t making much or any money on vaccinating kids.

And because vaccines work, pediatricians also don’t make as much money when vaccinated kids don’t get diarrhea and dehydration that is prevented by the rotavirus vaccine, recurrent ear infections that are prevented by Prevnar, or a high fever from measles, etc., all things that would typically trigger one or more office visits.

It should be clear that the only reason that pediatricians “push vaccines” is because they are one of the greatest achievements in public health.

A great achievement at a great value.

What to Know About the Cost Savings of Getting Vaccinated

There is no question that there is great value in getting fully vaccinated on time and that getting immunized is a very cost effective way to keep kids healthy.

More on the Cost Savings of Getting Vaccinated

News on the Latest Measles Outbreaks of 2018

Breaking News – Although there was not one, multi-state outbreak, we had reports of measles cases in at least 372 people in 27 states, including Arkansas (1), Arizona (1), California (10), Connecticut (3), Florida (15), Illinois (3), Indiana (1), Iowa (1), Kansas (22), Louisiana (1), Maryland (1), Massachusetts (4), Michigan (15), Minnesota (4), Missouri (10), Nevada (2), New Jersey (40), New York (161), North Carolina (2), North Dakota (1), Oklahoma (4), Oregon (5), Pennsylvania (4), South Carolina (7), Tennessee (1), Texas (10), Virginia (1), Washington (3), and Wisconsin(1), and the District of Columbia (1) in 2018. Also many reports of measles outbreaks in Europe.

The measles outbreak in Rockland County continues to grow.

We have come a long way since the development of the first measles vaccines in the early 1960s…

2018 Measles Outbreaks

Unvaccinated children exposed to measles are quarantined for at least 21 days.
Unvaccinated children exposed to measles are quarantined for at least 21 days.

We were only a few days into the new year when we had our first measles case of 2018, a new student at IU Bloomington, in Indiana. The student had traveled through Newark Liberty International Airport on their way to Indiana.

The next case occurred when a passenger on an international flight landed at Chicago’s O’Hare International Airport and left on a domestic flight to Arkansas (January 10).

In Arkansas, the person exposed at least 150 people at the University of Arkansas for Medical Sciences (UAMS) emergency department and other areas of Little Rock on January 10 and 11.

And it goes on already, with other measles cases in 2018 including:

  • another case in Illinois that is unrelated to the case at O’Hare, although this one was also at the airport (on January 9) while contagious and at other places in Skokie and Evanston, outside of Chicago, Illinois.
  • an unvaccinated person in Waxahachie, Texas (just south of Dallas), who may have exposed others at a movie theater on January 9.
  • five more cases, all unvaccinated, in Ellis County, Texas that are linked to the original case in Waxahachie
  • a graduate student at Carnegie Mellon University in Pittsburgh, Pennsylvania and exposed others on campus in late January and on several Port Authority of Allegheny County buses
  • a case in Norman, Oklahoma that is related to international travel and who exposed others at Chuck E Cheese, a pediatrician’s office, and the Norman Regional HealthPlex
  • a tourist from Australia exposed people at the The Metropolitan Museum of Art, Watchtower Education Center, an Urgent Care, and ER and a number of hotels around New York between February 16 and 21
  • an unvaccinated student who returned from a trip to Europe and developed measles, exposing others between February 28 through March 2 in Santa Clara County, California at a school in Campbell and the Westgate Center food court.
  • a traveler who arrived at Detroit Metropolitan Wayne County Airport (DTW) on March 6 and visited an urgent care center in Washtenaw County. No word yet on which airline or flight the person was on.
  • at least three infants who are too young to be vaccinated in Johnson County, Kansas have measles. No word on how they were exposed yet.
  • a young child arriving from Brussels to Terminal B at Newark Liberty International Airport in New Jersey on March 12, departing from Terminal C for Memphis, Tennessee
  • there are at least four more cases of measles in an ongoing outbreak in and around Kansas City, bringing the total to seven cases, including six cases associated with a daycare, and multiple exposures in Olathe, Paola, Kansas City, Overland Park, and Garner, Kansas between March 2 through March 10
  • The Kansas Department of Health and Environment (KDHE) now reports that ten cases have been identified in an ongoing outbreak associated with a daycare – eight Johnson County residents, one Linn County resident associated with the daycare and one Miami County resident not associated with the daycare.
  • a case in St. Louis County, Missouri who exposed others on March 13 at The Magic House, St. Louis Children’s Museum and Racanelli’s New York Pizzeria in Kirkwood, and on March 14 Homewood Suites in Chesterfield.
  • 3 more cases in Kansas, bringing the total to 13 cases in this ongoing outbreak, with 11 cases in Johnson County, 1 case in Linn County, and 1 case in Miami County.
  • another case in the Kansas City, Missouri area, this one following international travel and with exposures on March 19 and 22 at an area restaurant and a CVS pharmacy.
  • a fully vaccinated student at the University of Nevada, Reno who exposed others in Washoe County between March 27th to April 2nd on the UNR Campus and other places in Sparks and Reno, including a CVS Minute Clinic and the UNR Student Health Center.
  • two more cases in the ongoing Kansas outbreak, bringing the case count to 15, which we have now learned began when an infant who was too young to be vaccinated traveled to Asia.
  • a case in Tulsa, Oklahoma, linked to international travel, who exposed others from March 30th to April 3rd in multiple locations.
  • five more cases in the San Francisco Bay Area of California, linked to an earlier outbreak, bringing the total to 7, including the case at the UNR Campus, which is linked to this outbreak. The outbreak began when an unvaccinated traveler returned from Europe with measles and all California cases are unvaccinated.
  • a tourist from the United Kingdom who may have exposed others to measles in New Orleans in early April.
  • another case in the Kansas City area on April 12 that is reportedly not linked to the ongoing outbreak in the JoCo area.
  • two new cases in the Kansas City, Missouri area, bringing the total in that outbreak to 3, including an elementary school student who was apparently already in quarantine.
  • three more cases in the Kansas City area, bringing the case count to 18, including 14 Johnson County residents, 3 Linn County residents and 1 Miami County resident.
  • two cases in New York, tourists from Europe who visited the Kingdom Hall of Jehovah’s Witness in Brooklyn (April 15), the Watchtower World Headquarters in Tuxedo Park (April 16), and the Watchtower Education Center in Patterson (April 17)
  • a visitor from another state with measles went to Wisconsin and exposed folks in La Crosse, Onalaska and Galesville between April 13 to 18.
  • someone with measles from Missouri exposed others in Iowa on April 13 (Des Moines) and April 16 (Panera Bread)
  • two infants in New Haven County, Connecticut who had traveled out of the country and may have exposed others between April 11 to 17.
  • someone with measles visited Minnesota and exposed people on April 13 (Winona) and April 16 (Albert Lea)
  • two more cases in Clay County, Missouri, a student at South Valley Middle School (exposed others on April 18) and a student at Liberty North High School (no exposures), bringing the total number of cases to 22 in the Kansas City area, although it is unclear how they are all related (? two outbreaks)
  • a case in Santa Clara County, California that is unrelated to 5 other cases in the area
  • an adult at Derynoski Elementary School in Southington, Connecticut who may have exposed others on April 26, 27, and 30. This case comes a few weeks after two infants with measles exposed others in neighboring New Haven County.
  • a case in Fresno County, California who was infected in another state, exposing others at an urgent care center (April 30) and emergency room (May 2). Is this the same person who exposed folks at the Taco Bell in nearby Kern County on April 30th? And the case in San Luis Obispo County?
  • three cases in Putnam County, New York who exposed others at the Watchtower Educational Center in Patterson (April 26 and 27), the Museum at the Watchtower World Headquarters in Tuxedo Park (April 27), Red Line Diner in Fishkill, a Subway restaurant (April 29) in Patterson and a grocery store (May 1) in Brewster. These cases are related to the Jehovah’s Witness exposures in mid-April, bringing the case count in that outbreak to five.
  • a case in western New York, a traveler from Europe, who exposed people in Elmira and Leroy (April 30), Niagara Falls (May 1 and 2), and Dansville (May 2). Is this the same case that exposed folks in Monroe on April 29?
  • exposures in  Williamsport and Port Trevorton, Pennsylvania (May 2) related to a tour bus traveling from Niagara Falls, New York to Washington, D.C.
  • a visitor to Pottawatomie County, Oklahoma who exposed people in Shawnee on April 27 and 28.
  • a resident of Bergen County, New Jersey who exposed others in Englewood (April 24 to May 2), Newark Liberty International Airport (May 2), and Columbia (April 30)
  • a unvaccinated resident of New Orleans, Louisiana who had recently traveled out of the country
  • someone in Maryland who had recently traveled out of the country and exposed others to measles at Washington Dulles International Airport (May 15) and in Gaithersburg (May 17) and Rockville (May 18)
  • four people in Florida, including two unvaccinated people who traveled out of the country and two people from out of state who visited Florida while contagious.
  • a case related to international travel in Oklahoma City
  • a case in Illinois, who exposed others at the Honeygrow restaurant in Chicago on June 12
  • a case related to international travel in Wake County, North Carolina, when an unvaccinated resident exposed people at multiple places between June 8 to June 13, including the Duke University Hospital Emergency Department
  • a case in Michigan related to international travel, with exposures on June 12 and 14 at the Detroit Metropolitan Wayne County Airport and in Ann Arbor
  • a case in New Jersey related to international travel, with exposures on June 12 to 15 in Mount Laurel, Camben, Moorestown, and Marlton.
  • an additional case in Wake County, North Carolina, where six people are still in quarantine in an outbreak that started in early June
  • a case in Multnomah County, Oregon related to international travel, with exposures at an ER (Adventist Health Portland) and a child care center in Gresham, including at least 40 unvaccinated people.
  • a second case in New Jersey associated with an outbreak in mid-June, with new exposures in Westmont (June 26) and Marlton (June 27).
  • a second case in Oregon, reportedly already in quarantine, associated with an outbreak at a Gresham child care center that began in late June.
  • a child visiting from out of the country as part of a summer program, who exposed their host family and many others in Washington,  including multiple exposures in Monroe (June 20 to 21, June 24, and June 27), Everett (June 22 to 23), and Redmond (June 27).
  • another case in Oregon, as the Gresham childcare center measles outbreak grows to three cases, but there may not be any additional exposures as the person was unvaccinated and already in quarantine.
  • an unvaccinated person in Cook County, Illinois who traveled out of the country and got measles, returning to expose others in Chicago (July 13) and Mt. Prospect (July 14)
  • two residents of Michigan, one who returned from an international trip while contagious with measles, exposing others at Detroit Metropolitan Wayne County Airport (July 18)
  • an international traveler to Boston, Massachusetts, who exposed people at a Tasty Burger (July 19) and at Logan Airport (July 20)
  • an unvaccinated 5-year-old in Minnesota who was infected after international travel and required hospitalization during his illness
  • someone in Georgetown County, South Carolina – the first case in the state since 1997.
  • a case in Oregon who exposed people at multiple locations in Portland and Beaverton (July 30 to Aug 5) including at PDX Airport and on the Max Red Line.
  • an unvaccinated child in Pinellas County, Florida and it is unclear where the child was exposed.
  • two more cases, both unvaccinated, in Pinellas County, Florida, bringing the total number of measles cases in this outbreak to at least three, not including the person(s) who triggered the outbreak
  • a tourist in Arizona who exposed other people while visiting Sedona and Kingman (Aug 6 to Aug 8)
  • a tourist (is this the same tourist from Arizona?) in Santa Monica, California who exposed people to measles at multiple restaurants and hotels (Aug 8 to 10)
  • a second case of measles in Portland, Oregon who exposed others at the Portland International Airport (August 17) and an area restaurant (August 18)
  • a case in Massachusetts, with exposures at Logan Airport Terminal B in Boston (August 15), Lexington (August 16 and 19), and Burlington (August 20 and 21), and was apparently admitted to the Lahey Hospital & Medical Center
  • an unvaccinated person who had traveled out of the country and returned with measles to Plano, Texas with exposures at Plano West Senior High School (August 14-16) and Whole Foods (August 14)
  • a case in King County, Washington who got measles when traveling to Asia and exposed others at Sea-Tac Airport (August 21) and the Emergency Department at Harborview Medical Center in Seattle (August 21)
  • a case in Loudoun County, Virginia with exposures in Purcellville (August 17) and Lansdowne (August 20)
  • a case in Pennsylvania with exposure at the Emergency Room check-in area at Penn State Health Milton S. Hershey Medical Center (August 18)
  • a suspected case of measles in a toddler in Texas who had recently traveled overseas and is being treated at Texas Children’s Hospital in Houston
  • four more cases in Pinellas County, Florida, bringing the case count in this outbreak to seven, all unvaccinated
  • an unvaccinated child in Hennepin County, Minnesota who had recently traveled out of the country
  • a case in Dallas County, Texas who exposed others at a hotel and 5 restaurants between August 14 to 17
  • a case in Burleigh County, North Dakota, with exposures at three schools, a church, a supermarket, and during mass at Baptist Health Care Center, all during August 20 to 26, leading to at least 27 unvaccinated children being kept out of school – this person ended up testing negative
  • someone in Dallas, Texas who flew back and forth to Harlingen, through Houston Hobby airport, on Southwest Airlines while contagious (August 21 to 22)
  • another case in Minnesota – a two-year-old who had recently returned from a trip to the Middle East
  • a case in Rockland County, New York a traveler from Israel exposed others at Newark Liberty International Airport (Sept 28) visited at least places in New Square (Sept 28 to Oct 1)
  • an outbreak in Rockland County, New York has grown, as two additional international travelers exposed people in the community to measles in Monsey, New City, Nanuet, and Valhalla between Oct. 4 to Oct. 11, with an additional exposure in Montvale, New Jersey (Oct 5) and seven confirmed and eight suspected cases being investigated
  • six young children in Brooklyn, New York who got measles after returned from a trip to Israel. All but one of the children was unvaccinated and all are members of the Orthodox Jewish community of Williamsburg, Brooklyn. The vaccinated child was very recently vaccinated, but not yet immune.
  • a resident of New York who exposed people in Mifflintown, Pennsylvania between October 14-19.
  • the outbreak in Rockland County, New York continues to grow, with 25 confirmed cases and 8 under investigation.
  • 8 new cases in the Rockland County, New York outbreak, bringing the case count to 33 confirmed cases, with 5 more still under investigation.
  • a resident of Spartanburg County, South Carolina who had recently traveled out of the country
  • 7 new cases in the Rockland County, New York outbreak, bringing the case count to 40 confirmed cases, with 11 more under investigation and at least 1,000 students in 15 schools being kept quarantined in Spring Valley, Monsey, and New Square.
  • at least 3 cases in Ocean County, New Jersey with further exposures in Lakewood
  • 3 new cases in the Rockland County, New York outbreak, bringing the case count to 43 confirmed cases
  • 2 more cases in Spartanburg County, South Carolina, bringing the case count in that outbreak to 3, all unvaccinated young children
  • 11 new cases in Brooklyn, New York, bringing the case count in that outbreak to 17 children in Williamsburg and Borough Park
  • 4 new cases in the Rockland County, New York outbreak, bringing the case count to 47 confirmed cases, with 10 other cases still under investigation in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • another case in Lakewood, New Jersey, bringing the case count in that outbreak to 4, with further exposures between October 25 to 31
  • 5 new cases in the Rockland County, New York outbreak, bringing the case count to 52 confirmed cases, with more cases still under investigation in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • 2 cases in Michigan, after 2 residents of Oakland County arrived at Detroit Metro Airport with measles, exposing others on October 23
  • 2 more cases in Lakewood, New Jersey, bringing the case count in that outbreak to 6, with 7 more suspected cases and further exposures between October 28 and November 1
  • 3 more cases in Spartanburg County, South Carolina, bringing the case count in that outbreak to 6, with further exposures in Duncan (Oct 26), Spartanburg (Oct 27), and Greer (Oct 28)
  • a case in Lowell, Massachusetts, a pediatric patient who was at Lowell Community Health Center and may have exposed others in the main lobby, pediatric waiting room, pharmacy, or lab (Nov 8)
  • 16 new cases in the Rockland County, New York outbreak, bringing the case count to 68 confirmed cases, with 11 more cases still under investigation in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • 5 more cases in Lakewood, New Jersey, bringing the case count in that outbreak to 11, with 7 more suspected cases
  • 6 new cases in the Rockland County, New York outbreak, bringing the case count to 72 confirmed cases, with more cases still under investigation in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • another case in Lakewood, New Jersey, bringing the case count in that outbreak to 12, with 11 more cases under investigation and more exposures between Oct. 25 and Nov. 7
  • 7 new cases in Brooklyn, New York, bringing the case count in that outbreak to 24 children in Williamsburg and Borough Park
  • a second case in Lowell, Massachusetts, with exposures in Chelmsford (Nov 11), Lowell Community Health Center (Nov 15), and Tewksbury (Nov 15)
  • 2 more cases in Lakewood, New Jersey, bringing the case count in that outbreak to 14, with 10 more cases under investigation
  • 3 new cases in the Rockland County, New York outbreak, bringing the case count to 75 confirmed cases, with 6 more cases still under investigation in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • an infant in Orange County, New York, and the case may be connected to the Rockland outbreak
  • a new case in Lakewood, New Jersey, bringing the case count in that outbreak to 15, with an additional 17 potential cases under investigation
  • 3 cases in Passaic County, New Jersey, with links to Lakewood
  • 1 new case in the Rockland County, New York outbreak, bringing the case count to 77 confirmed cases in the ongoing outbreak in New Square, Spring Valley, and Monsey
  • new case counts in ongoing outbreaks are 29 in Brooklyn (up 5) and 80 in Rockland (up 3)
  • 3 more cases in Rockland County, New York reported today, with exposures in Spring Valley (Nov 22 and 24) and Nyack (Nov 24), bringing the case count to 83
  • 3 new cases in Lakewood, New Jersey (18 total), and 5 new cases in Brooklyn (34 total)
  • 5 new measles cases in Rockland (total of 88)
  • 5 new measles cases in Brooklyn (total 39) and 1 in Rockland County (total of 89)
  • 2 new measles cases in Rockland County (91 total)
  • 4 unvaccinated children in Sarasota County, Florida – no source or exposures sites reported.
  • 3 new cases in Brooklyn (total 42) and 1 new case in Lakewood, New Jersey (19 total)
  • a case in Erie County, New York, with exposures in Buffalo, Amherst, and Willimsville (December 4-10)
  • 5 new cases in Orange County, New York, which is right next to Rockland County, including two children who attend local schools.
  • 4 new cases in Rockland County (95 total)
  • 8 new cases in Brooklyn (50 total) and 1 new case in Orange County, New York (6 total)
  • 1 new case in Rockland County, New York (96 total) and 5 more in Ocean County/Lakewood, New Jersey (24 total), with an additional 10 cases under investigation
  • 7 more cases in Ocean County/Lakewood, New Jersey (33 total)
  • 2 new cases in Brooklyn (52 total)
  • a previously vaccinated adult from Clark County, Nevada who traveled out of the country and returned with measles, exposing others in Las Vegas (Dec 13-17)
  • an international traveler from Brussels who exposed people to measles when they arrived in Terminal B at Newark Liberty International Airport (Dec 24)
  • an unvaccinated toddler in Monroe County, New York
  • a child who had traveled to Clark County, Washington from out of the country and who exposed others at the PeaceHealth Urgent Care in Memorial on December 31.
  • a case in Malibu, California (Dec 29)

What kind of measles year will 2019 turn out to be? Unfortunately, it already looks like it will be a record year…

These outbreaks are a great reminder to review the special vaccine travel requirements, including that adults who “plan to travel internationally should receive 2 doses of MMR at least 28 days apart,” that infants traveling abroad can get their first dose of MMR as early as age 6 to 11 months, with a repeat dose at age 12 months, and that “children aged who are greater than or equal to 12 months need 2 doses of MMR vaccine before traveling overseas,” even if they aren’t four to six years old yet.

Get Educated. Get Vaccinated. Stop the Outbreaks.

For More Information On Measles Outbreaks:

Updated on February 6, 2019

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