Tag: measles myths

Is Measles Dangerous If You Are Pregnant?

While folks often try and make it seem like measles is a common childhood illness, we know that it can be dangerous.

“One of the patients was a 20-year-old pregnant woman who had rash onset on January 5 following exposure to her 12-year-old brother. After delivering a healthy baby on January 6, the mother developed severe pneumonia that was followed by respiratory arrest. She was resuscitated and transferred to an intensive care unit in a larger hospital nearby in Tennessee.”

Epidemiologic Notes and Reports Transmission of Measles Across State Lines — Kentucky, New Hampshire, Tennessee, Virginia

Rarely do people who have really had measles describe it as just a fever and a rash. They remember that it was called a harmless killer for a reason.

Is Measles Dangerous If You Are Pregnant?

And there are some situations in which measles can be especially dangerous, including if you get sick when you are very young, very old, or have immune system problems.

Pregnant women should be screened for measles immunity.
Pregnant women should be screened for measles immunity.

And what if you are pregnant when you get measles?

“The Health Department announced today that the number of measles cases has grown to 390, including two pregnant women diagnosed with the infection, one diagnosed in mid-April.”

The Number of Measles Cases Grows to 390

If you are pregnant and you are exposed to someone with measles, you can get IVIG post-exposure prophylaxis to prevent you from actually getting measles, but this typically only works if given within six days of the exposure.

“To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, studies suggest that measles infection is associated with an increased risk for miscarriage, stillbirth, prematurity and the baby being born with a measles infection.”

When Measles Strike, It’s Not The Happiest Place On Earth For Pregnant Women

Unlike a rubella infection during pregnancy, a measles infection is not thought to cause birth defects. Tragically, it can, like rubella, lead to an increased risk for having a miscarriage.

“Infants who develop congenital measles are at increased risk for mortality and for subacute sclerosing panencephalitis, which is more common when measles is diagnosed in infancy. In addition, subacute sclerosing panencephalitis in newborns infected with measles either congenitally or shortly after birth appears to be more severe, with a shorter latency and rapidly progressive course.”

What Obstetric Health Care Providers Need to Know About Measles and Pregnancy

And if the mother gets measles very late in her pregnancy, it can also lead to a case of congenital measles, or a baby being born with an active measles infection.

“In 52% of cases, measles was likely acquired from a relative. Complications included pneumonia in one child; two pregnant women required hospitalization, including one who miscarried.”

Notes from the Field: Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013

Don’t take the risk that you might get measles while you are pregnant.

Make sure you are vaccinated and protected before you ever start thinking about getting pregnant, as pregnancy is a contraindication to getting the MMR vaccine. And you should wait at least 4 weeks after getting vaccinated before getting pregnant.

More on Measles in Pregnancy

Is the MMR Safe for 6-Month-Old Babies?

Most parents understand that the first dose of the MMR vaccine is routinely given to children when they are 12 to 15 months old, at least in the United States.

In some other countries, the first dose is routinely given as early as 8 to 9-months of age.

And in high-risk situations, the MMR can safely be given to infants as early as age 6-months.

Is the MMR Safe for 6 Month Old Babies?

An early MMR, is that safe?

This type of pure anti-vaccine propaganda is what caused the measles outbreaks in New York in the first place...
This type of pure anti-vaccine propaganda is what caused the measles outbreaks in New York in the first place…

Yes, it is safe.

What about the package insert?

“Local health authorities may recommend measles vaccination of infants between 6 to 12 months of age in outbreak situations. This population may fail to respond to the components of the vaccine. Safety and effectiveness of mumps and rubella vaccine in infants less than 12 months of age have not been established. The younger the infant, the lower the likelihood of seroconversion (see CLINICAL PHARMACOLOGY). Such infants should receive a second dose of M-M-R II between 12 to 15 months of age followed by revaccination at elementary school entry.”

MMR II Package Insert

The package insert says to give infants who get an early dose another dose when they are 12 to 15 months old! It doesn’t say to not protect these babies!

But what about the idea that the safety and effectiveness of MMR hasn’t been proven for infants under 12 months of age?

In general, the package insert is only going to list studies that the manufacturer used to get FDA approval for their vaccine. Since it is an off-label recommendation of the ACIP, they would not include the studies that show that an early MMR is safe and effective.

“In conclusion, this study indicated that the MMR was well tolerated and immunogenic against measles, mumps and rubella with schedule of first dose both at 8 months and 12 months age. Our findings strongly supported that two doses of MMR can be introduced by replacing the first dose of MR in current EPI with MMR at 8 months age and the second dose at 18 months in China.”

He et al on Similar immunogenicity of measles-mumps-rubella (MMR) vaccine administrated at 8 months versus 12 months age in children.

Before 8 months, an early MMR isn’t likely to be as effective as giving it later. That’s because some maternal antibodies might linger in a baby’s system and can interfere with the vaccine working, even after six months. How many antibodies and how much interference?

It’s almost impossible to tell for any one child, but the risk that this maternal protection has begun to wear off and these infants are at risk to develop measles is too great. That’s the reason that they get an early MMR, even though we know it won’t be as effective as a dose given later and we know it will have to be repeated.

Is this early dose safe?

“This review did not identify any major safety concerns. These findings may facilitate discussions about the risks and benefits of vaccinating infants who are potentially exposed to this life-threatening disease.”

Woo et al on Adverse Events After MMR or MMRV Vaccine in Infants Under Nine Months Old

Of course! Although the complications of measles can be serious, even deadly, we aren’t going to recommend something that is even worse.

“Early MMR vaccination is well tolerated, with the lowest AE frequencies found in infants aged 6-8 months. It is a safe intervention for protecting young infants against measles.”

van der Maas et al on Tolerability of Early Measles-Mumps-Rubella Vaccination in Infants Aged 6-14 Months During a Measles Outbreak in The Netherlands in 2013-2014.

So an early MMR is safe, with few risks, and is likely effective at preventing measles.

And by now you know what’s not safe. That’s right, getting measles.

More on Early MMR Vaccines

Fact Checking Brian Hooker’s Statement to WA Legislators

Anti-vaccine folks brought out a lot of their big guns to a Washington State House Health Committee meeting about personal belief exemptions.

Brian Hooker makes a lot of statements about measles that mirror anti-vaccine talking points.

What was the meeting about?

A bill was introduced in the Washington Legislature that would limit non-medical vaccine exemptions by removing a philosophical or personal objection for the MMR vaccine.

Fact Checking Brian Hooker’s Statement to WA Legislators

Showing up to oppose the bill were Robert F. Kennedy Jr., Toni Bark, and Brian Hooker, none of which helped their side.

Why not?

Let’s see what Hooker said?

“There is a problem with measles in Washington State, but it’s not low vaccination rates, it’s actually high vaccination rates with a vaccine product unable to provide lifetime immunity or vigorous passive maternal protection to infants during the first year of life.”

Brian Hooker

Of course!

Unvaccinated kids are getting measles because we are vaccinating too many people. Why haven’t we noticed this before?

“When the measles vaccine was first introduced, most people over the age of 15 who had wild measles had lifetime immunity. In developed nations, like other communicable infections, measles was no longer dangerous except in rare circumstances because of inadequate nutrition, poor sanitation, and / or lack of healthcare.”

Brian Hooker

It is scary that Hooker makes statements like this, considering that he is an Associate Professor of Biology at Simpson University in Redding, California, where he specializes in chemistry and biology coursework.

When measles was killing kids in the 1950s in the United States, we had good nutrition, sanitation, and access to healthcare.

What was missing?

A measles vaccine!

“Because having the measles was a routine part of childhood, teens, adults, parents, and grandparents were immune. And because of maternal passive immunity, infants were protected.”

Brian Hooker

Yes, measles was once considered a rite of passage, but only because it had to be endured, as there was no way to avoid it. And you had to get sick and survive having measles to earn your lifetime immunity.

Tragically, not everyone did.

“But in fact, if the mothers of the children had wild measles when they were children and they are nursing, the babies may be protected. If the mothers were vaccinated, even if they are nursing, they may not be. Additionally, maternal antibodies transported across the placenta can provide vital immunity against measles for infants.”

Brian Hooker

While it is true that passive immunity from a mother who had a natural infection likely lasts longer than one who had vaccine induced immunity, it isn’t that much longer. At 6 months, few infants still have antibodies against measles, whether their mothers were vaccinated or had naturally acquired immunity. And it has nothing to do with nursing.

“As the editor of the journal Vaccine Dr. Gregory Poland of The Mayo Clinic stated in 1994, “…as measles immunization rates rise to high levels in a population, measles becomes a disease of immunized persons.”

Brian Hooker

Quoting Gregory Poland didn’t go so well for Toni Bark when she tried it at a Minnesota Senate hearing.

“But he also said that sometimes people who oppose the vaccines will pick out one sentence in the scientific study and extrapolate it to mean things that it does not mean… He said that measles is the most contagious disease that we know, and yet we found that fear and ignorance is more so.”

Senator Carla Nelson on The Anti-vaxxers Might Wish that What was Lost had not been Found

It makes you wonder why these folks are still quoting Poland.

“It was reported in the news and provided to legislators that in Clark County, WA there is a 22% exemption rate, but this is based on the voluntary Immunization Information Survey (IIS) which does not accurately reflect the vaccination status of all children enrolled in Washington schools. When compared to the more accurate CDC statistics for the state of Washington for MMR coverage among 19 to 35 month olds, it is 95.3% +/- 2.6%. The IIS erroneously reports this number at 81.8% and cannot be relied upon.”

Brian Hooker

These folks realize that the outbreaks aren’t occurring in the entire state of Washington, right? They are in very specific schools and communities where we do find very high levels of non-medical vaccine exemptions. These are the clusters of intentionally unvaccinated children experts have been warning about, the pockets of susceptibles.

“As I have already remarked, vaccination does not guarantee immunization and infectious diseases routinely break out in highly vaccinated communities. An example of this is pertussis outbreaks, which occur due to problems with the acellular pertussis portion of the DTaP and Tdap vaccine, creating asymptomatic carriers.”

Brian Hooker

Vaccination does not guarantee immunization?

I guess that is a way to say that vaccines aren’t 100% effective, but that is hardly an effective argument against getting vaccinated. Being intentionally unvaccinated often guarantees that you will get sick in an outbreak. Remember, even in outbreaks of pertussis and mumps, when waning immunity can be a concern, that attack rate is much higher in those who are unvaccinated.

“Over the past ten years in the U.S., there has been one reported death from the measles, and it is unclear based on the medical history of the patient whether and how measles played a role in their death. During the same time period (based on Vaccine Adverse Event Reporting System (VAERS) reports), there have been 105 reported deaths associated with the MMR or MMRV vaccinations.”

Brian Hooker

There have actually been seven measles deaths in the United States in the past 10 years, although only one was verified by the CDC.

Still, if Hooker is going to push unverified vaccine deaths in VAERS, why wouldn’t he also look at the reports of deaths from measles in the CDC Wonder database? And the 9 additional SSPE deaths?

And to doubt that measles actually killed a woman who got caught up in the 2015 measles outbreaks in Washington? What’s wrong with the modern anti-vaccine movement?!?

“You must not only protect those who are susceptible to poor infection outcome, but protect those who are susceptible to poor vaccination outcome, and to consider the unintended consequences of a fully vaccinated population that does not have lifetime immunity.”

Brian Hooker

It is becoming ever more clear that we must protect ourselves from these folks who push anti-vaccine propaganda and scare parents away from vaccinating and protecting their kids.

What does Hooker intend to do to “protect those who are susceptible to poor infection outcome?” How does he propose that everyone get lifetime immunity if they don’t get vaccinated?

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Anti-vaccine folks have already done such a good job scaring parents that too many of them are abusing vaccine exemptions. That’s why we are having more outbreaks, especially with the global rise in measles, and why states are having to tighten their vaccine laws.

More on Fact Checking Brian Hooker’s Statement to WA Legislators

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

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

Dr. Bob Sears, who actually wrote a book about vaccines, seems to think that he and his podcasting sidekick have put the nail in the coffin “of trying to use the herd immunity argument to justify coerced vaccinated.”

Dr. Bob seems to think that herd immunity doesn't apply to vaccines.

The meme he shared even includes the hashtag stating that herd immunity doesn’t apply to vaccines.

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

While arguing against the idea of herd immunity and for coerced vaccination are common among anti-vaccine folks, neither is true.

Herd immunity is real and no-one is going to force anyone to vaccinate their kids. Vaccine mandates do not mean forced vaccination.

What about the idea that “all vaccines wane within about 2-15 years, leaving vaccinated children & adults unprotected?”

If that were true, then wouldn’t everyone who got sick in latest outbreaks be vaccinated? Why are most folks unvaccinated?

So we are either getting a lot of outbreaks because of waning immunity or your titers are getting boosted because you are getting exposed to so much natural disease. Got it?

While waning immunity is an issue for some vaccines, like mumps and pertussis, the primary and secondary failure rates are still not as bad as Dr. Bob suggests, which is why, in an outbreak, the attack rate of disease is always higher among those who are unvaccinated and unprotected.

The numbers don't always add up correctly when anti-vax folks try to do math.
The numbers don’t always add up correctly when anti-vax folks try to do math.

Is herd immunity the main argument that’s made when experts suggest we need stronger vaccine laws? I always thought the main argument is that folks should just vaccinate and protect their kids, but maintaining herd immunity so that your intentionally unvaccinated kids don’t put everyone else at risk is a good reason too.

Does everyone see the problem with Melissa Floyd’s math? This probably won’t be on the SAT, but you still want to get this right…

Like many others are doing right now, she used state level data. Since many of the folks who don’t vaccinate their kids cluster together in the same communities and schools, the “2% of those filing for exemptions” end up making up 10, 20, or even 30% of some school’s student population.

“This means if you are a primary non-responder, you are walking around every day with a false sense of security, clinically unvaccinated for that particular disease.”

Melissa Floyd

This is the whole point of herd immunity!

Because vaccines aren’t 100% effective, we can walk around all day without actually thinking about it much, hoping that we can rely on the fact that most other people are also vaccinated and protected. That keeps disease out of our community or herd.

The system typically breaks down though, not because vaccines aren’t effective enough, but because too many folks don’t get vaccinated.

“A 2011 article in “Vaccines”, edited by Stanley Plotkin, says, “Much of the early theoretical work on herd immunity assumed that vaccines induced solid immunity against infection…” Theoretical… Assumed…”

Melissa Floyd

She should have read the whole article, or at least used the whole quote…

“Much of the early theoretical work on herd immunity assumed that vaccines induce solid immunity against infection and that populations mix at random, consistent with the simple herd immunity threshold for random vaccination of Vc = (1-1/R0), using the symbol Vc for the critical minimum proportion to be vaccinated (assuming 100% vaccine effectiveness). More recent research has addressed the complexities of imperfect immunity, heterogeneous populations, nonrandom vaccination, and freeloaders.”

Herd Immunity: A Rough Guide

It doesn’t say what she thinks it says…

“Indeed, one might argue that herd immunity, in the final analysis, is about protecting society itself.”

Herd Immunity: A Rough Guide

So why haven’t we eradicated measles like we said we would?

“What’s funny is after the measles vaccine was licensed in 1963, the medical community declared a goal of eradicating measles by 1967. But 1967 came and went and it still wasn’t gone, 1977, 1987, 2000… the dates kept getting pushed, and the result was always the same. Meanwhile they continued to increase the hypothesized “herd immunity threshold”, eventually winding up at the extremely high 95% you hear today. “

Melissa Floyd

That’s actually a good question.

What happened to the previous goals of eliminating measles?

“In 1966, the USA began an effort to eradicate the disease within its own borders. After a series of successes and setbacks, in 2000, 34 years after the initial goal was announced, measles was declared no longer to be endemic in the USA.”

Orenstein et al on Eradicating measles: a feasible goal?

Along the way, we have gone from an estimated 100 million cases and 5.8 million deaths in 1980 and an estimated 44 million cases and 1.1 deaths in 1995 to “just” 7 million cases and 89,780 deaths in 2016.

“Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.”

Measles

While there is doubt that we can truly eradicate measles with the current vaccine, we can certainly control and eliminate measles if folks stop listening to anti-vaccine propaganda and they get vaccinated and protected.

More on Dr. Bob and His Herd Immunity Arguments

More Measles Myths

It’s kind of sad that some folks still believe many of the measles myths that were being told in 1963.

Folks once accepted measles as inevitable because they had no choice, but that changed when we got a vaccine.
Measles was long known as a harmless killer

Wait, measles isn’t harmless?

But what about that Brady Bunch episode!?!

More Measles Myths

What other myths about measles have you heard?

Have you heard that folks never worried about measles before we had a vaccine? That it never even made the newspaper?

There were newspaper articles warning about measles in 1959 - a measles year.

The other myths they push are just as easily disproven

Which of these myths do you believe?

Which ones are keeping you from vaccinating and protecting your kids?

More on Measles Myths

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

Some folks just can’t understand why we are having so many measles outbreaks these days.

It is actually really easy to figure out and find the decline in vaccination rates if you really look for it…

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

And it is easy to understand why we are having these measles outbreaks, even though overall vaccination rates in a state might be good.

The problem is the clusters of unvaccinated people in very specific areas of each city, county, and state.

MMR vaccination rates have dropped over the years in Washington (red line) and Clark County (yellow line). Can we thank Andrew Wakefield, Jenny McCarthy, and Bob Sears, etc.?

These pockets of susceptibles put everyone at risk, especially those who are too young to be vaccinated, too young to be fully vaccinated, and those with true medical exemptions who can’t be vaccinated.

Looking at the state and county level rates of MMR vaccination by kindergarten, you can see that a lot more kids haven’t been getting vaccinated since 1990. In fact, while 97.6% of kindergarteners during the 1998-99 school year had their MMR vaccination, it quickly fell to about 90%, where it remains today. In Clark County, where we are currently seeing a large outbreak of measles, the drop was even worse.

Not surprisingly, this mirrors the vaccine exemption rates in these areas.

“What’s so important about all this data is that it destroys the false narrative. Vaccination rates haven’t gone down lately. Period. Ask any epidemiologist you know to run these numbers.”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

Speaking of false narratives, many states now publish school and county level immunization rates, so it is easy to see past anti-vaccine propaganda and see that vaccination rates truly have gone down lately in areas that are dealing with outbreaks.

Immunization rates are very low at the Portland Waldorf School.

The Oregon Health Authority actually publishes annual lists of child, adolescent, and school immunization rates.

“I wanted to make sure and corroborate that data with data from the Oregon Health Authority, which they conveniently don’t publish very often, but someone sent me their data from 2014, showing that 97.1% of 7th graders in Oregon have received an MMR vaccine! Where’s the decline?”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

In 2017, 95.5% of teens in Oregon had received one dose of the MMR vaccine. Only 90% had received the recommended two doses. Rates in Multonah County, near the current outbreak in Washington, were actually a little better, at 96.7% (one dose) and 92% (2 doses).

Still, there are plenty of schools with much lower rates, creating the pockets of susceptibles that are causing these outbreaks.

Where’s the decline?

Have you checked the Portland Waldorf school?

While schools with higher rates help to boost the average rates for the county and state, the schools and communities with low rates are prime for outbreaks.

SchoolMMR Rates
Orchards Elementary School71.4%
Minnehaha Elementary School89.3%
Cornerstone Christian Academy?
Hearthwood Elementary School72.2%
Home Connection86.7%
Homelink River61.1%
Slavic Christian Academy?
Image Elementary School78%
Eisenhower Elementary School89%
Tukes Valley Primary and Middle School​?
Maple Grove School?
Evergreen High School?

In Washington, for example, the schools involved in the outbreak (at least the ones that report) all have immunization rates below the state and county levels.

If you are on the fence about vaccinating your kids, check where you’re getting your information from if what you are hearing is scaring you.

Vaccines are safe, with few risks, and necessary. Get vaccinated and stop the outbreaks.

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?