Tag: measles vaccine

Vaccine Induced Measles

Why are anti-vaccine folks still pushing the idea that vaccine induced measles is a thing?

This study is not about vaccine induced measles.
This study is not about vaccine induced measles.

In yet another example of anti-vaccine folks inappropriately using a real vaccine study, the ironically named Physicians for Informed Consent continues to push the idea that many measles cases are caused by the MMR vaccine.

Vaccine Induced Measles

They aren’t…

The study they are citing, Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR, simply talks about how to “distinguish between measles cases and vaccine reactions.”

“During measles outbreak investigations, rapid detection of measles vaccine reactions is necessary to avoid unnecessary public health interventions.”

Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR

While many of these people do test positive for a vaccine strain, they do not actually have measles. They typically just have a rash and/or fever, with a concern that they might have measles because they are in the middle of a measles outbreak.

But if they have a rash and fever and test positive for measles, even if it is a vaccine strain, why shouldn’t we just say that they have measles?

Because measles isn’t just about having a rash and fever. It is having a specific pattern of a high fever for 3 or 4 days, then developing a rash, and continuing to have a fever. People with measles also typically have other symptoms, including irritability, cough, coryza, and conjunctivitis.

Confirmed Case Counts in Measles Outbreaks

Still, since these measles vaccine reactions can get confused with real measles cases, do they inflate the measles case counts in our outbreaks?

Testing helps to make sure that only real cases of measles are included in outbreak case counts.
Testing helps to make sure that only real cases of measles are included in outbreak case counts.

They don’t.

While we occasionally do see a “confirmed” case later change as further testing is done, it is important to realize that most cases are thoroughly evaluated to see if they are in fact really measles.

Most case counts are made up of confirmed cases and don’t include suspected cases that might be someone who has a rash after their MMR vaccine or some other viral infection.

“Vaccine‐associated measles is a possible, but extremely rare event.”

Sood et al on Vaccine‐associated measles in an immunocompetent child

Anyway, vaccine induced or vaccine associated measles is extremely rare.

What about the fully vaccinated woman in New York who developed measles, getting four other people sick in 2011?

Didn’t she have vaccine induced measles?

Nope.

“This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. “

Rosen et al on Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

She had the D4 strain of measles – not a vaccine strain.

Who Gets Measles?

Most people who get measles are unvaccinated, often intentionally unvaccinated.

Trying to get you to think that many people in an outbreak have a vaccine strain is just another propaganda technique to scare you away from vaccinating and protecting your kids.

Don’t fall for it!

Two doses of MMR are the best protection against measles.

Vaccines are safe, with few risks, and they are obviously necessary.

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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.

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Why Have We Forgotten About the Importance of Vaccination Against Measles?

While most of us know that measles is a serious, life-threatening disease, there are still some folks that want you to think that it is nothing to worry about.

It’s just a rash and fever, right?

The Importance of Vaccination Against Measles

Actually, while most people did recover after having a high fever, irritability, and other symptoms for a week or more, some didn’t. That’s why doctors at the time called it a harmless killer.

In the pre-vaccine era, hospitalizations, tracheotomies, encephalitis, sepsis, death from measles were not rare.
In the pre-vaccine era, hospitalizations, tracheotomies, encephalitis, sepsis, death from measles were not rare.

And why many were looking forward to a vaccine to get measles under control, as measles was a leading killer at the time.

Seymour Musiker calls on pediatricians to take action to get more kids vaccinated against measles.
A call for pediatricians to take action to get kids vaccinated against measles.

While measles vaccination was getting off to a slow start at the time, it should be obvious that there was a big need for these vaccines.

“Thus it is up to each one of us to convince our own segment of the population since this seems to be the only way to do it. And it is up to each one of us to remind our fellow physicians to cover his segment of the population.”

Norman Lewak, MD

Fortunately, everyone did finally take action and while it was a little later than originally planned, we got measles under control.

“Vigorous endorsement and execution of this aim by physicians and responsible health authorities should eliminate measles by 1970, and a suitable motto for the five-year period might well be “Mortus a morbilli.”

Lewis L. Coriell, MD

And the endemic spread of measles was eliminated in the United States in 2000.

Of course, that doesn’t mean that we eliminated or eradicated measles. It simply means that all cases and outbreaks are linked to someone from outside the United States.

Now, as too many people are either scared or have forgotten about the importance of vaccination against measles, cases are rising, continuing to reach new record levels.

So what’s next?

“All we need is one concerted campaign to get every susceptible vaccinated. One death, one brain-damaged child, or even one child who needs hospitalization is one too many.”

Norman Lewak, MD

Let’s get everyone vaccinated and protected.

Vaccines are safe, with few risks, and they are obviously necessary.

Measles is not a mild disease. And it never was.

More on the Importance of Vaccination Against Measles

Everything You Need to Know About the Measles Vaccine

The measles vaccine is one of the most effective vaccines we have.

It is also one of the safest, having very few serious side effects.

Everything You Need to Know About the Measles Vaccine

So why are some parents still afraid to allow their kids to get vaccinated and protected, putting them at risk to get measles, a life-threatening disease?

“Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.”

Cochrane Systematic Review on Vaccines for measles, mumps and rubella in children

Let’s see if you still are after we get all of your questions about the measles vaccine answered…

Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
  1. How long has the measles vaccine been around? The very first measles vaccine was licensed by John Enders in 1963. An improved measles vaccine was developed by Maurice Hilleman and licensed in 1968, and that is the measles vaccine that we still use today, at least in the United States. It was combined into the MMR vaccine in 1971.
  2. How effective is the measles vaccine? A single dose of the measles vaccine is about 93% effective at preventing a measles infection. Two doses (the second dose was added to the routine immunization schedule in 1994) are up to 97% effective. That’s why almost all of the people who get measles in an outbreak are unvaccinated.
  3. How long does immunity from the measles vaccine last? Immunity from the measles vaccine is thought to be life-long. It is important to understand that the second dose isn’t a booster dose, but is instead for those few folks who don’t respond to the first dose.
  4. Who should get the measles vaccine? Everyone without a true medical contraindication should get the measles vaccine (MMR), with the first dose at 12-15 months and a second dose at 4-6 years.
  5. Can my kids get their measles vaccine early? An advanced immunization schedule is available for kids in an outbreak or if they will be traveling out of the country. The first dose can be given as early as age 6-months, but is repeated when the child is 12 months because of concerns of interference with maternal antibodies. The official second dose can be given early too, as early as 4 weeks after the first dose, as long as the child is at least 12 months old.
  6. Do I need a booster dose of the measles vaccine? People who are fully immunized do not need a booster dose of the MMR vaccine, but it is important to understand whether or not you are really fully immunized to see if you need a second dose. Some adults who are not high risk are considered fully vaccinated with only one dose, while others should have two doses. Are you at high risk to get measles? Do you travel, live in an area where there are measles outbreaks, go to college, or work as a health care professional?
  7. Should I check my measles titers? In general, it is not necessary to check your titers for measles. If you haven’t had two doses of the MMR vaccine, then get a second dose. If you have had two doses of the MMR vaccine, then you are considered protected. Keep in mind that there is no recommendation to get a third dose of MMR for measles protection, although it is sometimes recommended for mumps protection during a mumps outbreak.
  8. If my child gets a rash after getting his MMR, does that mean that he has measles? No. This is a common, very mild vaccine reaction and not a sign of measles.
  9. Can the measles vaccine cause seizures? The MMR vaccine can cause febrile seizures. It is important to remember that without other risk factors, kids who develop febrile seizures after a vaccine are at the same small risk for developing epilepsy as other kids. And know that vaccines aren’t the only cause of febrile seizures. Vaccine-preventable diseases can cause both febrile seizures and more serious non-febrile seizures.
  10. Why do people think that that the measles vaccine is associated with autism? It is well known that this idea originated with Andrew Wakefield, but the real question should be why do some people still think that vaccines are associated with autism after so much evidence has said that they aren’t?
  11. What are the risks of the measles vaccine? Like other vaccines, the MMR vaccine has mild risks or side effects, including fever, rash, and soreness at the injection site. Some more moderate reactions that can rarely occur include febrile seizures, joint pain, and a temporary low platelet count. More serious reactions are even rarer, but can include deafness, long-term seizures, coma, or lowered consciousness, brain damage, and life-threatening allergic reactions.
  12. Why are there so many reports of measles vaccine deaths? There are extremely few deaths after vaccines. The reports of measles vaccine deaths you see on the Internet are just reports to VAERS and are not actually reports that have been proven to be caused by a vaccine. As with other vaccines, the risks from having a vaccine-preventable disease are much greater than the risks of the vaccine. The only reason that it might not seem like that now is because far fewer people get measles now than they did in the pre-vaccine era, when about 500 people died with measles each year.
  13. When did they take mercury out of the measles vaccine? Measles vaccines, including the MMR, have never, ever contained mercury or thimerosal.
  14. Why do we still have outbreaks if we have had a measles vaccine since 1963? In the United States, although the endemic spread of measles was declared eliminated in 2000, many cases are still imported from other countries. As measles cases increase around the world, that is translating to an increase in outbreaks here. Even though overall vaccination rates are good, because there are many pockets of susceptible people in areas that don’t vaccinate their kids, they get hit with outbreaks.
  15. Can we eradicate measles? Because measles is so contagious, the vaccine does have failures, and some folks still don’t get vaccinated, there is some doubt that we can eradicate measles without a better vaccine. That doesn’t mean that the current measles vaccines can’t prevent outbreaks though…

Are you ready to get your kids their MMR vaccine so that they are vaccinated and protected against measles, mumps, and rubella?

If not, what other questions do you have?

While you are thinking, here is a question for you – Do know why they used to call measles a harmless killer?

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