Fortunately, most of us can feel confident that we do have measles immunity and that we won’t get caught up in any of the ongoing outbreaks.
Because we are vaccinated and protected!
If you haven’t had two doses of MMR (or any measles containing vaccine since 1967), then understand that two doses is your best protection against measles.
Is There a Blood Test for Measles Immunity?
What about titer tests?
While there is a blood or titer test for measles immunity, it isn’t routinely used.
The one situation in which a measles titer test might be useful though, is for those born before 1957 to confirm that they really had measles.
For others considering a titer test in place of vaccination, it is typically better to just get another dose of MMR, but only if you haven’t already had two doses.
Why Was My Measles Titer Negative?
A positive measles titer does mean that you are immune, but what about a negative measles titer?
“For HCP who have 2 documented doses of MMR vaccine or other acceptable evidence of immunity to measles, serologic testing for immunity is not recommended. 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. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.”
Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
If you have had two doses of MMR and have a negative measles titer, you don’t need another dose of MMR. You are likely immune, even with that negative titer.
“Most vaccinated persons who appear to lose antibody show an anamnestic immune response upon revaccination, indicating that they are probably still immune.”
Epidemiology and Prevention of Vaccine-Preventable Diseases
And since you would need a second dose if you had a negative titer after having just one shot, you might as well just get the second dose instead of checking your titer.
It’s a common anti-vaccine myth that we rename diseases to make them go away. It helps them explain the control, elimination, and eradication of diseases, since many of them don’t believe that vaccines actually work.
Now imagine that “they” actually found evidence that we did rename vaccine-preventable diseases!
That would be something, wouldn’t it…
Did CNN Rename Mumps?
Of course, they haven’t.
The original CNN story about the USS Fort McHenry stated that the sailors and Marines had parotitis, which was “due to an outbreak of a viral infection similar to mumps.”
Why didn’t they just say that they had mumps?
Because that’s not what they were told by the US Navy’s Fifth Fleet.
“… a military medical team specializing in preventative medical care is expected to deploy in the coming days to make an assessment if further steps may be needed, according to the official.”
US warship quarantined at sea due to virus outbreak
It may come as a surprise to some people, but many viruses and bacteria can cause parotitis. And until the outbreak was further investigated, they didn’t know if it really was mumps or another condition.
Since then, the Navy’s Bureau of Medicine and Surgery (BUMED) has stated that “based on clinical presentation and laboratory testing, these cases are currently classified as probable cases of mumps.”
Still, a very small percentage of the sailors and Marines on board have gotten mumps. That’s because vaccines work, even when they don’t work perfectly well.
“Beginning in 1991, the military services implemented universal recruit immunization with a single dose of MMR vaccine, regardless of prior vaccination history. Shortly thereafter, and informed by the results of population serosurveys, the Air Force transitioned to a policy of targeted MMR vaccination, limiting the administration of MMR vaccine to recruits lacking serologic evidence of immunity to measles or rubella. With recent outbreaks of mumps, concerns have arisen that the practice of not specifically screening for mumps immunity in determining the need for MMR vaccine could lead to a relative increase in mumps risk among military recruits subject to screening. “
Eick et al on Incidence of mumps and immunity to measles, mumps and rubella among US military recruits, 2000–2004
Unlike measles, the MMR vaccine provides good, but not great protection against mumps.
And although military recruits are screened to see if they have low titers for measles and rubella, they still aren’t screened for mumps. The theory is that if their measles and rubella titers are low, then their mumps titer will be low too and they will get an MMR vaccine. Of course, this misses some who just have a low mumps titer, possibly an effect of waning immunity.
Mumps on the USS Fort McHenry
And that’s why we have been seeing mumps outbreaks on college campuses and most recently, on a Navy ship, although that isn’t a reason for everyone to go out and check their titers.
In the pre-vaccine era, although mumps was supposed to be a common childhood illness, about 1/3 to 1/2 of military recruits had never had mumps.
That meant big outbreaks of mumps that were hard to control, unlike what we see today.
“This article reports a recent public health response to 3 imported mumps cases occurring at Fort Campbell, Kentucky, that resulted in a contact investigation for 109 close contacts across varied settings. No secondary mumps cases were identified.”
Public Health Response to Imported Mumps Cases – Fort Campbell, Kentucky, 2018
Instead, not only do fewer people get sick during mumps outbreaks these days, but fortunately, they have fewer complications.
In addition to a swollen jaw, mumps is known to cause orchitis, aseptic meningitis, oophoritis, pancreatitis, and encephalitis.
“Risk was reduced for hospitalization, mumps orchitis and mumps meningitis when patient had received 1 dose of measles, mumps, and rubella vaccine. The protective effect of vaccination on disease severity is critical in assessing the total effects of current and future mumps control strategies.”
Young et al on Mumps Complications and Effects of Mumps Vaccination, England and Wales, 2002–2006
Fortunately, those complications are reduced when you get vaccinated. And so are your risks of actually getting mumps in the first place!
“This study demonstrates a significant preventive effect of two-dose vaccination against mumps complications (orchitis, meningitis, or encephalitis) and hospitalization for mumps.”
Orlíkováet al on Protective effect of vaccination against mumps complications, Czech Republic, 2007-2012.
Getting something posted in a medical journal is a big deal?
Getting something posted in The BMJ? Not so much…
Why Does the BMJ Post Anti-Vaccine Propaganda?
Oh, I’m sure it used to be, as they are one of the world’s oldest general medical journals, going back to 1840.
“Reader feedback online is actively encouraged in the form of Rapid Responses were introduced in 1998, and 20 years later, had generated 115,000 fully-moderated responses.”
History of The BMJ
The thing is, they allow just about anyone to post these Rapid Responses, without making it very clear that they aren’t in a peer reviewed section of the journal.
What’s wrong with this Rapid Response?
The Federal government isn’t issuing any kind of quarantine in this matter, the county is, so why would it be an issue as to whether or not measles is subject to Federal isolation and quarantine law? Anyway, while there are few diseases on the list that are subject to Federal isolation and quarantine law (they do include cholera, diphtheria, plague, smallpox, Ebola, and pandemic flu, etc.) measles could be added by a Presidential Executive Order. Still, the authority to issue Federal Quarantines has rarely been used. Quarantines for measles is usually handled by states and local governments.
Supposed to be protected anyway??? There are plenty of infants, children, and adults who simply can’t be directly protected by a vaccine. They are too young to be vaccinated, can’t be vaccinated because they have true medical contraindications, or could be among the very small minority for whom their vaccine wasn’t effective. They are at risk when your intentionally unvaccinated child gets measles.
The vaccination rates for everyone in the Rockland outbreak is posted and is updated weekly. Only 3.8% of the folks in the outbreak are fully vaccinated.
Since almost all of the folks in the outbreak are unvaccinated, that kind of busts John Stone’s last point – the Rockland measles outbreak has been caused by waning immunity and a failed vaccine. It is simply a failure of folks to vaccinate and protect their kids.
I get that The BMJ wants their “users to debate issues raised in articles published on bmj.com,” but they are simply contributing to the false balance we see in many other places if they want to allow folks to think there is a debate going on about the safety or necessity of vaccines.