February - The Importance of Measles Vaccination
Beverly Miller, MHA, MBA, Acting Area Director
Indian Health Service California Area Office
In our recent December message we presented the issue of vaccine hesitancy and its public health implications. We illustrated the importance of this concept as it relates to measles: “According to the Centers for Disease Control and Prevention (CDC), “Measles is a dangerous disease because it can lead to pneumonia, cause lifelong brain damage or deafness, and, in about one-third of the cases of measles around the world, death.” The potential importance of these statements recently became quite apparent to us living in California when we began to experience a measles outbreak in our beautiful state.
As is commonly known, it is currently felt that this highly infectious disease began to spread in Disneyland. California health officials had confirmed 79 cases in the state as of the morning of 1/29/15. Fifty-two of these were linked to the Disneyland outbreak. Concurrently, national public health officials reported that more than 600 measles cases were documented in 2014, “a significant spike over recent years.” This current scenario is beginning to impact our schools in many instances, impairing our ability to educate our children. For example, in Riverside County, four cases have been confirmed as of January 29th. As a result, the Desert Sands Unified School District informed 66 students they could no longer attend school as they were not able to verify they had received a measles vaccination.
As far as public health officials are concerned, our needed response to this circumstance is obvious for our youth – vaccinate infants and children who have not been vaccinated. However, we must also consider the needs of our adult population as well. This presents a slightly more complex scenario. Numerous variables need to be considered in making the important decision about the need for measles vaccination in adults. Fortunately, public health officials have created some frameworks we can use that enable us to make these important decisions effectively. The current recommendations from the CDC are noted below:
When should adults get the MMR vaccine?
The CDC says most adults born in 1957 or later should get at least one dose of the MMR vaccine. Because of the risk of birth defects, all women of childbearing age should have the MMR vaccine unless they're pregnant or have proof of immunity, or proof of already being vaccinated for rubella.
The CDC says adults at greater risk of measles or mumps should get two doses of MMR vaccine, the second one 4 weeks after the first. This includes adults who:
- Have been exposed to measles or mumps or live in an area where an outbreak has happened
- Are students in colleges or trade schools
- Travel internationally
- Work in health care
For measles, the CDC advises a second dose for adults who:
- Were previously given a vaccine made with "killed" measles (instead of the live-type of vaccine used today)
- Were given an MMR vaccine between 1963 and 1967, but there's no record of what type.
Exceptions: Who does not need the MMR vaccine?
Adults don't need the MMR vaccine if:
- They have proof of vaccination already.
- They have proof that they've already had measles or mumps and rubella.
Who should not have the MMR vaccine?
Adults who should not have the MMR vaccine include people in these groups:
Pregnancy. Pregnant women should not get the MMR vaccine due to risks to the baby. Women who get the MMR vaccine should wait 4 weeks before getting pregnant.
Medical conditions. Adults should talk with their doctor if they:
- Have HIV
- Have any other immune system disorder
- Have cancer or are being given cancer drugs or X-rays
- Are taking steroids or other drugs that affect the immune system
- Have had a low platelet count (a blood disorder)
- Have had a blood transfusion or took blood products
- Have a moderate or severe illness
You will note there is one key section in the above CDC recommendations – Medical Conditions - where the need for vaccination is not immediately clear and consultation with a doctor is recommended. Thus, if you have one or more of the conditions noted in this section, please consult with your physician.
Finally, if you have children or grandchildren, please carefully consider the serious consequences associated with this highly infectious, often lethal disease and make every effort to ensure your young, loved ones are protected by receiving the measles vaccine. Life is precious. Cherish it today by encouraging vaccination for measles and all other diseases that can be prevented by vaccination.