Dr. Marc Siegel: Protect against measles with safe and effective MMR vaccine

Measles continues to spread in the U.S. It has already infected 695 people in 22 states so far this year – the highest number in 19 years, the Centers for Disease Control and Prevention reports.

This is a serious disease that should not be increasing in our country. The very safe and highly effective MMR vaccine – which protects against measles, mumps and rubella – eliminated domestic cases of measles in the U.S. in 2000.

Most of the U.S. measles cases this year are in pockets of New York (Williamsburg in Brooklyn and Rockland County) and in Washington state. The disease was brought there by travelers arriving from other countries and spread primarily among unvaccinated people.

DR. MARC SIEGEL: MEASLES – AND VACCINE NON-COMPLIANCE – MEETS PUBLIC HEALTH

Anti-vaccine activists – known as anti-vaxxers – are fueling the problem by spreading the myth that vaccines are unsafe and may cause autism. In fact, several large studies have disproven this false claim. It is measles itself that is unsafe.

Parents who think they are protecting their children by denying them the MMR vaccine, no matter how well-intentioned they are, are in reality endangering the health of their sons and daughters as well as those around them.

I had all the common childhood illnesses – including mumps, German measles (rubella) and measles. I remember looking forward to time off from school, without realizing how potentially dangerous these diseases are.

In fact, according to the CDC, one out for four cases of measles lead to hospitalization, and common problems include pneumonia and hearing loss.

Parents who think they are protecting their children by denying them the MMR vaccine, no matter how well-intentioned they are, are in reality endangering the health of their sons and daughters as well as those around them.

Rare complications – one in every 1,000 cases – include brain swelling, and if you have that problem you may never fully recover. On average, one or two out of every 1,000 people who get measles die of the disease.

This is why the MMR vaccine was such a hugely important life-saving invention, both here and around the world. The measles vaccine was developed in 1963 and was integrated into the MMR vaccine in 1971.

By 1989, two shots were recommended before the age of 5 to achieve a 97 percent effectiveness against measles. When domestic cases of measles disappeared in 2000 the achievement was a great victory for U.S. public health.

But though measles was stamped out in the U.S., it continued to occur commonly in other parts of the world – especially Africa, Asia and the Middle East – where vaccines are not as available or compliance is lower.

Still, the World Health Organization estimates that between 2000 and 2017, measles vaccines prevented 21 million people from getting the disease.

But even with this great success, in 2017 measles still killed 110,000 people around the world. Unfortunately, the problem now seems to be getting worse again.

In the first three months of this year, WHO reports three times the number of measles cases as at this time last year.

What’s particularly problematic is that measles is wildly contagious. You have a 90 percent chance of getting the diseases if you are not immunized and are even in the same room as someone with measles.

This means that once someone who has contracted measles in another country brings it to an American neighborhood where far more than 5 percent of the people are not vaccinated, the disease can spread quickly.

Those with compromised immune systems – including cancer patients receiving chemotherapy – may not be able to fight off measles even if they received the vaccine. Infants too young to get the MMR vaccine are at risk of these diseases. Women cannot receive the MMR vaccine while pregnant and must make sure to have been immunized before.

What should you do?

The first thing you can do is cooperate with health authorities in your area if they are trying to trace and isolate patients with measles or those who have come in contact with them.

This is particularly important when you consider that the telltale angry red measles rash is absent for the first four days a measles patient is contagious and for four days more after the rash has disappeared.

Second, you can support legislation that makes it much harder to get an exemption from being immunized against measles, mumps and rubella. In Washington state, a bill is about to be passed that gets rid of personal exemptions entirely, if not for medical or religious reasons.

Of course, religious exemptions are frequently overblown. Most religions are not anti-vaccine, though the propaganda-wielding anti-vaxxers who attach themselves to religions make false claims about religious prohibitions.

The potential law that is currently being protested by anti-vaxxers in Los Angeles appeals to me. It takes the final word out of the hands of individual physicians and gives the state the right to decide on exemptions from the MMR vaccine.

In Philadelphia, the school district prohibits school nurses from barring unvaccinated children from attending school. Philadelphia has had a recent outbreak of mumps, but not measles so far.

New York University Professor of Bioethics Arthur Caplan said to me: “Nurses must have the authority to protect vulnerable kids at school. Sending home the unvaccinated is public health 101. Parents who care about their kids should insist that this be done.”

I couldn’t agree more.

Here’s the bottom line: We all have to make sure that we and our children are immune to measles. If you were born before 1957 the chances are very high that you had measles and developed a lifetime immunity.

But if you are traveling to a region where measles is widespread, including now parts of the U.S., I recommend getting a blood test to make sure. I am especially concerned about those of you who received the MMR vaccine before 1989, when two shots became standard and the effectiveness rose to 97 percent.

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For those born between 1957 and 1989 there are reasons for me to make sure you are immune, either because you were born when only one MMR shot was standard (between 1971 and 1989) or because you joined the world when one of the brand new measles shots commonly given wasn’t effective at preventing measles (between 1963 and 1967).

When in doubt, vaccinate. I recommend giving the younger baby boomers and Gen Xers an MMR booster if immunity can’t be proven. They have nothing to lose by it, and the young infant or elderly cancer patient in the house have a lot to gain.

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