The Centers for Disease Control and Prevention (CDC) monitors measles cases and outbreaks in the U.S. While vaccination rates overall remain strong, there can be pockets of low community vaccination coverage due to vaccine hesitancy, high population density, the closed social nature of some affected communities, and repeated introduction of measles from unvaccinated international travelers. These factors can contribute to communities becoming vulnerable to measles.
A recent WHO report indicates that measles vaccination coverage has steadily declined since the beginning of the COVID-19 pandemic, creating a greater risk for outbreaks.
CDC encourages clinicians to make sure that all their patients, including children, teens, and adults, are up-to-date on MMR vaccinations and other recommended vaccines. CDC recommends that children receive two doses of measles-mumps-rubella (MMR) vaccine with the first dose between 12 and 15 months of age, and the second dose between 4 and 6 years of age.
Healthcare providers should also be vigilant about identifying and reporting suspected measles cases. This quick-diagnosis guide from the CDC can help.
Be prepared to talk with your patients and reassure them that the benefits of measles immunization outweigh any adverse effects associated with the measles-mumps-rubella (MMR) vaccine.
The routine recommendation for the MMR vaccine starts at age 12 months. However, infants can get the vaccine as early as 6 months old if they are traveling outside of the United States. Many people may not be aware of the alternative vaccination schedules recommended when traveling abroad, so it’s often up to you, the clinicians, as well as your staff, to ask parents with small children if they may be traveling.
Each year, the American Academy of Family Physicians (AAFP) and the Advisory Committee on Immunization Practices (ACIP) collaborate to develop recommendations for the routine use of vaccines in children, adolescents, and adults. Some parents may consider refusing or delaying vaccinations because they are concerned about the number of vaccines given in a child’s first two years of life. Encourage your patients to follow the recommended immunization schedules, which are based on the best available data and designed to maximize benefit and minimize risk.
Parents cite concerns about fever, seizure, and autism as reasons for refusing the MMR vaccine. Reassure your patients that getting the MMR vaccine is much safer than getting measles. Although some people may experience mild temporary adverse effects such as burning or stinging at the site of the shot, fever, or rash, it is important to emphasize that most people who get the vaccine have no problems with it. Severe adverse effects of the MMR vaccine — such as immunization-related seizures — are rare.
One dose of MMR vaccine is approximately 93% effective at preventing measles; two doses are approximately 97% effective. Almost everyone who does not respond to the measles component of the first dose of MMR vaccine at age 12 months or older will respond to the second dose. Therefore, the second dose of MMR is administered to address primary vaccine failure.
You can address patients’ concerns about autism by emphasizing that there is no reputable scientific evidence of a causal relationship between the MMR vaccine and autism. The single study that purported to show a connection between the MMR vaccine and autism has been discredited and retracted. If patients are concerned about vaccine ingredients, let them know that the MMR vaccine does not — and never did — contain the mercury-based preservative thimerosal.