• Measles Vaccine

    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.

    Talk to Your Patients About Vaccination

    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.

    • Approximately 9 of 10 susceptible persons with close contact with a measles patient will develop measles.
    • Approximately 30% of patients who have measles develop one or more complications.
    • More than 95% of individuals who receive a single dose of MMR will develop immunity to all 3 viruses (measles, mumps, and rubella).

    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.

    MMR Vaccine Safety

    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.

    Why the MMR Vaccine Is Important

    • Measles is highly contagious and spreads quickly. Approximately 9 of 10 of susceptible individuals who are exposed to the measles virus will develop the disease.
    • Most cases of measles in the United States are brought back and spread throughout communities by unvaccinated travelers returning from countries where measles is more common.
    • Approximately 30% of patients who have measles develop one or more complications. Common complications from measles include diarrhea, otitis media, and pneumonia, which is the most common cause of associated death.
    • Complications are more common among children younger than age 5 years and adults older than age 20 years.
    • Most cases of measles occur in individuals who have not received the MMR vaccine.
    • More than 95% of individuals who receive a single dose of MMR will develop immunity to all 3 viruses (measles, mumps, and rubella). A second dose gives immunity to almost all individuals who did not respond to the first dose.
    • Providing the MMR vaccine to a critical portion of the population helps protect other members of the community who are not eligible for the vaccine—such as infants or immunocompromised individuals—because the spread of contagious disease is contained.