Measles

Many parents are calling me to ask about the recent measles outbreak and the measles vaccine. Measles vaccine is given as the MMR vaccine, which combines measles, mumps and rubella protection. Just measles alone is not available as a vaccine. The MMR is well-tested and is safe. It can cause one or two days of fever and rash in about one in six children who receive it, about 1-2 weeks after receiving the vaccine — this does not need treatment and goes away by itself. The rash and fever are not contagious. The vaccine is given at age one year old and again at 4 years old, at the well-visits. If your child had his or her one year old visit and you did not decline a vaccine, then your child has had the MMR vaccine. One shot of MMR makes 93% of the population completely immune to measles for life. Two shots makes 97% of the population completely immune. A blood test after the first shot does not indicate in a reliable way if you can skip the second shot, so this is not recommended.

If you are traveling out of the country, and your child is between 6 months and 12 months of age, it is recommended to get an early MMR. There is no risk from an early MMR. Early vaccines are never dangerous but may be ineffective. You don’t know if your child is able to develop immunity from the vaccine. Since most of the measles outbreaks have occurred in Europe, any international travel could put your child at risk for measles, so the early MMR may offer some protection. Similarly, if your child is between 1 year old and 4 years old, and you are leaving the US, you should get an early MMR booster for your child. The MMR given under the age of 1 does not “count” toward the recommended two shots. An early MMR booster does count. For people staying in the US, the CDC does not, at this time, suggest an early MMR.

Measles itself is a very serious disease. Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.

• As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
• About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or mentally retarded.
• For every 1,000 children who get measles, one or two will die from it.

Some parents are asking if their child could be exposed to measles in my office. It is true that some of my patients have not received all of the recommended vaccines. Very few have not received the measles vaccine. Because the office is small, and because we run as close to on-time as possible, it is never likely that you will be in the waiting room with any sick child. Measles, however, can linger in the air. So, if either of the doctors ever suspected measles in a patient in the office, we would cancel anyone who is not immune (either too young for the vaccine or not vaccinated) for the rest of the day. We would work closely with the health department to minimize any risk. It is true that your child could be exposed to measles in any doctor’s office, even one that refuses care to families who do not vaccinate. A child in one of those practices with measles might be under the age of one, or might be a new patient to the practice. Fortunately, there has not been a case of measles in Philadelphia so far.

There is lots more information on measles on the CDC website.