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Some adults may need 2nd measles vaccine

After national news reports recently suggested adults who received their measles vaccine before 1989 may need an additional shot, many people are wondering if that includes them.

According to infection control specialist Wendy Gullicksrud at CHI St. Joseph's Community Health, the answers depend on a variety of circumstances and the most up-to-date information can be found on the Center for Disease Control and Prevention (CDC) website.

Protecting vulnerable children

The CDC report that was released April 26 showed a total of 704 cases of measles in the U.S. so far this year, the highest number of cases reported since 1994.

Gullicksrud said, right now, there are no measles outbreaks in Minnesota.

"Last year, there was an outbreak in the Cities in the Somali community," she said. "They did a really good job of vaccinating and the Department of Health got on top of it. So far, we have been lucky because it hasn't hit us. But with all of the travel in between states and internationally it could."

She stressed that vaccinations not only protect the child who receives them, but those who have compromised immune systems.

"I have a grandson who has leukemia," she said. "It has brought even more to the forefront the idea that you don't only vaccinate for your kids' safety, but you vaccinate for others besides. He can't have the vaccine because it's a weakened live vaccine. Children who have had chemo, where their immune system is low, can't do the vaccination. It's called herd immunity. If you have so many vaccinated, then there won't be these big outbreaks like in Washington where there are so many who are not vaccinated where it spreads like wildfire. Where most people are vaccinated in a breakout, only a few people come down with it and it just doesn't spread."

According to the CDC, measles is primarily transmitted from person to person through large respiratory droplets, and transmission is possible up to two hours after the infected person has left the room. The virus can be transmitted four days before the measles rash and up to four days after the rash appears.

If susceptible (unvaccinated) people are exposed to measles, 90 percent of them will develop the disease.

Get vaccinated before an outbreak

Gullicksrud said a lab titer (blood work) can test for measles immunity with antibodies if childhood immunization records can't be found. More recent vaccination records may be available on the state system.

"All the new kids coming up have them automatically dumped in, so when they get older they'll be able to go in and find their immunization records," she said.

Gullicksrud said protection for those who received two Mumps/Measles/Rubella (MMR) vaccines after 1968 is 97 percent effective.

"If you were born when they were just doing one vaccine, they're recommending a second one," she said. "You should have a documented two doses."

Her recommendation to parents is to make sure all childhood vaccinations are up to date. "Measles isn't just a rash," she said. "It really can have some serious impacts. The perception of the risk from the shot like the child getting a fever or being achy or whiney for a few days is higher than the perception of the risks of measles because they've never seen the outcome of a bad measles case that can lead to encephalitis, blindness or deafness."

Gullicksrud said recent media coverage is raising the awareness of the importance of the measles vaccine.

Older children or adults who have never been vaccinated should get the series of two MMR shots. "They just need to be 28 days apart," she added.

No vaccinations, no school?

"There are some states that are saying no public school without vaccinations," Gullicksrud said. "I think Washington is looking at that, but parents who don't want to vaccinate are bringing lawsuits so I think that will be in court for awhile."

In 2000, the CDC announced measles were effectively eliminated in the U.S., with only a handful of cases each year. A lack of vaccinations led to outbreaks in some communities this year and health officials are concerned the virus will continue to spread.

In the decade before the vaccination was developed, CDC records show 3 to 4 million people got measles each year in the U.S. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis, or brain swelling, from the disease.

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Measles facts

The CDC offers these key facts:

• Measles can lead to serious complications and death. The outbreak in 1989-1991 resulted in more than 55,000 cases and more than 100 deaths.

• There is no evidence that the MMR vaccine causes autism. The website says after a thorough review by the Independent Institute of Medicine, a report was issued in 2004 concluding there is no evidence supporting an association between the MMR vaccine and the development of autism.

• People born before 1957 are considered immune from the measles because they most likely were exposed as children. However, during an outbreak, they may need to be revaccinated for MMR for optimal protection.

• Some people born between 1957-1968 may have been vaccinated using a dead virus that doesn't work as well. They should consider a second vaccine.

• One dose of the MMR vaccine is considered to be only 93 percent effective, which led to the new recommendation that adults with only one vaccine consider getting a second one for protection given the recent measles outbreaks in this country and abroad.

• Two doses of the vaccine provides protection against measles 97 percent of the time. The remaining three percent who contract measles are likely to have a milder illness and be less likely to spread the disease to other people.