With measles cases across the country breaking all records many families are contacting us to understand how they can best protect their children and themselves. This article was created to answer some of our frequently asked questions.Measles is a highly contagious, airborne viral illness. So contagious, in fact, that if someone with active measles infection was in a room even 2 hours earlier, if an unprotected person walks in that same room they have a 90% chance of getting measles. The virus can be transmitted from 4 days before the rash becomes visible to 4 days after the rash appears. In areas of the country where there are numerous active cases and the virus is spreading, it is really important to make sure your family is protected.
The good news is that there is a safe and effective measles vaccine. Measles vaccine is currently part of two licensed combination vaccines: the MMR (measles-mumps-rubella) and the MMRV (measles-mumps-rubella-varicella). There is no currently available single component measles vaccine.
MMR is routinely first given to children at 12-15 months of age per the standard schedule. The second dose of MMR is routinely given between 4-6 years of age. The second dose is not a booster, but rather is intended to produce immunity in the small number of people who fail to respond to the first dose.
Between 2% and 5% of people do not develop measles immunity after the first dose of vaccine. This occurs for a variety of reasons. The second dose is to provide another chance to develop measles immunity for people who did not respond to the first dose. The second dose can be given as early as 4 weeks (28 days) after the first dose and be counted as a valid dose if both doses were given after the child's first birthday.
If you live in, or are traveling to, a region where there is a current measles outbreak and your child has only had their first vaccine, you should discuss getting the second vaccine early with your doctor. It takes 10-14 days for the body to build up protection from the vaccine. Why don't we give the second dose early for everyone? Unlike measles which gives lifetime immunity after those two shots, we know the mumps protection starts to diminish after 7-10 years. We don't want to create a new problem with more mumps in the future (already a problem at some college campuses and other places.)
How can I protect my infant who hasn't yet received the 12 month MMR? If your child is at least 6 months old, they can receive a shot early. However, this will be considered "dose zero" and will give them temporary protection. They will still need the routine two doses at 12-15 months and 4-6 years of age.
Children under 6 months of age are not eligible to receive MMR vaccine. Antibodies circulating from their mothers prevent them from having an appropriate response to the vaccine. Best advice for infants traveling to an outbreak area (either in the US or abroad)? Whenever possible: don't go.
What about parents, grandparents, aunts and uncles? For those people born prior to 1957, they are considered immune. Measles was widespread before the vaccine and because of the highly contagious nature of the virus, those persons are considered immune. Anyone, who had two doses of vaccine or has proven measles immunity by antibody titers (bloodwork) is considered protected. There is no indication for a third measles vaccine. If you are not sure, or had only one vaccine, the CDC has great information here.
Remember, we are not only protecting our families, but those vulnerable members of our community who cannot get the vaccine either because they are infants and too young, are undergoing treatment for cancer, have immune deficiencies or are immunosuppressed because they have had an organ transplant. Thank you for keeping our community as safe as possible and contributing to herd immunity. #VaccinesSaveLives
Reprinted with permission from Kressly Pediatrics in Warrington, PA