What you need to know about measles – Part 2

As the number of confirmed cases of measles continues to increase in Portland and southwest Washington, we’re answering your questions about the disease. Please see our previous list of questions and answers for additional information.

I’m vaccinated against measles, but I’m pregnant. Can the baby or I get the virus?
If you are fully immunized, you’re 97 percent immune from measles. Pregnancy does NOT make your vaccines less effective, so you and your baby are highly protected. In the event that a pregnant person does catch measles, their complication rate and issues facing the baby as a result are more severe than a non-pregnant person catching measles. That is why pregnancy is considered high-risk for this disease.

In an outbreak, is there a recommendation from the AAP about administering the vaccine to infants younger than age 1 year?
In the event of an outbreak, infants 6 months and older should receive an MMR vaccine. They will still need their 1 year and 4 year doses, so this is an extra dose that is recommended for infants in an epidemic to offer them protection.

Should infants under age 1 in Lane County receive an extra MMR vaccine now?
No. An outbreak has NOT been declared in Lane County, so the CDC and AAP recommend that we continue to administer the vaccine for children ages 1 and 4, as usual. If this recommendation changes, the Lane County Public Health Department will notify our clinic and all other clinics in the county, and we will quickly begin administering the MMR vaccine to babies who are 6-12 month old.

What can be done to protect infants under 6 months in the event of an outbreak of measles?
All adults who have contact with a baby should be immunized, as should older siblings, to limit the risk of a family member bringing measles home. In the event of an outbreak, avoid crowded public areas with young unimmunized babies. When other family members return home, use excellent hand washing techniques and change clothes before handling the baby or any items the baby comes in contact. Breastfeeding gives babies a small added amount of immunity if the mother is immunized.

Can children under the age of 4 who have only received one dose of the MMR vaccine still catch measles?
The first dose of the MMR vaccine, given at age 1, is 93 percent effective, so the likelihood of a toddler catching measles in this scenario is quite low. It’s not a zero risk, but it’s highly unlikely.

Is it true that immunocompromised people need to avoid recently vaccinated people?
No. The MMR vaccine can be given to individuals who have immunocompromised people living in their home. A 2007 review found no evidence of secondary transmission of measles, mumps or rubella vaccine viruses from healthy vaccine recipients caring for or living with immunocompromised people. Since immunocompromised people would be at increased risk if they did contract measles, the people they come in contact with SHOULD be vaccinated.

Do you treat unvaccinated patients? I am worried about bringing my 6-month-old to your clinic if she has to share a waiting room with unvaccinated sick kids.
Yes, we do see unimmunized children, because we want to offer care to all children in our community. However, we are taking as many steps as possible to protect all kids. Eugene Pediatrics has a policy in place: sick children with a rash must wait in the car, then enter and exit the building through a back door, rather than entering the waiting rooms. The exam rooms they enter will be shut down and sanitized professionally if there is a question of the child having measles. In addition, we invite any parent with young babies who would feel more comfortable waiting in their car to do so, and we will call you in when it’s your baby’s turn to see their doctor. The problem is that young babies are exposed to many vaccine-preventable AND non-preventable illnesses every time they step into a public space. Recent measles exposures in Portland have included OMSI, the airport and various other spots where many babies under age 1 would go. We always want to do what is best for your child, so please talk to our schedulers when you call so that we can ease your mind or help customize your visit.

How soon after getting an MMR vaccine are you immune?
The CDC estimates that antibody levels begin to rise as soon as the shot is given and reach highly protective levels within 10-14 days.

If an adult cannot find their immunization records, should they get the MMR shot just to be safe?
In general, immunity to measles and mumps is presumed for adults born before 1957. In people born after 1956, the American College of Physicians recommends an MMR vaccine be given if there is uncertainty about their MMR vaccine status. For certain individuals (college/grad students, health care workers, international travelers, HIV infected patients who do not have current severe immunocompromise), formal documentation of immunity should be established and two doses of vaccine given at least 28 days apart.

2019-01-30T09:49:25+00:00Jan 30th, 2019|From Dr. B|