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MMR vaccine and Measles Outbreak Update

A Letter to Our Members about the Measles Outbreak

By

Greetings Welcome Health Members,

We wanted to send an update and recommendation regarding the ongoing measles outbreak.  We recognize that vaccines can be a polarizing subject in some cases but hope you trust us and our recommendations and recognize our interest in protecting our patients and giving you the best information to make good decisions. 

Currently there are outbreaks in 12 states with Georgia included.   There is a high likelihood it will make its way to our area in the coming months. 

Measles Information Sheet

What is Measles?

Measles is a highly contagious viral infection that can cause serious health complications, including pneumonia, encephalitis, and death. It spreads through respiratory droplets when an infected person coughs or sneezes.  90% of unvaccinated individuals will contract measles if exposed. 

Current Outbreak

Recent outbreaks have been reported globally, including in the United States and Europe. These outbreaks are often linked to unvaccinated populations and international travel. In 2022, there were approximately 9.2 million measles cases and 136,200 deaths worldwide.[1][2]

Mortality and Morbidity

Measles can lead to severe complications, especially in young children and immunocompromised individuals. The death rate in low-income countries can be as high as 2.2%. Common complications include pneumonia, otitis media, and acute encephalitis.[3][4][5]

Vaccination and Boosters

The MMR (Measles, Mumps, and Rubella) vaccine is highly effective in preventing measles. The Centers for Disease Control and Prevention (CDC) recommends two doses of the MMR vaccine: the first dose at 12-15 months and the second dose at 4-6 years. In outbreak settings, a third dose may be considered for additional protection.[6][7]   All adults born in 1957 or later should receive at least one dose of the MMR vaccine unless they have evidence of immunity or a booster given.  For those vaccinated between 1957 and 1968 (when a weaker form of the vaccine was given) we recommend re-vaccination with the current MMR vaccine.  For those unsure, re-vaccination is safe to give.  Vaccination should not be given during pregnancy and pregnancy should be avoided for 28 days after vaccine administration. 

Efficacy of the MMR Vaccine

The MMR vaccine is 95% effective after one dose and 96% effective after two doses in preventing measles. It also significantly reduces the severity of the disease in vaccinated individuals who contract measles.[8][9][10]

Safety of the MMR Vaccine

The MMR vaccine is safe and well-tolerated. Common side effects include mild fever and rash. Serious adverse events are rare. There is no evidence linking the MMR vaccine to autism or other chronic conditions.[8][11][12]

Importance of Vaccination

High vaccination coverage is crucial to prevent outbreaks and protect vulnerable populations. The World Health Organization (WHO) recommends maintaining high immunization rates to achieve and sustain measles elimination.[1][2]

Conclusion

We are committed to ensuring the health and safety of all our patients.  Measles is a preventable disease with serious health risks. Vaccination with the MMR vaccine is the best way to protect against measles and its complications. Ensuring high vaccination coverage is essential to prevent outbreaks and protect public health.  Please reach out to our office via spruce or phone if you have questions and would like to schedule a nurse visit for a titer draw or booster. 

We also encourage you to remain vigilant for signs and symptoms of measles. If you or your child develop symptoms, please contact our office immediately. To help prevent the spread of the virus, we ask that you avoid coming into the office if you suspect measles until we can provide specific guidance.  Immediately isolate any symptomatic patients after development of a rash and closely observe for development of symptoms.  Common symptoms are rash, high fever (104), cough, runny nose and watery eyes.  Below is an example of the classic rash.  Testing can be performed from a throat or nasal swab with results in 24-48 hours typically.  If unvaccinated and you or a child have been exposed- 21 days of isolation is recommended to prevent the spread of disease.  Post exposure vaccination can be effective if administered within 72 hours of exposure.

Close-up of a child's cheek showing red, patchy skin irritation or rash. The ear is partially visible on the left side.

References

  1. Progress Toward Measles Elimination – Worldwide, 2000-2022. Minta AA, Ferrari M, Antoni S, et al. MMWR. Morbidity and Mortality Weekly Report. 2023;72(46):1262-1268. doi:10.15585/mmwr.mm7246a3.
  2. Progress Toward Measles Elimination – Worldwide, 2000-2023. Minta AA, Ferrari M, Antoni S, et al. MMWR. Morbidity and Mortality Weekly Report. 2024;73(45):1036-1042. doi:10.15585/mmwr.mm7345a4.
  3. Estimates of Case-Fatality Ratios of Measles in Low-Income and Middle-Income Countries: A Systematic Review and Modelling Analysis. Portnoy A, Jit M, Ferrari M, et al. The Lancet. Global Health. 2019;7(4):e472-e481. doi:10.1016/S2214-109X(18)30537-0.
  4. Inpatient Morbidity and Mortality of Measles in the United States. Chovatiya R, Silverberg JI. PloS One. 2020;15(4):e0231329. doi:10.1371/journal.pone.0231329.
  5. Measles Epidemic in Pediatric Population in Greece During 2017-2018: Epidemiological, Clinical Characteristics and Outcomes. Gianniki M, Siahanidou T, Botsa E, Michos A. PloS One. 2021;16(1):e0245512. doi:10.1371/journal.pone.0245512.
  6. Measles and Measles Vaccination: A Review. Bester JC. JAMA Pediatrics. 2016;170(12):1209-1215. doi:10.1001/jamapediatrics.2016.1787.
  7. Immunogenicity and Safety of a Second Dose of a Measles-Mumps-Rubella Vaccine Administered to Healthy Participants 7 years of Age or Older: A Phase III, Randomized Study. Abu-Elyazeed R, Jennings W, Severance R, et al. Human Vaccines & Immunotherapeutics. 2018;14(11):2624-2631. doi:10.1080/21645515.2018.1489186.
  8. Vaccines for Measles, Mumps, Rubella, and Varicella in Children. Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V. The Cochrane Database of Systematic Reviews. 2021;11:CD004407. doi:10.1002/14651858.CD004407.pub5.
  9. Effect of Vaccination on Severity and Infectiousness of Measles During an Outbreak in the Netherlands, 2013-2014. van Dam ASG, Woudenberg T, de Melker HE, Wallinga J, Hahné SJM. Epidemiology and Infection. 2020;148:e81. doi:10.1017/S0950268820000692.
  10. Self-Collected Buccal Swabs and Rapid, Real-Time PCR During a Large Measles Outbreak in Wales: Evidence for the Protective Effect of Prior MMR Immunisation. Moore C, Cottrell S, Hoffmann J, et al. Journal of Clinical Virology : The Official Publication of the Pan American Society for Clinical Virology. 2015;67:1-7. doi:10.1016/j.jcv.2015.03.012.
  11. Prevention of Measles, Mumps and Rubella: 40 Years of Global Experience With M-M-Rii. Kuter BJ, Marshall GS, Fergie J, Schmidt E, Pawaskar M. Human Vaccines & Immunotherapeutics. 2021;17(12):5372-5383. doi:10.1080/21645515.2021.2007710.
  12. Evaluation of the Safety and Immunogenicity of M-M-Rii (Combination Measles-Mumps-Rubella Vaccine): Clinical Trials of Healthy Children and Adults Published Between 2010 and 2019. Nyaku M, Richardson E, Martinon-Torres F, Kuter BJ. The Pediatric Infectious Disease Journal. 2021;40(11):1046-1054. doi:10.1097/INF.0000000000003273.