What You Should Know About Measles and Immunization

Anat R Feingold, MD, MPH

Anat R Feingold, MD, MPH

In the last several months, measles – a once common childhood illness – has been in the news due to outbreaks of the disease in several states. Measles is a highly contagious disease caused by a virus which, fortunately, can almost always be prevented with a vaccine.

Before the widespread use of the measles vaccine in the mid-1960s, rates of disease were so high that the infection was considered to be an inevitable part of childhood. However, far from being a mild childhood illness or simple rite-of-passage, measles is a serious infection which can be fatal in young children or cause lifelong complications and injury. Symptoms – high fever, cough, red eyes, and a bluish-white rash on the inner lining of the cheek called Koplik spots – generally begin seven to 14 days after infection. Those symptoms are followed by a rash that spreads over the body. If left untreated, severe complications such as pneumonia or encephalitis, a potentially fatal inflammation of the brain, can develop.

Prior to the development of the measles vaccine, experts estimated that 3 to 4 million people (mostly children) were infected, 48,000 of them were hospitalized as a result, and 400 to 500 people died, according to the Centers for Disease Control and Prevention (CDC).

Due to the success of vaccination programs, in 2000, the United States declared that measles had been eliminated. It is important to understand that elimination does not mean the disease had been totally eradicated; but rather, that the disease was no longer endemic, or commonly found among the general population. According to the CDC, between 1997 and 2013, fewer than 200 cases were reported each year in the U.S. While death rates have been falling worldwide as more children receive the measles vaccine, the disease still kills more than 100,000 people a year, most are under the age of 5.

In 2018, the U.S. experienced a spike in the number of reported measles cases, and that trend is continuing into 2019. According to the CDC, the reason for these spikes is due to an increase in the number of travelers who get measles abroad and bring it into the U.S., as well as the spread of measles in communities with pockets of unvaccinated people.

While the majority of children born in the U.S. receive the recommended series of vaccines (including the MMR vaccine which protects against measles, mumps, and rubella), a small but growing number of parents are opting out. When that happens, they up the risk of outbreaks in their community. The most common reason parents skip vaccines is due to safety concerns, despite overwhelming evidence that they’re not dangerous. Some parents have had concerns that autism spectrum disorder (ASD) might be linked to the vaccines children receive, but numerous scientific studies have shown that there is no link between receiving vaccines and developing ASD.

With rare exceptions, most children can safely receive the vaccine to prevent measles and other diseases. Experts recommend children receive two doses of the MMR vaccine, first at 12 to 15 months of age and again between ages 4 to 6. All teens and adults should also be up-to-date on vaccinations.

Unfortunately, unreliable information is often presented on internet sites as facts, lending to the confusion about vaccines and their safety. Parents should always seek the advice of a trusted pediatrician or medical professional. By bringing a list of concerns and questions to every visit and working together, you and your health care provider can make informed decisions about your child’s health.

Anat R. Feingold, MD, MPH is the Division Head of Pediatric Infectious Diseases at Children’s Regional Hospital at Cooper.

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