The Fight Against Measles

The resurgence of measles can be stopped
By Josh Devine, PharmD, PhD,  and Lesley J. Craig, MPH

“Vaccinations save lives, protect our children, and are one of the greatest public health achievements in U.S. history.” –U.S. Surgeon General Dr. Jerome Adams

WE ARE CURRENTLY experiencing a resurgence of measles in the United States. The ongoing outbreak in the U.S. has resulted in the highest number of measles cases reported nationally since the disease was eliminated and the case count continues to increase with a majority of reported cases among people who are not vaccinated against the disease. Many states have been affected; Illinois has identified nine cases to date in 2019, including one in Chicago and one in suburban Cook County.

Measles is a highly contagious, potentially life-threatening disease; up to 9 in 10 susceptible persons with close contact to a measles patient will develop measles. The virus is transmitted by direct contact with infectious droplets or via airborne spread when an infected person breathes, coughs, or sneezes and it can remain infectious in the air up to two hours after an infected person leaves an area. Measles is disruptive to public health and can be extremely costly with each case averaging around $32,000.

Fortunately, measles can be prevented through vaccination, most often administered as the combination measles-mumps-rubella (MMR) vaccine, which is approved by the FDA for use in individuals 12 months of age and older. Children aged 12 months through 12 years can also be protected against measles, mumps, rubella, and varicella through the combination measles-mumps-rubellavaricella (MMRV) vaccine. Measles vaccines are highly effective and among the most extensively studied medical products we have. Their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken.

The City of Chicago has one of the highest MMR vaccination rates in the country; 94% of children in Chicago between 19 months and three years have received at least one dose of the MMR vaccine, which is slightly higher than the U.S. national measles vaccination coverage of >91% in children aged 19-35 months. However, misinformation about measles and MMR vaccine has led to undervaccination in some communities. Nationally, approximately 1.3%, or 100,000 children, under the age of two have not been vaccinated, making them vulnerable to the current measles outbreak.

Tools for Educating Parents
Health care professionals can correct misinformation and reassure fearful parents and expectant parents that vaccines are safe and highly effective in preventing measles. It is important to educate parents that young children are at increased risk for infections because their immune systems have not yet matured. Lifesaving vaccines protect children and prevent the spread of vaccine-preventable diseases within their families and communities.

Additionally, it is also critical to note that the need for vaccination does not go away with age and that teens and adults should also be up to date on MMR vaccinations. Specifically, students at posthigh school educational institutions who do not have evidence of immunity should have two doses of MMR vaccine, separated by at least 28 days, and adults without evidence of immunity need at least one dose of the vaccine.

Because misinformation about vaccines is circulating, the Centers for Disease Control and Prevention (CDC) developed the “Measles Outbreak Toolkit for Healthcare Providers” which includes tools to facilitate effective vaccine conversations with parents, resources to share with parents, and posters for office display.

The CDC also has information to quickly diagnose measles, a free Vaccine Schedules App, and numerous education and training programs all based on vaccine recommendations made by the Advisory Committee on Immunization Practice (ACIP).

The Assistant Secretary for Health, ADM Brett Giroir, stated, “we must continue to put science into action wherever and whenever we have the tools to confront and eliminate diseases.” Health care professionals play a lead role in this effort. It is critical that health care professionals ensure patients are up to date with their MMR vaccination and report all suspected cases of measles to their local health department within 24 hours.

We can work collectively to communicate the importance, safety, and effectiveness of vaccines. Together, we have the ability to safely protect our children, families, and our communities and to eliminate measles and prevent future disease outbreaks.

Josh Devine, is a Captain in the U.S. Public Health Service and Regional Health Administrator, and Lesley Craig, MPH, is a Public Health Advisor at the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Health (OASH) – Region 5 (IL, IN, MI, MN, OH, WI). Contact us at Lesley.Craig@hhs.gov.