Measles and Misinformation – Vaccinations Are the Best Way to Keep Disease from Spreading

Q. I am an adult female who moved to Western Mass. when I was a teenager. Somehow my medical records were lost in the process, and my mother isn’t sure if or what I was vaccinated for. With all the talk about measles today, should I get vaccinated? 
A. Yes, definitely. Adults 20 years and older make up more than half of the current confirmed measles cases, which are now spreading across the country after an initial outbreak at Disneyland in California. However, if you were born before 1957 or have had measles in the past (or you were immunized in the past), you are considered immune and do not need the vaccination.
Adults should have at least one dose of what we call the measles-mumps-rubella (MMR) vaccine. Certain groups at high risk need two doses of MMR, such as international travelers, healthcare workers, and college students. According to officials from the Centers for Disease Control and Prevention (CDC), more than 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of those who received a first dose of the MMR vaccine develop immunity to the disease, while a second dose gives immunity to nearly all who don’t respond to the initial dose.
Also, if you have children, they should receive their first dose of MMR vaccine between the ages of 12 and 15 months. School-aged children need two doses of MMR vaccine, and the second dose should be given between the ages of 4 and 6.
Q. Are there any reasons why I shouldn’t be vaccinated for measles?
A. When it comes to protection, the answer is ‘no.’ However, there are some medical reasons why the MMR vaccine should not be given, including if you are pregnant. You should also wait at least four weeks after being vaccinated before getting pregnant. Also, you should not get the MMR vaccine if you have had a serious allergic reaction to gelatin or to a medicine called neomycin. It is important to check with your primary-care physician for other reasons you should not be vaccinated, such as if you have advanced HIV or another cause of a weakened immune system, or you have certain types of cancer.
If none of these situations apply to you, then there is absolutely no reason to not be vaccinated. Measles is recognized as one of the most contagious of all infectious diseases. The measles virus can live for up to two hours on surfaces or in the air where an infected person has coughed or sneezed. Also, the CDC notes, measles is spread so easily between people that 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of those without immunity will become infected simply by being near someone who has the virus.
Q. Am I likely to have any side effects from the measles vaccine?
A. A vaccine, like any medicine, runs the risk of a serious allergic reaction, but they are rare. I always tell my patients that the benefits of the MMR vaccine, or any other vaccine for that matter, outweigh the risks of the disease, which sometimes can cause death. Most often people will only experience some pain, redness, or swelling at the injection site. Other side effects could include a mild rash, fever, swollen glands, or stiffness in the joints after getting the shot.
Q. How will I know if I have the measles?
A. Symptoms of measles occur 10 days to two weeks after exposure, and may initially resemble other viral respiratory infections (with fever, cough, runny nose, and red eyes). However, a raised, red rash develops with measles about 2 to 4 days after your initial symptoms. The rash appears first on the head, then moves downward and usually affects the entire body. It gradually disappears in the same pattern in which it appeared, and lasts about six days before completely disappearing. It’s important to know that people with measles are contagious from four days before the rash appears until four days after the rash’s onset.
Q. What are the health risks if I were to get the measles as an adult?
A. Measles infections in otherwise healthy adults can cause a number of the same problems seen in healthy school-age children, including pneumonia and diarrhea. According to the CDC, measles infections in pregnant women can result in higher numbers of miscarriages, premature labor, and low-birth-weight infants. Similar to children less than 5 years of age, adults with weakened immune systems are at increased risk for complications including severe breathing difficulties, brain damage, or even death.
Q. Are there vaccines that I need to get as an adult? My mother is 66 and just got a shingles vaccine and another to protect her against pneumonia.
A. You are never too old to be vaccinated. Some vaccines may not have been available when you were a child, and some vaccines lose their potency over the years, and a booster shot is needed. So, it’s a good idea to discuss with your primary-care physician what vaccines you might need, especially if you are pregnant or planning to become pregnant. In general, the CDC recommends that all adults be vaccinated every year against the flu. Also, adults need to get a Tdap vaccine once to protect against pertussis (also referred to as whooping cough) if they did not receive it as an adolescent. That should be followed by a Td (tetanus, diphtheria) booster shot every 10 years. Women should get the Tdap vaccine during each pregnancy, preferably at 27 through 36 weeks.
Other than MMR, additional adult vaccinations you might need, depending on your age and any medical conditions you might have, include those that protect against hepatitis B for anyone who has diabetes or is at risk, HPV (human papillomavirus which can cause certain cancers), hepatitis A, meningococcal disease, chicken pox (varicella), and pneumonia.
The shingles vaccine is generally recommended for those 60 years or older, and the pneumococcal vaccine for adults who are 65 years and older, or earlier if you have certain conditions which increase your risk of pneumonia.
Consider visiting the CDC website, which offers an Adolescent and Adult Vaccine Quiz to help you determine what vaccines you may need. The quiz page can be found at www2.cdc.gov/nip/adultimmsched.
Q. My sister has young children, and we are also planning to start a family soon. However, she is debating whether or not to have them vaccinated for measles or otherwise. We’ve heard the claims that some say vaccines cause autism, while others say they are safe. Who are we to believe?
A. There is a lot of misinformation out there, including on the Internet, about the negative effects of vaccines. Do not believe what you hear unless it is from a trusted healthcare professional, and do not believe what you read unless it is on a reputable website, such as from the CDC. There have been numerous studies and decades of experience that support the fact that vaccines are safe. The one study that suggested a link to autism was discredited and retracted by the British journal that published the research.
The bottom line is that, if you get vaccinated, you are not only protecting your child or other family members from serious preventable diseases, but you are protecting your community. If you elect not to vaccinate your child, then you are putting him or her at risk for serious and possibly deadly complications associated with vaccine-preventable diseases such as measles, mumps, and whooping cough.
There is something we refer to in medicine as ‘herd immunity.’ Simply explained, when most people in a community are immunized against certain diseases, there is less of a chance of a major outbreak occurring. And those who cannot be vaccinated because they are too young, pregnant, or who have compromised immune systems are somewhat protected because there is less chance of disease spreading throughout the community. v
Dr. Daniel Skiest is chief of the Infectious Disease Division at Baystate Medical Center.

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