Q&A with Dr. Sara: What parents need to know about the measles

Bundoo Expert

Dr. Sara Connolly
Bundoo Pediatrician

Sara Connolly, MD, FAAP, is a Board Certified Pediatrician who practices in Palm Beach County, Florida. Sara completed her residency at Jackson Memorial Hospital at the University of Miami, where she served as Chief Resident. At Bundoo, Sara is a Bundoo Pediatrician; she edits and writes, answers questions, and participates in group and forum discussions.

As of late February 2019, 159 cases of measles were already confirmed in ten different states. This is especially alarming since measles was eradicated in the United States nearly 20 years ago. Measles is back. Dr. Sara Connolly talks about what parents should know about the epidemic.

With almost 400 cases reported in the U.S. during the year 2018, what is the most important thing parents need to know about the outbreak?

Outbreaks are defined as three or more people in a community infected with measles. So far in 2019, the outbreaks are confined to communities with low vaccination rates. Travel to parts of the world where measles is more common is one way in which measles re-enters the United States. The CDC recommends all travelers to measles-endemic countries be vaccinated with the MMR, if possible.

If a child has been vaccinated, are there any measures a parent can take to help protect against a possible infection or ensure that the vaccine was effective? The CDC says the vaccine is 97 percent effective, but other sources give the actual failure rate as up to 10 percent. What’s the discrepancy, and does it undermine the argument for immunization?

The most important thing to do is vaccinate your child if they are due for immunization (just after the first birthday and again after the fourth birthday). If your child is up to date on their MMR vaccine, then you have done all you can do to lower their risk of disease. It’s true that for some people the vaccine will not produce immunity to disease. Whether this number is 3 percent or 10 percent, if the population as a whole is immunized then the disease does not get a foothold and cannot spread. In 2000, measles was declared eliminated in the US thanks to widespread vaccination both here and abroad. The few cases encountered were brought in by travelers overseas and isolated because there was no vulnerable population. With declining immunization rates, we now have a large enough vulnerable population that measles can spread.

If a child hasn’t been vaccinated and is old enough, would you recommend getting the vaccine now? Is there any benefit to “off-schedule” immunizations like this?

If a child is over the age of one and has not yet been vaccinated, they should be immunized with the MMR as soon as possible. Vaccinating at this time would not be considered “off-schedule.” It is just delayed. However, parents should understand that vaccination today does not mean protection tomorrow. It takes time for the body to respond and make antibodies against the diseases included in the vaccine. There is no instant protection.

Is there anything you would like to say to parents who are nervous about the vaccine for safety reasons?

The safety of this vaccine has been studied extensively both in the US and abroad. Try to be as specific as possible with your concerns when discussing them with your pediatrician. Help us understand your point of view so we can work together. We want all children vaccinated, and we want all parents comfortable with their decision. It is not our goal to strong-arm anyone into a vaccine, however strongly we feel about the importance of immunization.

We’re now reading about reports of doctor’s offices receiving phone calls from anxious parents of vaccinated children, asking if everyone else in the practice has received their vaccines. Is this something parents should be concerned with?

This is a huge swing in the vaccine pendulum, which I find very curious. My answer is a vague “it depends.” For most offices, the vast majority of patients have received their vaccines on time. In each office, there will be exceptions (children with cancer, for example, or children living with people with cancer). If your pediatrician serves a large population of people who choose not to vaccinate, you might be concerned, but I don’t think that’s representative of most pediatric offices.

Reviewed by Dr. Sara Connolly, April 2019

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