TIP Talk!


Tuesday August 28, 2018

When Do Adults Need the Measles Vaccine?

Christmas

Many adults are already aware that they should be getting a vaccine for shingles, a tetanus-diphtheria booster every 10 years, and the shingles vaccine at age 50 and older. But many also might need a vaccine they think of as being only for children – MMR, or measles, mumps and rubella.

Measles vaccines have long been recommended for travel among adults who don’t already have immunity against the disease. That was because measles was more common in many foreign countries.

But recently there has been more reason for concern, as various outbreaks have sickened people in the United States, where measles is no longer endemic. (Mumps outbreaks also have become more common.) Of special note was the so-called Disneyland outbreak that began in December 2014 and continued into February 2015. Health officials believe that one infected visitor to the amusement park set off an outbreak that sickened about 200. Only a handful of those had been vaccinated. And many of them were adults, leading public health experts to realize that too little had been done to encourage and track immunization among this group. That's why, with this being the last week of National Immunization Awareness Month, it's a good time to raise awareness that many adults should be asking their doctors about the MMR vaccine.

“Adults 20 years and older make up 59% of confirmed measles illnesses — and most had no record of being immunized as children,” the Los Angeles Times reported at the time. “Now, health officials are wrestling with how to better monitor the vaccination levels of adults to prevent even broader spread of the disease.”

The Times article went on to report:

The stakes are high, given how quickly and easily the measles can spread. Adults pose a greater risk than children of passing on the disease because they travel and come in contact with more people.

With declining rates of childhood measles vaccinations in California over the last dozen years, experts say more adults will be entering college and the workforce without being fully immunized.

"We've had this wake-up call with Disneyland," said Dr. James Cherry, a UCLA professor and primary editor of the Textbook of Pediatric Infectious Diseases. "Adults have been ignored for years."

It’s interesting to note that about 40 percent of those who caught the measles during that outbreak weren’t certain of whether they’d been immunized or not, and had no records to show they had. It’s certainly understandable; how many adults have their medical records from childhood?

In 2013, the National Vaccine Advisory Committee, a panel of the U.S. Department of Health and Human Services, called on doctors and other healthcare providers to do a better job of getting immunization records from their adult patients, and be more proactive about recommending needed vaccines.

Lack of knowledge about their immunization history shouldn’t keep adults from being protected. On the contrary.

The U.S. Centers for Disease Control and Prevention has several recommendations for adults who wonder whether they need to be immunized. Adults without evidence of immunity to measles, mumps or rubella should receive one dose of the vaccine, it says.

But what is evidence of immunity?

People who were born before 1957 are generally assumed to have naturally caught the disease because of the number of measles epidemics during their childhoods.  Except in special circumstances, they are considered protected.

So are people who have records of having received the vaccination, or records of having had the diseases, but the CDC warns that a doctor diagnosis of disease isn’t good enough. Laboratory confirmation is needed.

In addition, people can be tested to see if they show markers of immunity.

That last one can be important for people who received the vaccine when it first became available in the 1960s, the CDC says.

If you received a measles vaccine in the 1960s, you may not need to be revaccinated. People who have documentation of receiving LIVE measles vaccine in the 1960s do not need to be revaccinated. People who were vaccinated prior to 1968 with either inactivated (killed) measles vaccine or measles vaccine of unknown type should be revaccinated with at least one dose of live attenuated measles vaccine. This recommendation is intended to protect those who may have received killed measles vaccine, which was available in 1963-1967 and was not effective.

But people who are pregnant or sick at the time their vaccination is scheduled should not go ahead with the vaccination, and those with certain medical conditions, including AIDS or other conditions that affect the immune system, should advise their health care practitioners beforehand. The CDC provides the list of those who should exert extra care here.

For the rest of adults, that’s all the more reason to make sure you have immunity, whether natural or through vaccination. There are people who cannot be vaccinated for medical reasons; their protection is in the hands of all of those who can be. The vaccine against measles is extremely effective at 97 percent. That means that through vaccination, we not only protect ourselves but all the vulnerable people around us.

 

YOU MIGHT ALSO LIKE:

The Tragedy of Europe's Measles Outbreak 

TIP Op-Ed: The Link Between Texas and Minnesota's Measles 

Harvard Study Points to Possible Benefits of a Third Mumps Vaccination 

 

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