Protecting Your Infant or Young Child from the Measles Outbreak

This post is written by Dr. Ryan Hassan, M.D., local pediatrician and one of Boost Oregon’s Community Workshop leaders.

In the last month, as the measles outbreak has continued to spread in Oregon and Washington, I have gotten many questions from concerned parents about what they can do to protect their children from this potentially deadly disease.

This information has been discussed at great length on hospital and public health websites, so here I’ll provide a condensed summary of recommendations, focusing primarily on infants under one year, and young children.

Indications for the MMR vaccine

  1. Every child should get their first MMR vaccine at their 12-month well visit, or as soon as possible if they are older than 12 months. This dose leads to lifelong immunity in 93-98% of children who receive it.

  2. Every child should get their second MMR vaccine at their four year well visit at the latest, but can get it as early as 28 days after their first dose. There is no downside to getting the second dose early, and it would be reasonable, but not essential, to do so for children who are in close proximity to the outbreak. The second MMR vaccine will lead to lifelong measles immunity in >99% of children who receive it, so anyone who has had two doses does not need to take any extra precautions during the outbreak, as they can neither get the disease nor spread it.

  3. Babies six to 12 months old should get an MMR vaccine prior to international travel, and could receive a dose if they are in close proximity to the outbreak. Our clinic is not currently recommending this extra dose to our patients living in Clackamas County. This dose does not create lasting immunity, so children who receive it still need the normal two doses at 12 months and four years.

  4. Babies younger than six months should not receive the MMR vaccine. At this age, they cannot create an immune response to the disease due to circulating maternal antibodies. While these maternal antibodies do provide some passive immunity against the disease, they are not a replacement for vaccination at the 12-month well visit.

If your child is not yet immunized and visited an exposed location (see Oregon and Washington locations) during the timeframe of exposure, call your local health department or healthcare provider immediately. If older than six months, your child can receive a protective dose of MMR within 72 hours of exposure that will provide the best protection against getting the disease. It’s also important to note that you child will not be contagious until at least six days after exposure, so a timely response is essential.

Immunocompromised individuals who cannot receive the vaccination

Severely immunocompromised individuals, like those with AIDS or on chemotherapy, cannot receive the MMR vaccine. However, this is not a contraindication to having other household members vaccinated. In fact, it is even more important that other members get vaccinated in order to protect the immunocompromised person.

Protecting a child who is not immunized against measles

If your child is less than 12 months old and has not yet been vaccinated — or if you have a severely immunocompromised child that cannot receive the MMR vaccine — the best way to protect against measles is to limit outings in public spaces, especially in the Vancouver and Portland areas, during an outbreak.

Secondly, avoid contact with anyone who isn’t completely immunized. (This can be a delicate topic to broach; please attend one of our Community Workshops for tools and resources to make it easier.)

People with measles are contagious 4 days before the rash starts until 4 days after, so even people without symptoms could potentially spread the disease. If your incompletely-immunized child has been exposed, immunoglobulin can be given within the first six days after exposure to protect against developing disease.

Treating measles

Once measles develops, there is unfortunately no cure; treatment is symptomatic only. Common complications include diarrheal disease, ear infections and pneumonia.

At best, the illness will lead to several days of misery, missed school and work, increased stress, and unnecessary suffering.

At worst, it can lead to hospitalization, irreversible brain damage, and even death. The harrowing reality is that one to two children out of every 1,000 infected will die of measles, usually because of infection spreading to the lungs or the brain.

This is a serious disease, making it especially critical that children receive vaccinations to protect themselves and the community.

Moving forward

Measles is the most contagious disease known to man, and will infect 90% of unimmunized people who come into contact with it.

Before 1963, when the first measles vaccine was developed, there were three to four million cases per year in the United States. We are now fortunate enough to have a safe vaccine that works so well against the disease that we successfully eradicated it from the US in the year 2000.

Unfortunately, the rise of vaccine misinformation has led to decreased immunization rates and a subsequent rise in outbreaks like the one we are seeing today in Oregon and Washington. Low vaccination rates in local communities means that a once-eradicated disease has returned to infect our children.

Given what we’re experiencing locally, it becomes even clearer that vaccinating our children is not simply a personal choice. It is a very public choice, with very public consequences.

By vaccinating your child, you can help ensure an outbreak like this never happens again. Spread the word to friends, family, and colleagues, and encourage them to do the same.

If you or someone you know have questions about the MMR vaccine, or any other vaccine, speak to your child’s pediatrician, and join me at a free Community Workshop through Boost Oregon, where you can ask questions and learn the science and safety of vaccines.

Further reading

Dr. Ryan Hassan, M.D. is a pediatrician practicing at Oregon Pediatrics in Happy Valley, and a supporting member of Boost Oregon. He completed his Medical Degree and Masters degree in Public Health in Texas, and completed pediatric residency in Utah.