Recent measles outbreaks in New York City and California have many healthcare professionals concerned for their patients. According to the Center for Disease Control, measles was declared eliminated from the United States in 2000, with only an average of 60 cases of measles reported each year. But in 2013, that number increased to 189 cases. Many of the instances are occurring in areas with populations of unvaccinated children, which are the suspected result of anti-vaccination beliefs.
The New York City outbreak has 19 confirmed cases to date, 10 adults and nine children. Four of the affected children were too young to be vaccinated, three who had been vaccinated were 13 months to 15 months old and two others had not been vaccinated by parental choice, according to the New York Health Department. The California outbreak has 32 cases confirmed statewide, according to the California Department of Public Health, 10 of which have been imported by patients who visited countries with large measles outbreaks.
Pharmacists and clinicians play an important role in limiting the spread of measles. Make sure that patients know the facts: Measles is a highly contagious viral infection that causes fever, runny nose, cough and a rash all over the body. The virus is spread though the air by breathing, coughing or sneezing. Complications may include ear infections, pneumonia, miscarriage, encephalitis or death, and can occur in as many as 1-in-3 patients with measles. However, patients and parents need to understand that this highly infectious viral disease can be prevented.
The first measles vaccine was licensed in 1963, and the first combination measles-mumps-rubella, or MMR, vaccine first became available in 1971. Since then, the incidence of measles has dropped 99%. Prior to widespread vaccination, measles caused an estimated 2.6 million deaths per year. Globally, approximately 122,000 people died from measles in 2012, most of whom were children younger than 5 years.
Since maintaining high MMR vaccination coverage is essential to preventing measles outbreaks and sustaining measles elimination in the United States, pharmacists and clinicians need to emphasize the importance of immunizing patients in accordance with the CDC vaccine schedule. Although pharmacists are allowed to immunize in every state, most states do not allow them to immunize pediatric patients at the age when the MMR vaccine is recommended. Children should receive their first dose of MMR between 12 months and 15 months and a second dose between the ages of 4 years and 6 years. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose. The immunization schedule was developed to protect infants and children as early as possible by providing immunity before they are exposed to potentially life-threatening disease. There is no evidence that supports delaying a child’s immunizations, and parents who choose to follow an alternative schedule put their children at risk of developing disease while the vaccines are delayed. Make sure that all patients know that the MMR vaccine has never contained thimerosal, a mercury derivative, because it is manufactured as a single-dose vial and no preservatives are needed. Finally, studies continue to show that vaccines are not associated with autism spectrum disorders. By working to educate patients, the United States can return to an eradicated state for measles and many other diseases.