Before the measles vaccine was introduced in the 1960s, it’s estimated that 3 to 4 million people in the U.S. contracted the disease every year, of which 500,000 cases were reported. Among reported cases, 400 to 500 people died, 48,000 were hospitalized, and 1,000 developed encephalitis (brain swelling) from measles. Since then, the United States has done a good job of vaccinating children against the disease to the point that in 2000, the Centers for Disease Control declared that measles was eliminated from the U.S.
Then why do we keep seeing news reports of outbreaks of measles?
As is often the case, there are multiple reasons which are contributing to the recent outbreaks.
One of the biggest contributors to the apparent comeback of measles is international travel. While the U.S. has done a great job in controlling the disease, a combination of Americans traveling overseas and foreign visitors/workers coming to the country has started to expose our weaknesses.
While vaccination rates for children average around 92%, 11 states still have vaccination rates below 90% as of 2017. In pockets of the population, those rates can be even lower. So when someone who is unvaccinated travels and is exposed to measles, they can bring it back home and expose the entire community.
So while the guidelines for the measles vaccine from the CDC hasn’t been changed since 2013, the CDC website does have a special page about measles for people traveling outside the country. https://www.cdc.gov/measles/plan-for-travel.html
Do you need to get a measles shot?
The easiest way to know if you need to get a measles shot is to look at your vaccine record. If you received two doses of MMR, it’s not recommended for you to get any additional shots. This should be anyone vaccinated after 1989. As of now, that is supposed to protect 97% of those vaccinated from getting the disease.
People born before 1957 are not recommended to get the vaccine by the CDC because of the prevalence of measles at the time. All people of that generation are assumed to be exposed and therefore immune. However, if you were born after 1957, the older you are, the more likely you may want to get an additional shot of measles vaccine.
The original measles vaccine given between 1963 and 1967 was found to be ineffective and people who received that vaccine are recommended to get one to two doses of MMR based on their risk category.
Before 1989, most people only received only 1 dose of MMR vaccine. For those at low risk, there is no need for receiving another dose. However, there are special situations:
Students in postsecondary educational institutions, international travelers, and household or close personal contacts of immunocompromised persons with no evidence of immunity to measles, mumps, or rubella: 1 dose MMR if previously received 1 dose MMR, or 2-dose series MMR at least 4 weeks apart if previously did not receive any MMR
If you’ve only received one dose of MMR, it’s recommended that you get a second dose if you travel internationally. Even if you think where you are going is safe, think again.
Measles remains a common disease in many parts of the world, including Europe, the Middle East, Asia, the Americas, and Africa. Each year, an estimated 10 million people get measles, and about 110,000 of them die from it. Currently, many countries are experiencing measles outbreaks; this includes many popular travel destinations like Israel, Thailand, Vietnam, Japan, Ukraine, the Philippines, and more.
For those who have no vaccination records, it’s possible to get an antibody test to see if you have immunity to the measles. However, there is some debate as to whether it’s worth it.
Pediatric infectious disease specialist Dr. Matthew Zahn says the CDC is right that most adults are protected against measles.
Zahn figures people who are worried about the status of their measles immunity should just go ahead and get the vaccine, rather than go through an antibody test.
“If you’re not sure you’ve had your two doses before and you want to be up to date, there’s nothing wrong with getting that additional dose,” Zahn said, noting that a person who undergoes the antibody test pays extra and faces getting stuck with a needle twice.
So while it’s easy to think of the measles as a disease of the past, it’s still out there. We’ve just eliminated it from our area of the earth but the more that we go out and explore other areas, the more we need to protect ourselves from getting sick and bringing those diseases back home with us.
One last note, there are many good references out there about vaccines and there are many other websites which publish questionable advice. I urge you to stick to the major scientific sites like the CDC.gov or Vaccines.gov in the US or the NHS vaccines website in the UK.
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This post first appeared on Your Mileage May Vary