Vaccination Is Key to Stopping Measles

Kaiser Permanente. US:  Fifteen years ago, the United States declared victory over measles, and a whole generation has rarely had to think about the highly contagious, deadly disease since then. But waning vaccination rates and measles outbreaks in many other parts of the world, including Europe, Africa and Asia, have provided a gateway for measles to be widespread again in this country.

And now Americans are thinking — and worrying — about measles because of a mid-December outbreak at Disneyland and Disney California Adventure Park that shows no signs of slowing down.
That outbreak is largely responsible for 98 measles cases in California and 43 in 17 other states and Washington D.C. from Jan. 1 to Feb. 13. In the first six weeks of the year, there have been more cases than what’s been typical for a whole year.
To better understand the outbreak and how Kaiser Permanente is responding to it, we spoke with Stephen Parodi, MD, medical director, Regional Hospital Operations, The Permanente Medical Group.

Measles spreads through the air, making the disease very contagious. Nine of 10 exposed people who do not have immunity will get it. It’s a serious illness that caused 500 deaths a year before the vaccine was available. It can also lead to dangerous complications such as pneumonia, encephalitis (brain inflammation that can lead to swelling) and hearing loss.
The good news is that we have a highly effective vaccine, and it’s the best protection against measles. It’s given in two doses: the first one is when a child turns 1, and the second one is before kindergarten, between the ages of 4 to 6. When both are given, it’s 97 percent effective — one of the most effective vaccines — and it lasts a lifetime.
What we’ve seen with this outbreak is that mostly unvaccinated people are getting measles. When measles appeared previously, it was because it was imported from someone who was overseas. Now, people are getting it from their own communities because there are areas where there is not widespread immunity.
What’s been the reaction among Kaiser Permanente members during this recent outbreak?
There’s been greater interest in vaccinations. Some people want to move up their vaccination schedules. Right now, we are not recommending that we widely administer the second dose earlier. The first dose is 93 percent effective.
People are asking about vaccinating babies. For the first six months, babies are protected by their vaccinated mothers’ antibodies. If we give the vaccine to children younger than 12 months, it doesn’t have a lasting effect. We are advising parents of children who are too young to be vaccinated to avoid areas of known transmissions and crowds as much as possible, mainly because of the way it’s transmitted.
How will this outbreak be brought under control?
The key to slowing this outbreak or preventing others is to have widespread vaccination among children. We need a vaccination rate of 95 percent to keep communities safe. When most people in your neighborhood are vaccinated, the disease can’t spread well from person to person. This is called herd immunity. If rates drop below that threshold, then measles can cause illness in unvaccinated or non-immune people of all ages. Very young children are especially susceptible and can become very sick or even die from the disease.
At the end of January and early February, the Kaiser Permanente Northern and South California regions called parents of children, 1 to 18 years old, who had not received a measles vaccination to encourage them to get vaccinated. These calls were placed also in Spanish.
We are also advising adults who may have only one dose to get a blood test to see if they are immune. If they are not immune, we recommend a second dose.
What should providers tell members who don’t want to vaccinate?
Although we haven’t seen much of the measles in the past two decades, the risk still exists, especially as widespread immunity declines. It’s a serious, highly contagious disease that can cause significant lifelong consequences. One person can easily expose 100 others, creating a huge public health burden.
We can easily prevent measles with a safe, effective vaccine. Any claims of the vaccine leading to autism have been widely discredited. The most common side effect from the vaccine is a sore arm, and that pales in comparison to complications from measles.
By getting your children vaccinated, you protect not only your family, but also vulnerable populations who can’t get vaccinated.
We can eliminate measles. We’ve done it as a nation once, and we can do it again.

Fifteen years ago, the United States declared victory over measles, and a whole generation has rarely had to think about the highly contagious, deadly disease since then.
But waning vaccination rates and measles outbreaks in many other parts of the world, including Europe, Africa and Asia, have provided a gateway for measles to be widespread again in this country.
And now Americans are thinking — and worrying — about measles because of a mid-December outbreak at Disneyland and Disney California Adventure Park that shows no signs of slowing down.
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