12 Feb IDSA Spokesperson Discusses Recent Outbreaks of Measles Infections
MedicalResearch.com Interview with:
[caption id="attachment_72376" align="alignleft" width="190"]
Dr. Schaffner[/caption]
William Schaffner, MD
Professor of Preventive Medicine, Department of Health Policy
Professor of Medicine, Division of Infectious Diseases
Vanderbilt University Medical Center
Nashville, TN 37203
Dr. Schaffner discusses the recent increase in the incidence of measles infections.
MedicalResearch.com: What is the background for this study?
Response: The fundamental reason leading to the increase in measles cases in the US is that some parents are withholding their children from routine measles vaccination: Failure to vaccinate. As a result, there are neighborhoods, schools, and communities that now have vaccination rates substantially below the 92% to 95% needed to prevent outbreaks of infection. Measles is the most contagious virus we know, so it takes very high vaccination rates to prevent transmission and to avert outbreaks.
Vaccine hesitancy has many causes: Lack of knowledge of the severity of measles, concern over vaccine side-effects, low trust in public health, a desire to do things more “naturally” and it can also have political overtones, among others.
The measles vaccine is extraordinarily effective; the routine two-dose series confers 97% to 98% protection for life. The rare “breakthrough” infections that occur in vaccinated persons are generally milder, with fewer complications than in persons who are unvaccinated.
The US was certified as having eliminated measles in 2000 because of high vaccination rates across the country. Sadly, the US is likely to lose that designation because of sustained measles transmission, reverting us back to the bad old days. It is particularly sad for any of our children to have to endure measles and its consequences. All these cases could have been prevented by vaccination.
MedicalResearch.com: What roles do a decrease in US immunization rates and/or increased immigration from under-vaccinated area play in this increase?
Response: The substantial majority of unimmunized children in the US were born and raised in this country. They usually are members of middle- or upper-income families. The most frequent importers of measles into the US are our own unimmunized children who travel abroad, encounter measles virus and bring it back to their homes where the virus then spreads among the child’s schoolmates and playmates, creating an outbreak.
Dr. Schaffner[/caption]
William Schaffner, MD
Professor of Preventive Medicine, Department of Health Policy
Professor of Medicine, Division of Infectious Diseases
Vanderbilt University Medical Center
Nashville, TN 37203
Dr. Schaffner discusses the recent increase in the incidence of measles infections.
MedicalResearch.com: What is the background for this study?
Response: The fundamental reason leading to the increase in measles cases in the US is that some parents are withholding their children from routine measles vaccination: Failure to vaccinate. As a result, there are neighborhoods, schools, and communities that now have vaccination rates substantially below the 92% to 95% needed to prevent outbreaks of infection. Measles is the most contagious virus we know, so it takes very high vaccination rates to prevent transmission and to avert outbreaks.
Vaccine hesitancy has many causes: Lack of knowledge of the severity of measles, concern over vaccine side-effects, low trust in public health, a desire to do things more “naturally” and it can also have political overtones, among others.
The measles vaccine is extraordinarily effective; the routine two-dose series confers 97% to 98% protection for life. The rare “breakthrough” infections that occur in vaccinated persons are generally milder, with fewer complications than in persons who are unvaccinated.
The US was certified as having eliminated measles in 2000 because of high vaccination rates across the country. Sadly, the US is likely to lose that designation because of sustained measles transmission, reverting us back to the bad old days. It is particularly sad for any of our children to have to endure measles and its consequences. All these cases could have been prevented by vaccination.
MedicalResearch.com: What roles do a decrease in US immunization rates and/or increased immigration from under-vaccinated area play in this increase?
Response: The substantial majority of unimmunized children in the US were born and raised in this country. They usually are members of middle- or upper-income families. The most frequent importers of measles into the US are our own unimmunized children who travel abroad, encounter measles virus and bring it back to their homes where the virus then spreads among the child’s schoolmates and playmates, creating an outbreak.
Dr. Emily Parker Hyle[/caption]
Emily Parker Hyle, M.D.
Assistant Professor of Medicine
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: We found that many children who were planning to travel internationally were eligible for MMR vaccination prior to departure but often did not receive it - especially if they were aged 6 months to 6 years. That is because most children do not routinely receive their first dose of MMR till 12-15 months of age and their second dose of MMR till 4-6 years of age. However, ACIP recommendations are different for children who are traveling internationally. The risk of being infected with measles is much higher outside of the US, so it is recommended that children older than 1 year have had 2 MMR vaccinations and that children 6-12 months receive 1 MMR vaccination prior to travel. MMR vaccination is a safe and effective way to greatly reduce the risk of measles infection. 
Dr. Nandi[/caption]
Arindam Nandi PhD
Center for Disease Dynamics, Economics & Policy
MedicalResearch.com: What is the background for this study?
Response: The motivation for this study comes from a small but growing body of evidence on the potential long-term benefits of vaccines. The recent resurgence of measles outbreaks in several countries which had previously eliminated the virus makes our study additionally relevant. There have been over 1,000 measles cases reported across 28 states in the US so far in 2019, which is the largest number of cases the country has seen in almost 3 decades. Similarly high number of cases have been reported in several European countries in recent years. This study reiterates the importance of vaccination and proves the long-term benefits of the measles vaccine in low- and middle-income countries, which account for a large proportion of global measles cases.
