Why are you campaigning about measles? Expand The UNICEF and World Health Organisation (WHO) reported earlier this year that measles cases nearly doubled globally in the first two months of 2022, compared to the same period in 2021. (1) Covid-19 has caused issues around accessing vaccination, distribution and roll out programmes. This is on top of wider socioeconomic issues like war and poverty that began before COVID-19. In the UK, data has revealed that the MMR vaccination has dropped to its lowest level in a decade with more than one in ten five-year-olds not up to date with their two doses of the vaccine. (2) A recent scientific paper highlighted that one of the devastating complications of measles (subacute sclerosing panencephalitis- SSPE) was at the highest in 2021 since 2000. (3) These are alarming figures as measles can have devastating complications including encephalitis which can result in severe disability and even death. We aim to provide reliable information to ensure people understand how contagious measles is and how severe the complications of measles are. The good news is that it is a vaccine-preventable disease, so people can protect themselves, their families and others around them.
What is measles and how do you get it? Expand Measles is a highly contagious infection disease that is very easy to catch. Much like the common cold or COVID-19, it is caught by breathing in droplets from infected people’s breath, sneezes and coughs, as well as touching surfaces droplets have come into contact with. (1) However, it is much more contagious. One infected person can transmit measles to other nine non-immune (not vaccinated and didn’t have the illness) people. (2) (compared with Covid-19 which can infect 2-3 people after a contact) (3) Measles virus can live up to two hours in the environment of an infected person after they have left. Anyone can catch measles if they are not vaccinated/or had the illness, however it is more common in young children. (4) Measles symptoms show up within the first ten days after a person become infected. Infected people can spread measles from four days before to four days after the rash appears.1
Are there complications from measles? Expand There are serious complications that can occur from measles such as ear infection, blindness, severe diarrhoea, pneumonia, seizures and encephalitis. These diseases can cause severe disability and even death. People who are more likely to develop severe complications include: Adults over 20-year-old Children under 5-year-old Pregnant women Children with chronic illness People with immune system compromised (such as suffering from leukaemia or HIV infection) Infants are more likely to require hospitalisation than older children, and are at a higher risk of developing pneumonia, otitis media, encephalitis and death from measles. (1) (2)
How do you get encephalitis from measles Expand Encephalitis can occur either during or after a measles infection. This can happen as a result of the brain becoming infected with the virus during the rash phase of the illness or by an immune-mediated brain inflammation subsequent to measles infection. (1) There are different types of measles encephalitis depending on the stage of the rash. (2) Primary measles encephalitis when encephalitis is concurrent with measles infection (the brain becomes infected during the rash phase of the infection). Acute post-measle encephalitis when encephalitis is caused by immune-mediated brain inflammation subsequent to measles infection (occurs 2–30 days after infection). Measles inclusion body encephalitis most commonly occurs in immunodeficient children (within 1 year of measles infection). It leads to death in 75% of cases. Subacute sclerosing panencephalitis (SSPE) is a progressive and fatal central nervous system disease occurring following reactivation of the measles virus (6-15 years after measles infection).
How serious is encephalitis? Expand Encephalitis is a highly disabling neurological disease that can cause long-term consequences and even death. 1-3 in 1,000 children contracting measles will develop encephalitis concurrent with the measles infection. 10–15% of those children will die and a further 25% of patients will be left with permanent neurological damage. 1 in 1,000 children with measles will develop post-infectious encephalitis. 1 in 25,000 of children (1 in 5,500 children if they are under 1) with measles will develop subacute sclerosing panencephalitis (SSPE) which has a fatal (death) outcome. 1-2 in 1.000.000 children who had vaccination will develop encephalitis from the vaccination which is less than the incidence of all types of encephalitis. (1)
How can I protect myself against measles? Expand Measles is a vaccine preventable disease. The MMR ((measles-mumps-rubella) vaccination is the best way to protect yourself and your loved ones from measles. Adults and older children can be vaccinated at any age if they haven’t been fully vaccinated before. The MMR is given as two doses of the single injection into the muscle of the arm or the thigh. After two doses are taken, around 99% of people are protected against measles, which makes the MMR vaccine very effective. Protection against measles starts developing around two weeks after the vaccine has taken place. (1)
When do children get vaccinated? Expand Centers for Disease Control and Prevention (CDC) recommends all children to get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose. (1) In the UK, the MMR vaccine schedule includes the first dose at one year old and the second dose at three years and four months. If you miss any of these doses, you could still ask your GP surgery for them. (2) In the USA, CDC recommends that any baby as young as six months old who will be travelling internationally should get a vaccine before leaving the US, followed by two additional doses later. (3) Adolescents who haven’t been vaccinated should get two doses with 28 days in between. If they already had one vaccination, a second dose is required. (4)
Can adults get vaccinated if they haven't had the MMR? Expand Adults can be vaccinated if they haven’t been fully vaccinated before, with at least one dose. If you are not sure about your vaccination status, it is safe to get another measles vaccine. (1) (2) CDC (in the USA) and NHS (in the UK) state that two doses of MMR vaccine are recommended for adults at higher risk, including: College or University (or similar level) students Those who work in a healthcare setting International travellers or those who are passengers on a cruise ship Women of childbearing age (1) (2) The vaccine is not recommended in: Pregnant women. You should also avoid becoming pregnant for one month after having the MMR vaccine. People with a severe weakened immune system (those receiving chemotherapy). Those with a condition or taking immunotherapies, need to consult with their doctor. (2) If you have had a confirmed anaphylactic reaction to gelatine or neomycin, you should speak to your doctor. (2)
I'm not sure if I had the MMR vaccine, it would have been a long time ago Expand If you’re not sure if you had both doses of the MMR, the GP surgery/family doctor should be able to see if you have had two doses. Even if you have had the vaccine previously, there is no harm from having extra doses. (1) If you are unsure what the vaccination procedure is in your country, please speak to your doctor.
Can I have the vaccine after I had encephalitis? Expand There is no straightforward answer, it may depend on when you had encephalitis and what medication you may be on. It is therefore best to speak to your doctor about your suitability and he will advise you if it is safe for you to have the MMR vaccine.
Why is it important to get vaccinated when travelling? Expand Measles is common in many countries. Individuals who have never had measles infection or who are unvaccinated or incompletely vaccinated, may therefore be at risk from measles when travelling, in particular where they are staying with friends, family and/or mixing with the local population. All travellers over the age of six months should seek travel health advice and ensure they are up to date with the MMR vaccination. (1) There is a different vaccination schedule if you travel and you haven’t been vaccinated. Please check with your doctor. (2)
I don't want my child to get vaccinated Expand Worldwide, depending on the country, vaccination is mandatory, mandatory just for school entry or recommended. (1) In countries where the vaccination is not mandatory, it is important to realise the deadly consequences measles can have if a child is not vaccinated, and how infectious measles is. CDC state that a child can get measles just by being in a room where a person with measles has been, even after two hours the person have had left. You can get measles in any country you are due to risk of getting infected while travelling (you or others around you). (2)
I've heard vaccination can have risks and side-effects so what should I do? Expand The MMR vaccine protects against the measles, mumps and rubella. Most side effects are mild, manageable and do not last long. The most common mild side-effects are local (sore and red area), feeling unwell, crying (babies) and fever. There can be very rare side effects, like allergic reactions or encephalitis. However, the risks for not having the vaccination outweigh the risks of having the vaccination, due to the risks of severe complications from measles if you’re not vaccinated. (1)
Should I get vaccinated after being exposed to measles? Expand If you are not vaccinated and you have been exposed to measles, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, and doing so may possibly prevent later disease. In other cases, you may be given a medicine called immunoglobulin (IG) within six days of being exposed to measles, to provide some protection against the disease, or have milder illness. (1)
I've heard the MMR vaccine can cause autism Expand There is no evidence of any link between the MMR vaccine and autism, and this is confirmed by many studies that have investigated this. If you wish to view these studies, you can find them here: http://vk.ovg.ox.ac.uk/vk/mmr-vaccine There is a wide range of credible information available on the good safety record of MMR vaccine at: www.gov.uk/government/uploads/system/uploads/attachment_data/file/147968/Green-Book-Chapter-21 It is difficult to find reliable information with social media and various news outlets. The best way to be informed is to find credible sources of information, such as the CDC, WHO, NFID or speaking to a health professional who will be able to provide you with good information. It may be useful to look at how the misconceptions on the measles vaccination developed into the 90’s and are still having an effect today. European Centre for Disease Prevention and Control wrote an article that addresses concerns below: https://www.ecdc.europa.eu/en/measles/prevention-and-control/addressing-misconceptions-measles