Note that I put epidemic in quotes, since at 131 people, it's hardly an epidemic. Nonetheless, as MMR rates fall, I have some concerns, summarized (at length!) here. I was going to send it to this mom's group I'm on - someone just sent an email with the CDC press release about the epidemic, blaming it on unvaccinated kids, but I'm not sure I feel up to getting in a debate. Any thoughts?
Here's what worries me about a resurgence of measles (and no, it's not my child getting measles). In the normal cycle of things (and I realize there would always be moms who can't breastfeed or immuno-compromised babies for whom this scenario would not work, but just for the sake of discussion...), moms would get measles when they were age 5-9 (as something like 95% of people did pre-vaccine according to the CDC) and thus, develop life-long immunity. Those moms would then breastfeed their babies through their toddler years, thus conferring passive immunity to the measles virus to their child during their infant years. Once passive immunity wore off, the child (now fortunately old enough to deal with measles) would get measles herself, and the cycle would repeat with her children.
The problem is that most moms today did not get measles when they were young - they got the measles vaccine. Thus, as the CDC points out in their Pink Book chapter on measles, moms are passing little if any immunity to their babies even if they *are* breastfeeding (and these days only 36% of women are breastfeeding after 6 months of age - the infant gets no immunity if mom is not breastfeeding). This means that today's babies who are not yet eligible for the vaccine (<12 months) are susceptible to measles - at an age when the disease is likely to be more damaging.
Additionally, since measles vaccine wears off after a while (as little as 10 years in some cases - that's why you need boosters), older people who got measles vaccine instead of measles when they were young are getting it when they are older and/or pregnant, when the disease can be much more dangerous.
And finally, it's rarely mentioned that MMR causes recently vaccinated people to shed the live virus (meaning the vaccinated person himself or others who come into contact with him may contract vaccine-derived measles) and that the sheding can continue for up to six months. That means that if you have a recently vaccinated child, it might be best to keep the child away from unvaccinated children, babies who are not yet eligible for vaccinations and maybe even pregnant women; and to wash your hands meticulously after diaper changes (as you should anyway).
The same thing worries me with rubella and chickenpox - rubella is pretty much harmless UNLESS you get it while you're pregnant, in which case it's effects can be devastating. None of us get rubella anymore (which would have given us lifelong immunity) because we all get the MMR vaccine, which confers temporary immunity. As vaccination rates fall and these disease experience a resurgence, I would caution all who have not had these diseases as children to get their titres checked prior to pregnancy to ensure that they are immune - otherwise, first time exposure in adulthood or during pregnancy could be a very bad thing.
In summary, it's not my child getting measles that worries me (I feel confident that she'd be fine if she did), it's the babies and the pregnant and older people. Those are the people I'm worried about
CDC Pink Book Chapter on Measles:
http://www.cdc.gov/vaccines/pubs/pin...loads/meas.pdf
CDC Discussion of How Vaccines Work (Includes Active vs. Passive Immunity):
http://www.cdc.gov/vaccines/pubs/pin...ds/prinvac.pdf
Here's what worries me about a resurgence of measles (and no, it's not my child getting measles). In the normal cycle of things (and I realize there would always be moms who can't breastfeed or immuno-compromised babies for whom this scenario would not work, but just for the sake of discussion...), moms would get measles when they were age 5-9 (as something like 95% of people did pre-vaccine according to the CDC) and thus, develop life-long immunity. Those moms would then breastfeed their babies through their toddler years, thus conferring passive immunity to the measles virus to their child during their infant years. Once passive immunity wore off, the child (now fortunately old enough to deal with measles) would get measles herself, and the cycle would repeat with her children.
The problem is that most moms today did not get measles when they were young - they got the measles vaccine. Thus, as the CDC points out in their Pink Book chapter on measles, moms are passing little if any immunity to their babies even if they *are* breastfeeding (and these days only 36% of women are breastfeeding after 6 months of age - the infant gets no immunity if mom is not breastfeeding). This means that today's babies who are not yet eligible for the vaccine (<12 months) are susceptible to measles - at an age when the disease is likely to be more damaging.
Additionally, since measles vaccine wears off after a while (as little as 10 years in some cases - that's why you need boosters), older people who got measles vaccine instead of measles when they were young are getting it when they are older and/or pregnant, when the disease can be much more dangerous.
And finally, it's rarely mentioned that MMR causes recently vaccinated people to shed the live virus (meaning the vaccinated person himself or others who come into contact with him may contract vaccine-derived measles) and that the sheding can continue for up to six months. That means that if you have a recently vaccinated child, it might be best to keep the child away from unvaccinated children, babies who are not yet eligible for vaccinations and maybe even pregnant women; and to wash your hands meticulously after diaper changes (as you should anyway).
The same thing worries me with rubella and chickenpox - rubella is pretty much harmless UNLESS you get it while you're pregnant, in which case it's effects can be devastating. None of us get rubella anymore (which would have given us lifelong immunity) because we all get the MMR vaccine, which confers temporary immunity. As vaccination rates fall and these disease experience a resurgence, I would caution all who have not had these diseases as children to get their titres checked prior to pregnancy to ensure that they are immune - otherwise, first time exposure in adulthood or during pregnancy could be a very bad thing.
In summary, it's not my child getting measles that worries me (I feel confident that she'd be fine if she did), it's the babies and the pregnant and older people. Those are the people I'm worried about
CDC Pink Book Chapter on Measles:
http://www.cdc.gov/vaccines/pubs/pin...loads/meas.pdf
CDC Discussion of How Vaccines Work (Includes Active vs. Passive Immunity):
http://www.cdc.gov/vaccines/pubs/pin...ds/prinvac.pdf