Measles | Imamother

southernbubby

Mon, Nov 12 2018, 1:31 pm

http://www.immunize.org/askexp.....r.asp

This sheds a lot of light on a lot of questions. Unless there is serologic evidence of immunity, we cannot assume that a person is immune, even if vaccinated.

Sometimes people have lost or failed to keep records of vaccinations and possibly did not have as many vaccinations as they claimed to have. Without a written record, a person's claim of immunity is meaningless, unless they were diagnosed with measles. Only a titer can say for sure in those cases. The same is true of my generation, 98% of whom have serologic evidence of immunity but that is obviously not everyone.

This does state, however, that the vaccine fails to induce immunity in a small percentage of the population and it says nothing about how long the person can be immune as a result of the vaccine. I have a feeling that it wears off in many cases but there would have to be serologic evidence of immunity and then serologic evidence on non-immunity in order to prove that.

While there is harm in giving too many DPT vaccinations, there is no apparent harm in giving the MMR in case of doubt, just to be on the safe side.

It does not state that vaccinated people have nothing to worry about during an outbreak because without serologic evidence, a vaccinated person may not be immune.

As far as the MMR and autism, the link does not seem to be related to the MMR and if any link exists between vaccines and autism, it may be to a different vaccine or to a combination of a genetic disorder and stimulation of the immune system. Autism, in that case, would also be possible in response to any virus including those given by vaccine as well as those acquired by exposure, either pre-or postnatally.

Obviously studies done on autistic children who showed signs of autism prior to being given the MMR would be invalid studies for demonstrating a link between autism and the MMR.

Miri7

Mon, Nov 12 2018, 1:35 pm

bunchagirlies wrote:

take a school of 100 kids
97 are vaccinated, 3 are not.
bring in the measles
2 of the 3 unvaccinated get it.
since vaccines are 97% effective, 2 vaccinated also get sick.
so with 4 active cases of the measles, half were vaccinated!!!!!
So vaccines don't work, right???

I mean, how stupid can a person be??? a person that claims to be educated, knowledgable, certified, whatever. Why don't they stop with the craziness of saying that most people in an outbreak were vaccinated??? 95% of the developed world vaccinates!! so, yeah, duh!!!

Correct. We all know that the vaccine isn't 100% protection. So, when there is an outbreak, chances are very good that some of those who are sick will have been vaccinated.

The real question is - how many kids in a school of 100 would get the measles if it were introduced and NONE were vaccinated. That scenario would not look good. Mass vaccination saves lives. Does it prevent every single case - no, but it greatly reduces transmission.

nchr

Mon, Nov 12 2018, 1:36 pm

southernbubby wrote:

Sometimes people have lost or failed to keep records of vaccinations and possibly did not have as many vaccinations as they claimed to have. Without a written record, a person's claim of immunity is meaningless, unless they were diagnosed with measles. Only a titer can say for sure in those cases. The same is true of my generation, 98% of whom have serologic evidence of immunity but that is obviously not everyone.

This does state, however, that the vaccine fails to induce immunity in a small percentage of the population and it says nothing about how long the person can be immune as a result of the vaccine. I have a feeling that it wears off in many cases but there would have to be serologic evidence of immunity and then serologic evidence on non-immunity in order to prove that.

Your link does not state that. It states this "There are two circumstances when a third dose of MMR is recommended. ACIP recommends that women of childbearing age who have received 2 doses of rubella-containing vaccine and have rubella serum IgG levels that are not clearly positive should receive 1 additional dose of MMR vaccine (maximum of 3 doses). Further testing for serologic evidence of rubella immunity is not recommended. MMR should not be administered to a pregnant woman.

In 2018, ACIP published guidance for MMR vaccination of persons at increased risk for acquiring mumps during an outbreak. Persons previously vaccinated with 2 doses of a mumps virus–containing vaccine who are identified by public health authorities as being part of a group or population at increased risk for acquiring mumps because of an outbreak should receive a third dose of a mumps virus–containing vaccine (MMR or MMRV) to improve protection against mumps disease and related complications. More information about this recommendation is available at www.cdc.gov/mmwr/volumes/67/wr.....quot;

It clearly states further testing for serologic testing is not necessary with regards to Rubella and references a potential 3rd vaccine with regards to Mumps for at-risk contacts. This says nothing about serologic evidence of measles and clearly indicates additional serologic testing is not necessary.

nchr

Mon, Nov 12 2018, 1:37 pm

Miri7 wrote:

If the child with measles was act school once the immune system's Dendritic Cells had become infected and subsequently infected T and B cells in the lymphatic system, 90% of all of the children would develop measles.

southernbubby

Mon, Nov 12 2018, 1:39 pm

bunchagirlies wrote:

Interesting article: https://www.babygaga.com/top-1...../?v=8

Wherever you go, you encounter people from foreign countries. Yesterday at Ikea, I heard lots of foreign languages being spoken.

Bunchagirlies, do you use any type of public transportation? Whenever I use the subway at rush hour, I feel like I have to bench gomel from all the germs that I was just exposed to. These Nigerians love to drive taxis in NY and I wonder what disease that I am exposed to just by taking a taxi.

I am relying on my age plus a couple of shots to consider myself immune to measles and I hope that I really am!

I also haven't seen too many claims that half of the sick people were vaccinated but many people who claim to be vaccinated may not have been and others may have had their immunity wear off so it is really hard to tell. I did see an article that where the bochrim at MIR who caught measles claimed to have been vaccinated.

nchr

Mon, Nov 12 2018, 1:42 pm

amother wrote:

https://www.ncbi.nlm.nih.gov/pubmed/8053748Send to
Arch Intern Med. 1994 Aug 22;154(16):1815-20.
Failure to reach the goal of measles elimination. Apparent paradox of measles infections in immunized persons.
Poland GA1, Jacobson RM.
Author information
Abstract
BACKGROUND:
Measles is the most transmissible disease known to man. During the 1980s, the number of measles cases in the United States rose dramatically. Surprisingly, 20% to 40% of these cases occurred in persons who had been appropriately immunized against measles. In response, the United States adopted a two-dose universal measles immunization program. We critically examine the effect of vaccine failure in measles occurring in immunized persons.

METHODS:
We performed a computerized bibliographic literature search (National Library of Medicine) for all English-language articles dealing with measles outbreaks. We limited our search to reports of US and Canadian school-based outbreaks of measles, and we spoke with experts to get estimates of vaccine failure rates. In addition, we devised a hypothetical model of a school where measles immunization rates could be varied, vaccine failure rates could be calculated, and the percentage of measles cases occurring in immunized students could be determined.

RESULTS:
We found 18 reports of measles outbreaks in very highly immunized school populations where 71% to 99.8% of students were immunized against measles. Despite these high rates of immunization, 30% to 100% (mean, 77%) of all measles cases in these outbreaks occurred in previously immunized students. In our hypothetical school model, after more than 95% of schoolchildren are immunized against measles, the majority of measles cases occur in appropriately immunized children.

CONCLUSIONS:
The apparent paradox is that as measles immunization rates rise to high levels in a population, measles becomes a disease of immunized persons. Because of the failure rate of the vaccine and the unique transmissibility of the measles virus, the currently available measles vaccine, used in a single-dose strategy, is unlikely to completely eliminate measles. The long-term success of a two-dose strategy to eliminate measles remains to be determined.

PMID: 8053748

Sorry, you did not understand the verbiage. This is essentially stating that: take a school of 303 students: 3 are not immunized, 300 are immunized. Since 2 MMRs is 97% effective, 9 of the 300 immunized students can still develop measles. Therefore, the 3 non immunized children infect the 9 who were immunized and did not develop immunity and then you have 9 out of 12 total cases (or 75%) of the cases in that school occurring in an immunized population. It's not saying immunized individuals create primary measles cases. Also, should the 300 students not have been immunized, about 270 of them would have come down with the measles.

Additionally, this study is based upon a single dose MMR, which is less effective than the 2 dose so the percentages would be greater.

southernbubby

Mon, Nov 12 2018, 1:54 pm

nchr wrote:

Rubella titers are checked on all pregnant women as part of their care. It is only after they have already received the third dose of the MMR that they undergo no further testing because an additional dose is not recommended. https://www.acog.org/Patients/.....false

From the CDC:
Presumptive Evidence of Immunity
Acceptable presumptive evidence of measles immunity includes at least one of the following: [28]

written documentation of adequate vaccination— receipt of one or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk, and two doses of measles-containing vaccine for school-age children and adults at high risk for exposure transmission (I.e., health care personnel, international travelers, and students at post-high school educational institutions); or
laboratory evidence of immunity; or
birth before 1957; or
laboratory confirmation of disease.
Persons who do not meet the above criteria are considered susceptible and should be vaccinated unless contraindicated.

Some people opt for this lab work to demonstrate immunity rather than getting a third MMR. I am not sure how anyone can guarantee that someone is immune any other way. Notice that it is presumptive evidence of immunity.

Also, during an epidemic, pregnant women, who cannot receive the MMR are having titers checked.

nchr

Mon, Nov 12 2018, 2:02 pm

southernbubby wrote:

Again, CDC lists ways to provide immunity, which include proof of adequate vaccination. If you do not have your records, then you may prove through titers. Pregnant women with proof of vaccination with 2 MMRs do not need to do titer testing. Call the CDC or DOH yourself. The list says or not and.

southernbubby

Mon, Nov 12 2018, 2:11 pm

nchr wrote:

You have a bunch of women on here who claim that their physicians drew titers and they are NOT immune to measles. Now I realize that just because someone posts that here doesn't make it true but to my knowledge, Rockland county had titer clinics and presumably it was partially for those who could not be vaccinated and would have to use immune globulin if exposed.

nchr

Mon, Nov 12 2018, 2:14 pm

southernbubby wrote:

Right now DOH is saying if you have proof of immunization with 2 MMRs that trumps your titers, regardless. Don't even bother with you titers if you have proof of immunization and that is because titers can be misleadingly low on a test, when in reality you'd still be immune (as I explained before re allergic responses). Titers is an expensive test and if you have proof of immunization its unnecessary. If you are unsure then do titers or get vaccinated, that's what CDC is saying.

southernbubby

Mon, Nov 12 2018, 2:22 pm

nchr wrote:

Ok, if the test is misleading, then there is no reason to trust it but the CDC trusts it enough to warrant a third MMR as a result of it.

They don't suggest stopping at 2 doses if the titer is low.

I think that if they did more titers at 10 and 20 years after vaccination, they might see that many people are low but it has no relevance unless there is an outbreak or exposure to measles. Then you might see the previously vaccinated getting sick.

nchr

Mon, Nov 12 2018, 2:27 pm

southernbubby wrote:

CDC does not recommend a third for MEASLES. It happens to be the same vaccine, but the recommendations purpose is not for this virus. Read what you posted again: it referred to rubella and mumps in an at-risk population, which was based on the spread of mumps in at risk populations historically. Measles is extremely protective otherwise we'd be looking at thousands of cases annually. There would currently be 100s in Monsey and think about all the people who were exposed on the plane or in the airport; however, there are no cases there because of the efficacy of the vaccine.

southernbubby

Mon, Nov 12 2018, 2:36 pm

nchr wrote:

Here is what is recommended if a pregnant woman is shown via titer to be not immune to measles and is exposed:

Pregnant women without evidence of measles immunity who are exposed to measles should receive an intravenous IG (IGIV) dose of 400 mg/kg of body weight.

It doesn't look like anyone is telling them to forget about it if there is actual exposure, regardless of how many MMR vaccines they had.

nchr

Mon, Nov 12 2018, 2:39 pm

southernbubby wrote:

Without evidence of immunity means without proof of 2 MMRs. CDC considers proof of vaccination with 2 MMRs to count as evidence of immunity (you posted that yourself)

southernbubby

Mon, Nov 12 2018, 2:47 pm

DOCUMENTATION OF MEASLES IMMUNITY
A two-dose MMR vaccine schedule has been recommended by the Advisory Committee on Immunization Practices and the American Academy of Pediatrics since 1989.3 Despite these national vaccine recommendations, obstetric health care providers cannot assume that pregnant women in the United States were vaccinated with MMR vaccine in childhood. Recent studies have documented high levels of nonimmunity to measles among pregnant women in the United States; in a study by Haas et al of women presenting for prenatal care in 2004, 16.5% of women were not immune to measles. In that study, three quarters of women did not recall whether they had received the recommended second MMR vaccination, and even among those who reported receiving a second dose of vaccine, only 85% were measles-immune,13 raising questions about maternal report of vaccination. One might assume that rubella immunity (a routine part of prenatal care) could serve as a surrogate for measles immunity; however, in a study in Iowa, only 88% of those who were rubella-immune were also immune to measles, leading these authors to recommend that pregnant women who are exposed to measles be tested to document measles immunity.14 These results emphasize the importance of written documentation of MMR vaccination. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552307/)

They are willing to accept written documentation as proof of immunity but they also seem to be recommending drawing a titer if the pregnant woman is exposed to measles.

southernbubby

Mon, Nov 12 2018, 2:58 pm

I would also add this:

My children who now range in age from 29 to 39 were all vaccinated before electronic medical records were established and did not have all of their vaccinations at the same location. Although we always had new doctors obtain the records from old doctors, some vaccinations occurred at our local health department and I didn't always keep those records handy where I could prove anything so sometimes doctors simply took my word for it.

This is probably no longer the case with my grandchildren's generation but my children's generation may be in that age group that can't absolutely prove that those immunizations were ever given.