Measles Outbreak: What Nurses need to know about the MMR Vaccine

By: Portia Wofford

A little over a month into 2019, the Centers for Disease Control has confirmed 101 individual cases of measles- in 10 states- in the U.S. These states are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington. 

Measles is an upper respiratory infection usually characterized by a fever and the 3 C’s - cough, coryza (runny nose), and conjunctivitis (red, watery eyes). Two or three days after symptoms begin,  Koplik spots (tiny, white spots) may appear inside the mouth. Three to five days after symptoms begin, a rash breaks out. Measles is extremely contagious and can have serious complications (such as hearing loss, pneumonia, encephalitis, and even death), especially for those who are high risk. 

As nurses, we have a responsibility to educate patients about vaccinations and the implications when vaccine-preventable diseases reemerge. The ability of nurses to quickly assess patients for infectious diseases saves lives by reducing the potential spread of this highly communicable disease,” reports Barbara Pate, Ph.D., MPH, RN. The majority of the confirmed cases, in the U.S., are people who were not vaccinated. As frontline professionals, nurses can stay informed about the current outbreak and recommendations for vaccinations. 

Read: Some Nurses Are Personally Against Vaccines 

How measles spreads

The measles virus spreads through respiratory droplets and aerosols. It’s transmitted by direct contact with infectious droplets or spread airborne when an infected person breathes, coughs, or sneezes. Measles virus can remain infectious in the air for up to two hours after an infected person leaves an area. It is highly contagious, and more than 90% of those exposed, nonimmune people will contract the disease. 

Infected patients should be isolated for four days in an airborne infection isolation room (AIIR). Airborne precautions should be followed, and only staff wearing N95 masks should enter the room.  Most importantly, measles is a reportable illness, and local health departments should be notified within 24 hours of suspected measles cases. 

Vaccination

As the measles outbreak flares, vaccination rates have begun to soar. Why? The only way to prevent measles is to get the measles, mumps, and rubella (MMR) vaccine. One MMR vaccine provides around 93 percent protection against measles. A second booster dose helps to improve the effectiveness of the measles vaccine to more than 97 percent.  Almost everyone who does not respond to the measles component of the first dose of MMR vaccine at age 12 months or older will respond to the second dose. It's advised that children receive the vaccine. Routine childhood immunization for MMR vaccine starts with the first dose at 12-15 months of age, and the second dose at 4-6 years of age or at least 28 days after the first dose. 

CDC recommendations

The CDC recommends that people 6 months of age or older be vaccinated before they travel abroad. Additionally, adults born after 1956, who have never had the disease or received an MMR vaccine should receive at least one MMR vaccination. Although, it is recommended that pregnant women, those who have an allergic reaction to prior MMR vaccines, or those who are immunocompromised not be vaccinated, nurses should advise them to speak with their provider if they are in situations that could place them at risk of contracting the disease. MMR protects those who are immunocompromised and cannot receive the vaccine themselves. 

One Twitter user tweets, “My son has autism; he has also had Leukemia (and therefore no immune system) which meant we walked around in a constant state of terror for 3 and a half years in case we came in contact with anyone who decided not to vaccinate. MMR saves lives, and it protects the vulnerable.” (@evepink123) 

Nurse Sofiya Pastergoat writes, “I used to work as a blood cancer nurse. There are kids with cancer who can’t be vaccinated and who would die if exposed to measles. Get vaccinated.” (@sofiapastermack)

Nurses addressing vaccine-hesitancy 

Although vaccines are important, as nurses we must remember that some patients choose not to vaccinate themselves or their children. 

Nurses are taking to social media to spread the word on the importance of vaccinations. 

Earnest Grant -American Nurses Association’s president- tweets, "In January alone, there were 79 confirmed cases of measles, a disease declared eliminated from the U.S. in 2000. As nurses, it is our responsibility to educate patients on recommended vaccines." (@ANAPresident) 

Another user writes, "The claim that getting an infectious disease helps one acquire a more effective immunity than the immunity provided by vaccines is ignorant and dangerous." (@nurseswhovax). 

One of the biggest concerns surrounding vaccine-hesitancy is that vaccines cause autism. 

Dr. Rachel Clarke (@doctor_oxford) tweets, "Vaccines do not cause autism.  Please, please chat to a nurse or doctor before deciding not to vaccinate your kids." There is simply no scientific evidence that links vaccines to autism. Many studies have confirmed this.  For most people, the benefit of the vaccine outweighs the risks. However, as with any vaccine, nurses should advise their patients on side effects of the vaccine and when to contact their provider or seek immediate medical attention. Some people have been noted to develop a short-term mild rash, fever, swollen glands, or pain and stiffness in the joints after getting the shot. More serious, and rare, side effects include a temporary low platelet count or severe allergic reaction. 

Check the CDC website for more detailed effects. 

Portia Wofford is a nurse, millennial strategist, healthcare writer, entrepreneur, and micro-influencer. Chosen as a brand ambassador or collaborative partner for various organizations, Wofford strives to empower nurses by offering nurses resources for career development--while providing organizations with tools to close generational gaps within their nursing staff. Follow her on Instagram and Twitter for her latest.

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