The Measles Imperative: Communicate, Educate, Vaccinate!
Measles certainly is a matter of great interest in the United States. In recent weeks, we have seen the true effects of the measles outbreak,1 which has sparked awareness of the need for the vaccine among the general public. We as health care professionals need to vaccinate as many persons who are susceptible and unvaccinated as quickly as possible. That will end the outbreak and further ensure that future importations of measles from abroad will not spread widely in the United States.
IMMUNIZATION IN THE UNITED STATES
We currently have an array of vaccine-preventable diseases. The infant, child, and adolescent immunization program2 in this country has been so successful in reducing and eliminating many of these diseases from our population, such that we no longer have striking disparities by urban or rural location, by income, or by race. That means we now have 1 or 2 generations of individuals who have not seen these diseases and are not familiar with them. If you are not familiar with them, then you may not respect them or may even fear them. If you do not respect the disease, then it is difficult to value the vaccine.
In addition, because we have more vaccines now, children are being simultaneously vaccinated with a number of vaccines—sometimes 3 or 4 immunizations at one time—which can cause stress not only for the child being vaccinated, but also for the parents. Both of these factors have conspired to raise skepticism about our vaccination program. Pediatricians, family doctors, and public health officials are conducting “Vaccine 101,” if you will, daily—often multiple times daily—as parents come into the clinic or health department expressing hesitations, reservations, concerns, and skepticism about vaccines.
Education is key for the general population. We need to get as much good, solid education out there as possible. As health care providers, we need to listen very carefully to the individual concerns of each parent, and respect that concern. Then we can address that concern, not in an argumentative or confrontational manner, but in a manner of reassurance to help them put their concerns into context: We are vaccinating millions of children around the world, not just those in our community.
COMMUNICATION IS KEY
As public health experts, we must keep open communication at all times with the health care professionals in each community—many of whom might have never even seen a case of measles. We have to define the clinical features of measles and let providers know what to do if they have a suspect case. Are there specimens to be obtained? How do community health professionals transmit them to the laboratory? What are the consequences? How do you actually go about reporting a case quickly to the health department? The Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases both offer good resources on measles.3,4,5
Then, of course, health professionals are tasked with communicating information to, reassuring, and comforting the affected population. It takes a terrific amount of work, and if you have a small health department, it puts an extra strain on those few workers. They may have to call the state health department for assistance, depending on the extent of the outbreak.
Measles is a major issue for local and state health departments as well as the CDC. Because measles and other childhood diseases are communicable, it matters not only that an individual child is vaccinated but also that the overall health of a community is guaranteed. Because, should that child become ill with whatever infection, he or she can spread it to others. Individuals living among us may not have been vaccinated for genuine medical reasons—such as very young infants or immunocompromised individuals—and the way we protect them is for the rest of us to be vaccinated to provide a “cocoon” of protection around them. It is harder for the infectious agent to gain access to those individuals if everyone around them is protected. It is harder for the virus or bacteria to find those persons. So, we protect ourselves by being vaccinated, and we provide our contribution to a healthier community.
When in doubt, vaccinate!
William Schaffner, MD, is the medical director of the National Foundation for Infectious Diseases (NFID) and is a professor of preventive medicine in the Department of Health Policy and a professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
- Vogt C. CDC: measles cases surpass those reported in 1992 [published online May 31, 2019]. Consultant360. https://www.consultant360.com/exclusive/consultant360/primary-care/cdc-measles-cases-surpass-those-reported-1992. Accessed June 5, 2019.
- Immunization schedules. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Reviewed February 5, 2019. Accessed June 5, 2019.
- Measles. National Foundation for Infectious Diseases. http://www.nfid.org/idinfo/measles. Accessed May 16, 2019.
- Measles (rubeola): for healthcare professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/measles/hcp/index.html. Updated February 5, 2018. Accessed May 16, 2019.
- Meeting archive: measles outbreaks: lessons learned. National Foundation for Infectious Diseases. https://cc.readytalk.com/cc/s/meetingArchive?eventId=eg1zt2x35ru0. Published August 7, 2018. Accessed May 16, 2019.