The following measles guidance for providers has been issued by Norton Healthcare’s department of infection prevention and employee health.
When should children receive MMR (measles-mumps-rubella) vaccine? Do we need to vaccinate children early because of measles cases in the United States?
All children are recommended to get two doses of the MMR vaccine, starting with the first dose between ages 12 months and 15 months, and the second dose between ages 4 years and 6 years. Children can receive the second dose earlier as long as it is at least 28 days after the first dose, but according to public health experts in Kentucky, this is not routinely necessary unless a child is at higher risk of exposure to measles.
For patients traveling internationally or to a place where an outbreak is occurring, children may be vaccinated as early as age 6 months. At the date of this post, no county in Kentucky is experiencing an outbreak of measles.
What about people who are traveling internationally?
Before any international travel, infants ages 6 through 11 months should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses according to the routinely recommended schedule (12 to 15 months and 4 to 6 years). People ages 12 months and older who will be traveling internationally or to a place where an outbreak is occurring should receive two doses of MMR, unless they have other presumptive evidence of immunity. The minimum interval between vaccines is 28 days.
Who is protected against measles?
Most people are immune to measles due to routine childhood immunization. Older adults would have been exposed before measles had been considered eliminated in the United States. The presumptive criteria for immunity to measles includes any of the following:
- Born prior to 1957; or
- Have written documentation with date of receipt of at least one dose of measles-containing vaccine given on or after their first birthday in 1968 or later; or
- Have documentation of positive immunoglobulin G (IgG) test for measles immunity (frequently needed for health care workers as a condition of employment); or
- Have laboratory confirmation of previous disease; or
- Served in the U.S. armed forces
Do patients need booster vaccines?
No. People who received one or two doses of measles according to the U.S. vaccination schedule or have presumptive evidence of immunity to MMR, according to above, are usually considered protected for life and usually do not need a booster dose.
Do adults who got one dose of the vaccine as a child still need the second dose?
For adults born after 1957, one dose of measles vaccine is sufficient to be considered protected from measles. Certain adults may need two doses. Adults who are going to be in a setting that poses a high risk for measles transmission should make sure they have had two doses separated by at least 28 days. These adults include:
- Students at post-high school education institutions
- Health care personnel
- International travelers
- People whom public health authorities determine are at increased risk for getting measles during a measles outbreak
How can patients verify whether they’re immune?
Individuals can check vaccination records for themselves or their children using the Kentucky Immunization Registry Public Portal or MyVaxIndiana, though these records may be incomplete for adults unless their health care provider back-entered their historical vaccine doses.
If patients born after 1957 do not have written documentation of measles immunity, recommend testing to determine immunity or vaccinate with another dose of MMR.
If a patient can’t produce written documentation of measles immunity, they should get the MMR vaccine. There is no harm getting another dose if the patient is already immune.
Norton Healthcare employees who are unsure about their immunity to measles can contact Employee Health.
