Q&A: With More Measles Reported, What Should Adults Do?

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This week, Massachusetts public health authorities confirmed six new cases of measles. That brings the total number of cases of the highly contagious disease up to 11 for the year. We all know that our children should be vaccinated against measles, but what about adults? Do we need boosters of some sort? How much risk are we at, and how much effort should we expend to protect ourselves at this point?

I spoke this morning with Dr. Ben Kruskal, director of infection control at Harvard Vanguard Medical Associates and an expert on vaccines.

Q: So what should grown-ups be doing about measles?

A: We’re not quite at the point yet of an all-out effort for adults or kids. But what I would say for adults is that the most important thing — and unfortunately, not an easy thing — is to ascertain if they are immune.

For most of us who’ve grown up in the US, if you were born before 1957, you’re generally presumed to be immune because measles was circulating so much back then that just about everybody got it. And once you’ve had it, you’re immune.

For people born after 1957 who’ve grown up and gone to school in the US, the vast majority have been vaccinated because of school requirements.

For people who haven’t grown up in the US, they should make sure they’ve had two doses of measles-containing vaccine (MMR or just measles vaccine).

For people who don’t have a definite history of their vaccinations, there’s a simple blood test that can be done to demonstrate whether they’re immune. Insurance generally covers the test, and clinicians can generally order it without an office visit. If the blood test is ever positive, immunity is lifelong—the test need not be repeated.

One footnote: From 1963-1967, there was a “killed virus” vaccine used in the US and some parts of the world that was not very effective. People who were immunized with that vaccine may benefit from the blood test.

[module align="left" width="half" type="pull-quote"]You can get measles by walking through a room where someone who has it was present an hour earlier.[/module]

Q: Would you recommend going to the effort of the blood test mainly for people at particular health risk?

I don’t think the magnitude of the outbreak is big enough to do it for everybody.

On the other hand, measles is so contagious, and a bad enough thing to get, that I don’t think it’s easy to focus on a subgroup that’s at high risk. Measles is probably the single most contagious infection. You can get measles by walking through a room where someone who has it was present an hour earlier.

Q: So bottom line, for your average Massachusetts resident, what do you recommend?

Given that it’s going to take most people a while to figure out their vaccine history, it’s probably a reasonable thing to initiate that process now, realizing it’ll take a few days or a week.

I don’t know that it’s quite time to move up to the next level. I’d say, certainly, anybody who’s seeing their doctor in the near future should discuss it, should confirm their vaccine records at the doctor’s office or see if they’ve ever had the blood test before.

It makes sense to do those things when the opportunity presents itself. How much it’s worth going out of your way to do this is less clear.