Local physician outlines who’s at risk from Texas measles outbreak and what we should do

Could a measles outbreak in a Texas community deliberately avoiding the vaccine pose risks beyond the community’s borders?

Not likely, says a local physician, as long as an area’s herd immunity is maintained with at least 95% of the population vaccinated.

“The best thing you can do to protect yourself and your family is to get vaccinated on schedule,” said Dr. Julie Holland, vice chairman of the Department of Pediatrics for Endeavor Health. “I don’t understand why someone would make a choice that would leave their child vulnerable to disease.”

There are only two recognized medical reasons to avoid the vaccine. These are for people who already have displayed allergic reactions to their components or who have compromised immune systems.

But even accounting for the numbers of people who fall into those categories, vaccinations remain at or above the 95% threshold needed to achieve herd immunity, Holland said.

The recommendation is for children to receive a first dose of the vaccine at 12 to 15 months old and the second between the ages of 4 to 6 years. But children traveling internationally are recommended to receive a dose as early as 6 months old.

Any adult who missed vaccination in childhood should also receive it, Holland said.

For the most part in the United States, children not fully vaccinated are considered most at risk for measles. Since a vaccine was introduced in 1963, most people have received it. Those who grew up before then typically had the measles by the time they were 15, leading to immunity afterward.

But attaining immunity naturally by getting the measles first was not an easy path for children before the 1960s. Until then, between 400 and 500 people in the U.S. died from the disease each year, with about 48,000 hospitalizations.

Childhood measles was declared eliminated in the U.S. in 2000. But misinformation is considered to have played a role in its not staying that way.

“There have been some concerns about the vaccine in the past 15 to 20 years that have been completely unfounded,” Holland said.

The disease hit an endemic level in 2019 when more than 1,200 cases were reported across 31 states. This was the highest reported level since 1992, with the majority of cases being among the unvaccinated.

Illinois saw its first measles cases last March in Cook, Will and Lake counties. Holland said the cases were largely contained to new immigrant populations from countries where childhood vaccination wasn’t as much a norm.

The current cases in Texas stem from a community where about 16% have claimed exemptions from the vaccine, putting the population below the level needed for herd immunity, she said.

If anything, the outbreak highlights the continued need for the measles vaccine as well as those for all other diseases that have been kept contained with their use, Holland said.