The confirmation of a measles diagnosis in Cumberland County, following closely on the heels of a multi-state measles outbreak that began in California, has led to concerns about how best to address this public health concern in Pennsylvania.
In Jan. 2015, there were 102 people from 11 states reported to have measles. The Pennsylvania Medical Society (PAMED) hosted a media call-in with Pennsylvania reporters and the public on Feb. 3, 2015, to address the recent increase in measles cases nationwide.
Participating in the call in were Karen Rizzo, MD, FACS, otolaryngologist in Lancaster and PAMED president; Rachel Levine, MD, Acting Pennsylvania Physician General; John Goldman, MD, an infectious disease specialist in Harrisburg; and Tibisay Villalobos, MD, a pediatric infectious disease specialist in Allentown.
The physicians on the call agreed that maintaining a high vaccination rate is best way to combat measles. The recent outbreak was preventable, Dr. Goldman noted. “If vaccination rates had been high, we would not have seen this outbreak,” he said.
Since measles is a highly contagious respiratory illness, vaccination rates need to be high in order to prevent outbreaks. A vaccination rate of 95 percent is necessary.
Pennsylvania is taking measures to ensure that it takes action to protect its residents and improve vaccination rates. “We’re being vigilant but we’re very hopeful and optimistic,” said Dr. Levine. She announced a new vaccination clinic being held on Thursday, Feb. 5 at the Dauphin County State Health Center in Harrisburg from 2-6 PM.
Dispelling Myths about Vaccines
The MMR vaccine is both safe and effective. Physicians on the call said that there is no proven link between autism and the MMR vaccine. The 1998 study suggesting a possible link was proven to contain falsified data, Dr. Levine stated.
Concerns have also been raised by the public about a possible connection between the MMR vaccine and epilepsy or seizures. Dr. Villalobos clarified that the risk of febrile seizures and resulting encephalitis is significantly lower for those who get the vaccine compared to those who do not: a risk of approximately one in a million for those who are vaccinated versus one in one to 200 for those who are not.
What Should Physicians Do?
Dr. Villalobos had first-hand experience of measles cases during her own medical training, and she stresses the importance of:
- Recognizing the symptoms of measles
- Developing a strategy for your health care team for dealing with possible measles cases
- Creating talking points in advance of having conversations with families
Having the Vaccination Conversation with Families
When it comes to discussing vaccination, the earlier the better. The best time to have the vaccination conversation is during a mother’s pregnancy, Dr. Villalobos said.
Not every family is going to decide to have their child vaccinated. Some may have religious objections, and it’s important to be sensitive to those concerns. However, many parents will be open to the possibility if their physician is committed to having that discussion.
Physicians can reassure families that there is no significant risk associated with the MMR vaccine. When such a high percentage of the population is vaccinated, it is inevitable that conditions completely unrelated to the vaccine may develop shortly after vaccination. “Temporal association does not mean causality,” said Dr. Levine. Physicians must be prepared to address and explain this.
There may still be concerns about adverse reactions to a vaccine, however. These can be reported online using the Vaccine Adverse Event Reporting System (VAERS).
Further questions were raised during the call regarding whether Pennsylvania allows philosophical exemptions for vaccines and the relatively low vaccination rate for kindergartners in Pennsylvania compared to other states. PAMED will be monitoring these and other concerns and will keep its members and the media advised of any breaking news and updates.
- Centers for Disease Control and Prevention (CDC) resources for health care professionals interested in learning how to talk to parents about vaccines.
- Immunization advice and resources for parents, developed by PAMED, the Pennsylvania Chapter of the American College of Pediatrics, and the Pennsylvania Chapter of the American College of Physicians
- Receive alerts on this and other issues from the Department of Health (DOH) by subscribing to the Pennsylvania Health Alert Network (PA-HAN).