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Immunity against measles: Some millennia need another shot: shots



The measles virus is highly contagious. If someone with measles or sneezes, the virus in these droplets can survive two hours afterwards ̵

1; infecting about 90% of people with immunity who pass through this space.

Eric Witso / EyeEm / Getty Images


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Eric Vitso / EyeEm / Getty Images

The measles virus is highly contagious. If someone with measles or sneezes, the virus in these droplets can survive two hours afterwards – infecting about 90% of people with immunity who pass through this space.

Erik Witsoe / EyeEm / Getty Images

Destination: Bulgaria. It is a small country in Eastern Europe, often overlooked by American tourists. But my husband's father grew up in Bulgaria, so he has long been on our travel list.

It is also on the list of countries with recent measles outbreaks. Bulgaria has nearly 800 cases this year, according to the World Health Organization.

In California, where I live, four of the five outbreaks that occurred this year were related to international travel. Most of these travelers were infected in the Philippines or Ukraine with severe outbreaks, and 37% of the cases were imported from Europe. New measles infections continue to be reported, with as many as 67 cases reported in California as of August 28.

The measles virus is highly contagious. If someone who is ill visits a popular tourist site and coughs, or rides in the subway and sneezes, the virus can live in the air for two hours after they leave. If people who are not immune and vaccinated go through the same space 90% of them will become ill.

That's why the road nurse at my health center wants to check on my vaccination status before I leave for Bulgaria. This is routine for the Xers gene and millennials born in the 70's and 80's, because when the measles, mumps, rubella (MMR) vaccine was first introduced in 1971, scientists recommended only one dose. But over the years, they have noticed that some children still have measles. It was not until 1989 that public health officials changed the two-dose guidelines.

But many people now in their 30s and 40s, like me, are not sure if they have ever received a second dose. [19659008] Therefore, my nurse recommends that I go to the lab to have a blood test to check my immunity. This is a major test that seeks out measles antibodies and should return positive or negative – yes or no.

But my results come back "borderline". In other words, maybe I'm immunized, but maybe I'm not.

"The blood test is imperfect," says Dr. Art Ringold, professor of epidemiology at the University of California, Berkeley. "If you have antibodies, then we are almost certain that you are immunized. But if you do not have antibodies, you may still be immunized, but your antibodies cannot be detected by the test."

So it is possible for me to have a false negator. There is simply no way of knowing for sure.

"I know a lot of people who would say that this is a good reason not to take tests," Reingold says with a laugh. "Because you get these results. You don't know how to interpret them. People worry."

And now what? My doctor suggests you get another dose of measles vaccine. It's safe. But when I look at it, it turns out that there are some possible side effects listed in adults that don't occur in babies: Some studies have found that 25% of women and teens get "acute arthritis" "three weeks after receiving the vaccine.

This will be right in the middle of my trip, just when my husband and I are due to arrive on the Black Sea coast of Bulgaria.

I imagined lying on the beach, meditating on rolling waves – enveloped in pain in my joints.

"That would be nasty," I say to my husband as we speak.

"Yes," he replies. "But wouldn't it be more difficult to get measles disease?"

So I go back to the experts. This time I'm talking to Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital and a professor at UCSF.

Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital, holds a stuffed version of the measles virus she keeps in her office. If you're not sure about your vaccination status and you're traveling somewhere with a known measles epidemic, a second dose of the vaccine may be reasonable, she says.

April Demboski / KQED


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April Demboski / KQED

p. Lisa Winston, an epidemiologist at San Francisco General Hospital, holds a stuffed version of the measles virus she keeps in her office. If you're not sure about your vaccination status and you're traveling somewhere with a known measles epidemic, a second dose of the vaccine may be prudent, she says.

April Demboski / KQED

She tells me not to worry about acute arthritis, which really means "sudden onset and short term". And she says joint pain is usually mild – nothing the ibuprofen couple would worry about.

Above all, the side effect is caused by the rubella part of the measles, mumps, rubella vaccine and rarely occurs in women who have already had a single dose of MMR.

"I would say that if the choice was between 'I'm a little worried I may get this arthritis or some joint pain,' versus 'I'm going somewhere where I'm really going to be at risk for measles,' the balance will focused on vaccination for sure, "Winston says.

But before I get through the problems of another medical visit, I want to make sure I really need it. My mother was a nurse and she kept my baby vaccine records. Squeezed at the end of the paper, scratched with a black pen, it says that I received a second dose of the vaccine when I was 11. But the handwriting is difficult to read and looks so … unofficial. That's why I got the blood test.

Winston tells me that medical records are generally more reliable than a blood test.

"For someone who knows that she has been vaccinated – who has a history – you would actually be considered immunized," she says, "regardless of what your blood test shows. "

Bottom line: If you are not sure what your vaccination status is and you are traveling to a country with a known measles epidemic, there is no harm in getting a second dose of vaccine. But if you know you have had two doses, there is no benefit in getting a third.


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