BOSTON — It was considered a public health triumph 25 years ago, when the U.S. declared measles eradicated. But in recent years, the virus has made a comeback- in part due to an increase in international travel.
“In areas of the world without higher levels of MMR vaccination, they’ve never gotten to the point where measles is considered eliminated,” said Vandama Madhavan, MD, MPH, clinical director of pediatric infectious disease at Massachusetts General Hospital. “Then in places like the U.S. and other European countries, measles had been eliminated but because of declining MMR vaccination, measles became reestablished.”
Madhavan said that for the most part, those vaccinated after 1968 with two doses of the live, attenuated MMR vaccine should continue to enjoy excellent protection against measles. And while two doses are ideal, she said even one dose offers significant protection. What’s less clear is the protection level for those vaccinated from 1963 to 1968.
“If you got the measles vaccine before 1968, it may have been the killed virus vaccine version, which didn’t protect as well or for as long,” she said.
The answer, in that case, may be to get a booster two weeks before traveling overseas. Madhavan said those concerned about their immunity levels can get measles antibody titers tested.
One group at very high risk for measles while traveling are children ages six to 11 months. Madhavan said they are not old enough to get the first dose of the MMR (it’s usually given between 12 and 15 months) but too old to still benefit from maternally acquired immunity.
“Which is why we do recommend an early dose if they’re traveling to an area with measles,” she said.
And it’s never too late to get the MMR vaccine if it was never administered in childhood- though, again, the body requires two weeks to build up antibodies.
While MMR vaccination rates in the U.S. hover around 90%, Madhavan is concerned about dropping rates -- and the dramatic rise in measles cases this year. The CDC reported tracking 222 cases as of March 7, with one fatality. The vast majority -94% developed in those unvaccinated or in those with unknown vaccination status.
Just this week, Vermont officials announced that state’s first measles case this year -- in a child who traveled internationally.
“It is very possible that 2025 is the year that I see measles for the first time,” Madhavan said. “It’s extraordinarily worrisome because measles is so extraordinarily contagious.”
That is made clear by statistics from The National Foundation for Infectious Diseases. It is estimated that 90% of those not vaccinated for measles will catch the virus if exposed to an infected person. Worse, infected people don’t show the most classic sign of measles, a rash, for four days -- and they remain infectious four days after the rash appears. Madhavan said early symptoms resemble a common respiratory infection, so it’s not obvious precautions should be taken.
At Logan Airport, international travelers told Boston 25 News they are aware of the risks in other countries.
“I have huge concerns, actually,” said Isabelle Bryan, who was headed to France. “My husband is immunosuppressed, so this is definitely something we worry about a lot. We were just discussing it today about going into crowds and how we don’t feel we have a lot of time before this is going to become a big problem.”
Louise Chauncey just returned from London, where she noticed more mask-wearing than she expected.
“I did just see a report that people are getting on planes now and then are landing somewhere, and it’s possible they are carrying it and bringing it into other communities,” she said. “So it does make me a little concerned.”
While most cases of measles result in mild illness, serious, even fatal complications are possible, according to the CDC, including pneumonia and encephalitis.
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