Address Measles Vaccine Concerns and Promote Immunization

You're on the front lines to ensure patients are vaccinated against measles...especially with the recent outbreaks.

It's a big problem in areas with low immunization rates. Explain that 9 out of 10 nonimmune patients will get measles when exposed.

Be open to questions...and put benefits and risks into perspective.

Reassure that numerous studies show MMR and other vaccines DON'T cause autism. And about one in 1,000 patients who get measles will die.

Discourage delaying vaccines. Educate that giving multiple vaccines according to the recommended schedule won't overwhelm the immune system.

Give clear, strong recommendations...and share positive experiences.

For example, saying "I'm fully vaccinated and so are my kids" helps build trust. Use our conversation starter, Vaccine Adherence: Addressing Myths and Hesitancy, to support your discussions and tackle barriers.

Promote appropriate vaccination and follow provincial schedules.

Kids. Continue to recommend two doses of MMR or MMRV...at 12 to 15 months, then between 18 months and 6 years, preferably by school entry.

For infants 6 to 11 months travelling outside North America, advise one dose of MMR. But point out they'll still need two MORE doses per the usual schedule...instead of two doses total.

Recommend kids 12 months or older finish their 2-dose series before travel...given at least 4 weeks apart.

Adults. Point out that adults born before 1970 usually have natural immunity to measles. But recommend one dose of MMR if they're travelling outside North America.

For those born in 1970 or later, confirm they've had at least ONE dose of MMR. But recommend TWO doses separated by at least 4 weeks for travellers outside North America or post-secondary students.

Also recommend TWO doses for healthcare workers or military personnel...regardless of what year they were born.

Don't recommend MMR for severely immunocompromised or pregnant patients...since it's a live vaccine.

Explain MMR boosters aren't recommended during a measles outbreak. About 97% of people develop lifelong immunity after two doses of a measles vaccine. This differs from mumps, where waning immunity is a concern.

Be alert for measles symptoms, such as fever, the "three Cs"...cough, coryza (runny nose), and conjunctivitis...and a rash starting on the face.

See our chart, Measles FAQs, for answers to common questions.

Key References

  • www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#p4c11a5
  • www.cdc.gov/measles/cases-outbreaks.html
  • Ann Intern Med Published online Mar 5, 2019; doi:10.7326/M18-2101
  • MMWR Recomm Rep 2013;62(RR-04):1-34
  • www.cdc.gov/measles/hcp/index.html
Pharmacist's Letter Canada. Apr 2019, No. 350401



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