The current measles outbreak in Europe has provided an unfortunate reminder of the dangers of this deadly disease, as well as the need for vigilance over vaccination programs. As soon as our guard is let down and MMR vaccination uptake rates falter, measles raises its ugly head once again.
Although it has not yet reached Malta, the outbreak provides an opportunity to remind ourselves why MMR vaccination is so essential, and why it is strongly recommended by all health organizations around the world.
Here’s a breakdown of what you need to know about the vaccine.
1. What are Measles, Mumps and Rubella (MMR)?
These are 3 viral infections, most commonly contracted in early childhood.
Measles looks like any other viral illness, you’ll get a fever and a rash, runny nose, red eyes, and a cough. There is little to tell it apart from less serious viruses because there are no early signs to pick up on, and there’s no specific treatment to prevent complications.
Measles is extremely contagious: following exposure, approximately 90 percent of susceptible individuals will develop measles. It can also be severe, with involvement of the lung and brain in some cases leading to death. Worryingly, measles can lead to brain damage in a child several years after the acute infection.
There is little to tell it apart from less serious viruses
Mumps causes fever and a rash, and can sometimes be complicated by encephalitis (brain inflammation with seizures), meningitis (inflammation of the lining of the brain), pancreatitis (inflammation of the pancreas), orchitis (inflammation of the testicles, potentially leading to male infertility), and deafness.
Rubella can infect the unborn fetus, resulting in severe birth defects
Rubella infection is often asymptomatic or unremarkable – meaning, if you get sick with rubella you will just feel vaguely unwell, or might not even notice. Unfortunately, this is not the case in pregnant women: rubella can infect the unborn fetus, resulting in severe birth defects such as heart disease, brain abnormalities, and miscarriage.
Many people have forgotten how severe these viruses can be, precisely because the MMR vaccine has been so effective in preventing them that we rarely see them any longer.
2. MMR is a very effective vaccine
Measles vaccination alone has saved an estimated 17.1 million lives since the year 2000. Let’s break it down: two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps. One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella.
People who received two doses of MMR vaccine as children are considered protected for life.
3. It does have side effects
MMR vaccination is associated with several side effects. The most common of these include mild symptoms such as fever (1 in 6 recipients), a rash (1 in 20 recipients), and swelling of the glands in the cheeks or neck (1 in 75 recipients).
If these problems occur, it is usually within 6-14 days after the shot. They occur less often after the second dose. The fever caused by the vaccine may trigger off seizures (jerking or staring) in 1 in 3,000 doses, while MMR vaccination may also cause temporary pain and stiffness in the joints (1 in 4 recipients).
Rarely (1 in 30,000), the vaccine can cause a temporarily low platelet count, which can increase a child’s risk of bleeding. The most significant side effect is an allergic reaction, though this occurs in <1 in 1,000,000 doses.
4. But it does not cause autism
The MMR vaccine does not cause autism. Scientists are as close to certain about this as they could ever possibly be.
The concerns about the link with autism can be traced back to a single study involving just 12 patients, published in 1998. Since its publication:
- 10 of 12 co-authors retracted their conclusions, saying “no causal link was established between MMR vaccine and autism as the data were insufficient”.
- The journal that published the study admitted that the author had undisclosed financial interests of his own in undermining the vaccine. This journal subsequently retracted the study, saying the methods used were incorrect.
- The authors were found guilty of ethical violations, scientific misrepresentation, and deliberate fraud, i.e. they picked and chose date that suited their case, and falsified facts. In other words, they were lying about their findings the whole time.
- The lead author has been struck off the medical register in the UK: he is not allowed to practice as a doctor any longer.
Huge international studies, involving hundreds of thousands of patients, have since disproved any link between MMR and autism. This means that children who take the MMR vaccine do not have any increased risk of being autistic.
The truth is that measles itself can cause severe brain damage (1:1000 get brain/spinal cord inflammation, and half of these develop permanent disability), as can rubella infection of the unborn fetus.
‘The overall evidence clearly indicates no association of MMR vaccine with developmental disorders including autism’
World Health Organisation – WHO
5. Vaccination protects your child and all other children simultaneously
The MMR vaccine not only prevents a child from contracting these 3 viruses, but also prevents a child from transmitting the viruses to anyone else.
This is why it is so effective: it prevents infection and interrupts transmission from child to child. This phenomenon is called herd immunity.
6. It’s free in Malta
So there’s really no reason not to make sure your child has it. Here’s some where you can get more info on the vaccine.
7. It is given in two doses
The first dose at 12-13 months, then a booster at 3-4 years. Kids have can still have it if they are late – better late than never!
8. Your child can’t have the vaccination if…
He or she is sick at the time of planned vaccination. In that case it’s a good idea to wait a couple of weeks till your child recovers before administering it.
Also, the vaccine can’t be administered if:
- The child has had a severe allergic reaction to a previous MMR dose
- A woman wants it but she is pregnant
- If the child has a suppressed immune system
Outbreaks of measles occur every year, wherever parents stop vaccinating their children
9. MMR infections are still a danger
Vaccination programs have led to the eradication of certain infections in the past: smallpox was successfully eradicated, and we are close to getting rid of polio. This is unfortunately not the case with measles, mumps and rubella.
Outbreaks of measles occur every year, wherever parents stop vaccinating their children. This happens all over the world, most recently in Romania and Italy. Communities which refuse MMR vaccination have high rates of measles, such as Amish communities in the USA, and the so-called Bible Belt in Holland. This teaches us that we can never let our guard down on MMR vaccination.
If have any questions please contact the National Vaccination Centre in Floriana on +356 25 680 000 or +356 25 680 222.
Lovin Malta thanks Paul Torpiano for his help with writing this article. Paul is a Paediatric trainee currently working at Mater Dei Hospital.