As moms, we all want to do the best we can to keep our children safe and healthy. But with all the information out there--and in many instances, misinformation--doing our best can get confusing. When it comes to vaccinating our children against measles, though, we can’t afford to be confused. After near eradication, there’s a sharp rise in reported cases of this potentially deadly disease, and those who cannot take the vaccine--including young infants and pregnant women, among others--are at risk. Especially in areas where pockets of the population are purposely opting against vaccinating their children. Like New York City.
To put some clarity back into the conversation, we turned to Dr. Jennifer Trachtenberg, pediatrician at Carnegie Hill Pediatrics in NYC and co-founder of Baby Bundle App. Below, Dr. Trachtenberg guides new moms on talking to their doctors (and friends) about vaccinations, and arms you with the information you need to keep your baby--and everyone else’s--safe and healthy.
There have been cases of measles in the past. Why is this particular measles outbreak so noteworthy?
Measles is extremely contagious, so much more so than, for example, chickenpox. If you are not vaccinated or had the disease already and you are in the air space of someone who is contagious, then you are very likely to develop measles. They do not have to sneeze or cough directly on you--the measles particles stay circulating in the air for a very long time.
It’s important that this issue receives a lot of press because parents need to understand that measles was considered eliminated from the United States, then last year there were about 600 cases. This year, with the Disneyland outbreak, we are up to about 100 cases, and it’s only February! In addition many people may be unaware that measles is contagious about 4 days before the sick individual even shows any signs or symptoms of the disease, leading to a lot of people being exposed. If you are unvaccinated and around someone who is contagious with measles, you have a 90 percent chance of getting the disease. That's super high.
How or why is it particularly relevant in NYC where we have a larger population of affluent parents not vaccinating?
In areas where there are pockets of children that are not vaccinated, there runs the risk of a greater spread of the disease. California was the epicenter of the current outbreak at Disneyland; however, due to visitors from all over the U.S., the infection has spread to other states such as Arizona, New York and Utah. In addition, international travel contributes to cases being brought back into the U.S. In 2013, the largest outbreak occurred in NYC. None of the patients had documentation of vaccination, and of those that were eligible for the vaccine, 67 percent had parental objection because of religious or philosophical beliefs.
What's the timing of the measles vaccination? Why might someone delay the vaccination? Can a child still get the vaccination if he or she is sick?
In general, the first MMR (measles/mumps/rubella) is given between 12-15 months, and then a second dose given between 4-6 years of age. However, it is ok to give the second dose any time after 28 days from the first dose.
The American Academy of Pediatrics strongly recommends vaccinating children on time to protect all children, as some have medical reasons that the vaccine cannot be given to them. A person should not get the vaccine if they have had a severe allergic reaction (anaphylaxis) after a previous dose, or if a child has a severe immunodeficiency disorder, cancer, HIV, is on chemotherapy or has severely low blood count. Also pregnant women should not get the vaccine. If a child is acutely very sick, for example with pneumonia or a flu with fever, you can delay your vaccine until the child is well. However an illness like the common cold is not a reason you would need to delay getting the vaccine.
How can I find out how my own doctor handles vaccinations? What are some of the policies out there and why are they so different?
The best way to find out about your doctor’s procedures on vaccinations is to speak to them directly, just as you do about any other health or parenting question you may have about your child. As a pediatrician, it’s my job to educate and relay the facts to parents so they can understand why vaccinations are so important to the health of our children. There is no specific policy regarding how a practitioner decides to deal with those that decide not to vaccinate their children so this is a conversation you should have with them.
My child already got the vaccination. Is there any reason I should be worried or careful in public or around kids that aren't vaccinated?
The measles vaccine is very protective. It is ok for your child to continue all their daily activities and attend school. I tell my patients not to worry--you’ve done your best at protecting your child from the disease.
What about other vaccinations? How can I stay vigilant about protecting my child against other diseases?
Make sure that you take an active role in your child’s health and discuss with your child’s pediatrician what may be needed. Make sure your child remains up to date. Tools like my Baby Bundle App allow you to record and store all your child’s vaccines as well as other health information, so you can always have the information you need right at your fingertips. It also gives you suggested questions to be asking your pediatrician at the check-ups. Just another way to help simplify and organize so you can stay on top of your baby’s health and development.
How do I talk to other parents about vaccinations? It's such a heated topic--any suggestions?
As a parent you will certainly have many discussions and hear varying points of view from other parents. I think it’s great to express your views, but don’t get frustrated trying to change the views of others. It will more likely than not end with hard feelings. As moms, we are all trying to do our best for our kids, so try not to be judgmental. However you certainly can inquire about your child’s friends’ vaccination status, so you as the parent can decide if you want to take the risk of possible exposure to your own child.
There's so much misinformation out there. Where can I find accurate, up-to-date information on measles vaccinations and other health issues?
HealthyChildren.org, which is from the American Academy of Pediatrics