BC Measles Outbreak - What You Need to Know
As many of you know, there’s currently a measles outbreak in Vancouver (as of Feb 2019). Originating from a family travelling overseas without vaccinating against measles, the disease has spread to enough students at their school that an official outbreak was declared.
Unfortunately, measles is an often misunderstood disease - so here are the most common questions that have been submitted to our sister site, ImmunizeBC. Please note that although portions of the content below applies to everyone, it is tailored towards BC, Canada (particularly vaccine schedules and availability/costs). For more detailed information about the measles vaccines in your area, check your health authority in your region.
As always, take the measles quiz at the bottom to earn vaccines for UNICEF!
- I’m an adult and not sure If I had the vaccine or if I’m immune. What do I do?
First, Check your immunization records. Tips for locating immunization records are here. If you can’t find it:
- For all individuals born after January 1, 1970, two doses of measles-containing vaccine (given as MMR in Canada) are recommended.
- Individuals born before 1970 are generally assumed to have acquired immunity to measles from natural infection, and therefore MMR vaccine is not recommended for these individuals.
- However, health care workers born between 1957 and 1969 are recommended to have two doses of MMR vaccine.
- Without a record of immunization (or proof of immunity to a disease), a person is considered unimmunized and unprotected and should generally be vaccinated (or revaccinated) to ensure protection. It is safe to repeat vaccines.
- Information about where to get the Measles, Mumps, Rubella (MMR) Vaccine is here.
- The schedule for an adult without a vaccine record is here, which includes 2 doses of Measles, Mumps, Rubella (MMR) vaccine. Contact your local health unit, pharmacy or doctor's office. Services vary throughout BC.
- In 1996, a measles/rubella (MR) vaccine campaign provided a second dose of measles-containing vaccine to children over 19 months of age in BC. If you have documentation of 2 doses of a measles-containing vaccine, you are considered protected and no further doses of Measles, Mumps, Rubella (MMR) Vaccine are recommended.
- Are there any side effects or risks in re-vaccinating for measles?
It is safe to repeat vaccines. Without a record of immunization (or proof of immunity to a disease), a person is considered unimmunized and unprotected and should generally be vaccinated (or revaccinated) to ensure protection. Read about the benefits and possible reactions after the measles mumps rubella (MMR) vaccine here.
- Do I need to pay for the measles vaccine?
Measles, Mumps, Rubella (MMR) Vaccine is part of the BC routine immunization schedule and it is publicly funded (free). Two doses of MMR vaccine are recommended for adults born in 1970 or later for measles protection. The MMR vaccine is available from some pharmacies/doctors' offices and local health units. Use the health unit finder.
- Children are routinely given two doses of the MMR vaccine. The first dose is given at 12 months and the second dose is given at 4-6 years of age. Children 4 - 12 years of age who also need protection against chickenpox (varicella) can get their second dose as the combined measles, mumps, rubella and varicella (MMRV) vaccine.
- Older children and teens who have not been immunized should also get two doses of the MMR vaccine.
- Those with documentation of two doses of a measles-containing vaccine are considered immune and no booster doses are recommended.
- Find out more information about Measles, Mumps, Rubella (MMR) Vaccine.
- My Child is under 4 years old, and has only had one shot of the measles vaccine so far. Are they protected?
In BC, there is no change to the routine Measles, Mumps, Rubella (MMR) Vaccine schedule at 12 months and 4-6 years of age. There is not a routine recommendation for your child to receive a measles containing vaccine early. The efficacy (vaccine’s ability to prevent illness in research studies) of a single dose of measles-containing vaccine given at 12 or 15 months of age is estimated to be 85% to 95%. Also, the varicella (chickenpox) component of the combined MMR-V vaccine cannot be given before the 4th birthday.
However, if your child is younger than four years of age and traveling overseas to an area with high rates of measles, an early second dose is recommended prior to travel. This dose can be given as early as four weeks after the first dose. To receive vaccines related to travel, contact a travel health clinic.
Individuals most at risk from measles are those who are completely unvaccinated against the disease. Those who are concerned about their potential measles exposure but have no symptoms can call HealthlinkBC at 8-1-1 and speak to a nurse.
- Can I get the MMR vaccine while breastfeeding?
There are no contraindications or precautions to immunization of either of a breastfeeding mother or her baby with vaccines that are part of the BC Immunization Program, which includes the Measles, Mumps, Rubella (MMR) Vaccine. After immunization of either a breastfeeding mother or her baby, there is: no reduction in the mother's or baby's immune response to vaccines; no increase in the risk of adverse events for either the mother or her baby.
In BC, for adults born after 1970, 2 doses of the MMR vaccine are recommended for measles protection. This vaccine is available from local health units, and some pharmacies/doctors' offices. Use the health unit finder.
- I will be travelling with a baby and I’m worried. Are there any precautions to take?
Considerations around travel with a baby are challenging.
- You can also speak with a nurse at your local health unit to ask questions about vaccines and book the 2 and 4 month vaccine appointments. Use the Health unit finder.
- If your baby is under 6 months old, they are too young for measles, mumps, rubella vaccine, you can protect your baby against many other vaccine preventable diseases with the BC routine immunization schedule.
- During pregnancy, a woman who is immune to measles from past vaccination or measles disease, shares her measles antibodies (IgG) through the placenta to her developing baby. After birth, the amount of measles antibodies the baby has and how long they last for vary depending on the woman's level of measles antibodies, whether the baby was born premature etc.
- For further questions about measles risk and protection for your baby when travelling, please speak with your health care provider or a travel health clinic.
- My family and I are travelling for spring break, do we need the measles vaccine?
- Measles travel health notices are currently posted for Europe, South America, Africa and the Philippines. Those with documentation of two doses of a measles-containing vaccine are considered immune and no booster doses are recommended.
- Find out which vaccines may be recommended or required for your destination here. Travel vaccines are available from travel health clinics, most pharmacies, and some doctors’ offices in BC.
- Read more about travel vaccines here.
- Does the measles vaccine contain human or animal cells?
Vaccines do not contain human or animal cells or tissues. Read more about vaccine ingredients here. A list of the ingredients in each approved vaccine in Canada can be found in the Canadian Immunization Guide or the vaccine product monograph available through Health Canada's Drug Product Database.
- Can a vaccinated person who is exposed to measles spread measles to others?
The measles vaccine is very effective and with the second dose of measles, mumps, rubella (MMR) vaccine efficacy (vaccine’s ability to prevent illness in research studies) approaches 100%. The MMR vaccine works with the body's immune system to produce antibodies to the measles virus. When an individual is fully vaccinated against measles and then exposed to the virus, the body recognizes and destroys the measles virus so that individual doesn't get sick. For individuals to bring home measles and pass it onto others, they would have to be infected with measles and become sick with the disease.
- Can a mother who has been vaccinated pass on their immunity to their newborn baby through breastfeeding?
When pregnant, a woman can only share antibodies against those infectious diseases she is immune to from vaccination or past disease. If present, measles antibodies (IgG) are shared through the placenta, from a woman to her developing baby. After birth, the amount of antibodies the baby has and how long they last for vary depending on the mother's level of antibodies, whether the baby was born premature etc. Breastfeeding primarily provides IgA antibodies, which mostly protect against diseases that affect the gut, such as diarrheal infections, not measles. In BC, the first dose of Measles, Mumps, Rubella (MMR) Vaccine is given at 12 months of age. MMR vaccine is not recommended for infants under 12 months of age because they may not respond to the measles component of the vaccine due to the presence of antibodies received from their mother during pregnancy.
For further questions about measles protection and your baby (under 12 months of age), please speak with your health care provider. You can also speak with a nurse at HealthlinkBC by calling 8-1-1.
- What are the symptoms of measles?
Measles, also known as red measles, is very contagious and spreads easily. Symptoms of measles include fever, cough, runny nose, and red and inflamed eyes that are often sensitive to light. These symptoms are followed by a rash, which starts first on the face and neck, and spreads to the chest, arms and legs, and lasts about 4 to 7 days. There may also be small white spots inside the mouth.
Symptoms can start as soon as 7 days after a person is infected with the measles virus.
- What should I do if I think I have measles?
If you have fever and a rash and think you may have measles, especially if you have been in contact with someone with measles or traveled to an area with a measles outbreak, have yourself examined by a health care provider. It is best to call ahead so that you can be seen quickly and without infecting other people. Measles can spread easily in places like waiting rooms and emergency rooms. The doctor or triage nurse can make sure that you are taken into a closed area for an examination and attend the clinic at a time when the waiting room is empty. Bring your immunization record with you. A physical examination, blood test, and throat swab or urine sample will be collected to make the diagnosis of measles.
- How is measles spread?
When an infected person breathes, coughs, or sneezes, the virus spreads through the air. The measles virus can survive in small droplets in the air for several hours. Learn more about measles and the vaccine to prevent it, measles, mumps, rubella (MMR) here.
If you are concerned that you have measles, contact HealthlinkBC by calling 8-1-1 to discuss any symptoms and whether to see a health care provider.
- I was recently vaccinated for the flu. Can I get the MMR vaccine?
The measles, mumps, rubella (MMR) is a live vaccine and has to be separated from other live vaccines by 4 weeks. The injected influenza and pneumococcal vaccines are inactivated (non live) and can be given anytime before or after the MMR vaccine. Read more about live and inactivated vaccines here.
Note: The nasal spray influenza vaccine FLUMIST® is a live vaccine and must be given 4 weeks from the MMR vaccine.
- Once my baby has had the first dose of the MMR vaccine, how long will it take for them to develop immunity?
In general, protection starts to develop after about two weeks of getting the measles, mumps, rubella (MMR) vaccine; however, a number of factors impact an individual's’ response to vaccines. The efficacy of a single dose of measles-containing vaccine given at 12 months of age is estimated to be 85% to 95%. With a second dose at 4-6 years of age, protected against measles for children approaches 100%.
- Can you spread measles from a measles vaccine rash?
The MMR vaccine cannot cause measles disease in people with healthy immune systems. However, a rash that looks like measles can be a side effect of the MMR vaccine and occurs about 7 to 12 days after getting the vaccine. The vaccine rash is non-infectious and will resolve on its own. You can find more information on MMR vaccine, its benefits and possible reactions here.
We recommend that you follow up with your health care provider to have the rash diagnosed as there are many different causes of rashes in young children.
- Can babies under one year of age get the MMR vaccine?
Infants under 12 months of age
- MMR vaccine is not recommended for infants under 12 months of age.
- Infants under 12 months of age may not respond to the measles component of the vaccine due to the presence of antibodies received from their mother during pregnancy. MMR vaccine is only recommended for infants 6 – 11 months of age if traveling overseas to areas with ongoing measles outbreaks. Such infants would still require 2 doses of MMR vaccine after 12 months of age. To receive vaccines related to travel, contact a travel health clinic.
- I am pregnant. Are there any risks if my household is vaccinated for measles?
Immunization of household contacts with the MMR vaccine is safe for pregnant women. Vaccine viruses in the MMR vaccine are not transmitted to contacts so the vaccine does not pose a risk to a pregnant household member. The MMR vaccine should be administered to children and other household contacts of pregnant women as recommended. Ensuring that children and other close contacts are up-to-date with their immunizations can help protect the health of the pregnant woman and her baby.
- I’ve had two doses of the measles vaccine, do I need a ‘booster’ dose?
Those with documentation of two doses of a measles-containing vaccine are considered immune and no booster doses are recommended.