What People Should Know About Measles
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Welcome to Paging Dr. Gupta. You know, I just got back from West Texas. I was covering the measles outbreak there, and it was really interesting to be on the ground in the middle of all that.

There's a sense of frustration among a lot of the citizens, a lot of the healthcare workers that were experiencing this sort of outbreak at all. I think there are people who are really frightened about what is unfolding, especially people who have members of their family or who they themselves are immunocompromised. They're worried about contracting measles. And then I think there's a real sense of just trying to figure out what is going to happen next. Like how much is this measles outbreak likely to grow?

We obviously don't know the answers to those questions, but I will tell you that if you talk to health officers on the ground,

they will tell you that this outbreak is probably going to last for months. And there's going to be several hundred people ultimately who do get the measles. So that's what they're sort of preparing for. You know, we don't talk about measles much anymore, and that's in large part because it was considered eliminated in the United States back in 2000. That means they hadn't seen a new case of measles for many years in the United States.

Many of the doctors who are now caring for these patients with measles, this is the first time they've actually seen a patient with measles. So I think that's the source of frustration, that these are vaccine-preventable diseases, and here we are taking care of them.

A big part of the reason why we're seeing an uptick in numbers is because of lower vaccination rates. That's what it's allowed these cases to pop up again. And it's also led to a lot of questions. So to start sharing them as one of our producers, Kira. Kira, what's the first one? Hey, Sanjay. So Kathleen wants to know, why is the vaccination rate so low in that part of Texas and New Mexico?

Yeah, this is a good question. You know, most of the cases are actually occurring in a under-vaccinated community, a community which does not traditionally seek traditional health care. It's largely a Mennonite community. It is rural. It is close-knit. It is insular.

And what we know when we look at the vaccination rates there is that they're close to 82%. That's in Gaines County, Texas, where the epicenter of this outbreak has been, 82%. So that means roughly one in five incoming kindergartners, for example,

did not get the vaccine in that particular area. Many of them, by the way, are homeschooled, so they're not required to get the vaccine as part of attending a public school. But that is typically what you see, is that you see pockets of under-vaccinated communities versus a broad swath of a population that is under-vaccinated. But when you have a virus as contagious as measles, one of the most contagious viruses that exists on the planet,

you can run into problems once you start to drop below sort of 95% coverage, for example. That is one of the big concerns here. Public health officials want the vaccination rates to be above 95% by the time kids are four or five years old. By the time they start to attend school, that is the number they're shooting for to try and get herd immunity.

Nearby counties stand closer to that, you know, 92, 93 percent. But again, the under-vaccinated communities in this area can have an impact on the community overall. So that is what we're really running into. And it's not just West Texas, not just New Mexico. There are other places around the country where we see this. Back in 2019, I covered a large outbreak that occurred in Brooklyn, New York. There have been outbreaks in Minnesota.

There was an outbreak in Disneyland in Southern California. So it's not just West Texas, but what I just described is typically what drives at least the initial outbreak, and then it just grows from there. Okay, Kara, what's next? Next, Elizabeth said, I'm 72 years old and had measles as a child, but I don't remember children dying from this disease. So has measles become more virulent?

Yeah, Elizabeth asks a really important question. For a lot of people, again, they've never seen measles or they don't remember how bad it once was.

The virus has not become more virulent. In fact, the measles virus has stayed pretty stable over the decades. Unlike flu, which shifts and drifts every year, or COVID, which has a lot of mutations, measles has been pretty stable. And the average complications of measles, or the death rates, occur just infrequently enough that the average person may not have been aware of them even before widespread vaccination.

So if you go back to the mid-60s, early 70s, when we really started to vaccinate robustly in the United States, there were about 400 to 500 people dying a year. Those numbers had come down from the decades earlier, in large part because of better medical care. We could treat medical care better, but then 400 to 500 people were still dying every year. A lot of people were ending up in the hospital, a lot of people getting sick. If you looked around the world,

Measles would typically claim around two and a half million people every year, sadly. Two and a half million people would die. These days, the comparative figure is closer to 107,000 measles deaths every year. And those typically occur in countries with low vaccination. So, you know, that's really what you have to sort of keep in mind. A few hundred people were dying every year before vaccination.

And after vaccination, there were just a few people, period, dying of the United States every year. So, Elizabeth, it should not be surprising that maybe you did not know people dying of the disease, but it was happening. And because of vaccination, those numbers have come down very, very significantly. There are many vaccine-preventable diseases out there. Measles is one of them.

And the vaccines really do work. They've been around a long time and they've made a huge difference. Okay, coming up after the break, a question a lot of you have been asking. If you got the measles vaccine as a child, are you still protected? This podcast is supported by Sleep Number.

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These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Okay, Kira, who's paging us next? So Sanjay, a lot of people actually had this question, including Mary. And she asks, I'm 59 years old. Does the measles vaccine I got as a child still protect me now? So Mary, the short answer to the question is yes. You should still be protected now.

Measles vaccine is typically two doses, one dose around a year of age or so, and the second dose before you start school, so four to five years of age. One dose usually is about 93% effective against measles, two doses 97% effective.

You've probably heard those numbers, but the number you may not have heard, and this sort of answers your question, is that less than 1% of people who receive those two vaccines will have waning immunity to measles to the point where they are now susceptible to infection. You know, you make antibodies in response to the vaccine. Again, most people, they will maintain those antibodies. You'll still have antibodies years, decades later. But less than 1%, those antibodies do tend to wane.

One thing I'll point out, a little nuance, is that the first version of the vaccine came out in 1963, and that version was used until 1968. So many people like Mary and myself, for that matter, probably got that first version of the vaccine. The CDC does recommend the people who got the first version of the vaccine get at least one dose of the newer MMR vaccine. Now, if you're wanting to be sure before you do that, you can get your titers checked.

It's a blood test, and it basically is checking for your antibodies against measles. I actually had that done recently because I'm working on a documentary about transplant surgery. And as part of being in the operating room with these immune-compromised folks, they wanted to make sure that I was still protected against measles. I had my titers checked. I'm in my mid-50s now, and my titers were fine. So if you're curious, if you're worried, if you just want to make sure,

you can get that blood test done. And also, you know, people who have weakened immune systems, they may in particular want to get this checked out. Okay, we've got time for one more question. Kira, what's the last one? All right, this one's coming from Laura, who asks, should my two-year-old grandson get his second dose of the measles vaccine now instead of waiting until he's four like he normally would? Okay, this is a question that I heard a lot even when I was on the ground in West Texas.

Again, first dose, 93% effective. Second dose sort of boosts your immunity to 97% protection. The reason that the vaccine schedule exists the way that it does in the United States, which, by the way, is different than a lot of other countries around the world. But that first dose given, again, around a year of age. And then the second dose was to be given before kids start school. So around four or five years of age, because most kids start school shortly thereafter.

Now, Laura did not share where her two-year-old grandson lives, but if he lives in the midst of a measles outbreak, such as Gaines County, Texas, state health officials are now recommending that children over 12 months who have received one dose now get their second dose as soon as possible.

Again, the normal vaccination schedule would be for Laura's grandson to get that second dose at four to six years of age. But where an outbreak is occurring, the thinking is let's increase the measles immunity and prevent more occurrence of the disease as much as possible. Now, if your grandson, Laura, or if anybody who's listening child does not live in one of the communities impacted here, then waiting for that second shot until four to six years old is fine.

Again, there are countries around the world where they say get a shot at 12 months of age and then another shot at 18 months of age. There's no harm in advancing the timing of that second shot. But the reason they wait is they want to make sure it's given as close to the time as when they're starting school as possible. So bottom line, most important thing is to be fully vaccinated because getting that second shot does boost your immunity even more.

And it's really important to be thinking about these things, especially when you're in the midst of a measles outbreak. So Laura, thank you for that question.

And that is all for today's episode. You know, we've only been doing this for a few weeks now, and so many of you are sending in questions. I had no idea there were so many questions out there about these topics. So keep them coming in. If you've got a health question, I want to hear it. Record a voice memo, email it to asksanjay at cnn.com, or give us a call, 470-396-0832, and leave a message. Thanks so much for listening, and I'll be back next Tuesday.

Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sophia Sanchez, and Kira Dering. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Seeley is our showrunner. Dan DeZula is our technical director. And the executive producer of CNN Audio is Steve Liktai.

With support from Jameis Andrest, John D'Onora, Haley Thomas, Alex Manassari, Robert Mathers, Lainey Steinhardt, Nicole Pesereau, and Lisa Namarau. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Katie Hinman.

There's a reason the Sleep Number smart bed is the number one best bed for couples. It's because you can each choose what's right for you whenever you like. Firmer or softer on either side, Sleep Number does that. One side cooler and the other side warmer, Sleep Number does that too. You have to feel it to believe it. Sleep better together. Why choose a Sleep Number smart bed? So you can choose your ideal comfort on either side. And now save 40% on the new Sleep Number special edition smart bed. Limited time.

exclusively at a Sleep Number store near you. See store or sleepnumber.com for details.