Record Number of Measles Cases in 2019 Highlights Importance of Immunization

Measles cases in the United States have reached a record high in 2019, according to a recent CDC report that highlights the importance of immunization. During January 1 to October 1, 2019, there were 1249 measles cases and 22 outbreaks across 31 states and New York City that were reported in the United States, with 10% resulting in hospitalizations.¹

These numbers represent the most US cases reported in a single year since 1992.¹ Additionally, 89% of the measles cases occurred in patients who were unvaccinated or had an unknown immunization status. Measles cases have increased since the CDC’s May report, as there were 704 cases January-April 2019.²

Measles cases this year have occurred across all age groups: 13% were infants less than 12 months; 31% were children aged 1 to 4 years; 27% were children aged 5 to 17 years; and 29% were adults aged 18 years and older.¹ Eighty-six percent of measles cases were associated with outbreaks in under immunized, close-knit communities, including 2 outbreaks in New York’s Orthodox Jewish communities that threatened to end measles elimination status in the United States¹ The anti-vaccination movement and the spread of vaccine misinformation were largely responsible for these outbreaks.

It was recently announced that the United States has maintained its measles elimination status since the New York State Department of Health declared the end of an almost year-long outbreak in New York, making it a close call.³ “But this past year’s outbreak was an alarming reminder about the dangers of vaccine hesitancy and misinformation,” said HHS Secretary Alex Azar.³

Measles can spread rapidly, especially when it is introduced into an under vaccinated community, and measles elimination status is lost if a chain of transmission in an outbreak is sustained for more than 12 months.³

Pharmacists can play an important role in reminding patients about the importance of measles vaccination through evidence-based guidance. The CDC’s report highlights that many school-aged children were infected with measles and most never received the measles, mumps, and rubella (MMR) vaccine.

The first dose of the MMR vaccine is generally given at age 12-15 months, so the 13% reported by the CDC who were infected with measles were too young to be vaccinated.¹ This further emphasizes the importance of vaccination to protect those too young for the immunization.

Pharmacists should continue educating parents about the negative health consequences of not vaccinating against measles, which include brain damage, hearing loss, pneumonia, hospitalization, and death.

REFERENCES

• Patel M, Lee AD, Clemmons NS, et al. National Update on Measles Cases and Outbreaks-United States, January 1-October 1, 2019. MMWR Morb Mortal Wkly Rep. ePub. DOI: http://dx.doi.org/10.15585/mmwr.mm6840e2. Reviewed October 10, 2019. Accessed October 14, 2019.
• Gershman J. CDC report shows measles cases are rising in the United States. Pharmacy Times. https://www.pharmacytimes.com/contributor/jennifer-gershman-pharmd-cph/2019/05/cdc-report-shows-measles-cases-are-rising-in-the-united-states. Published May 3, 2019. Accessed October 7, 2019.
• U.S. Department of Health & Human Services. With end of New York outbreak, United States keeps measles elimination status. HHS website. https://www.hhs.gov/about/news/2019/10/04/end-new-york-outbreak-united-states-keeps-measles-elimination-status.html. Published October 4, 2019. Accessed October 7, 2019.