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Expert advice

15th Feb 2024

Pharmacist shares what parents need to know about the measles

Jody Coffey


Measles cases have been increasing across the globe

The outbreak of measles has left families with a lot of questions and concerns about the contagious disease and the MMR vaccine.

The World Health Organisation recorded 42,200 cases of Measles across 41 member states in Europe in 2023.

That’s compared to 941 cases in total for 2022.

This trend shows a worrying trajectory, with a person sadly losing their life to a measles infection in Ireland last week.

Irish Pharmacist, Sheena Mitchell, owner of totalhealth pharmacy in Milltown, has called on the Minister for Health and all relevant departments to urgently allow the MMR vaccine to be delivered by community pharmacists.

In the meantime, she has answered several Measles and MMR-related questions to ensure expectant parents and families in Ireland have the correct information.

Will the MMR vaccine be free from my GP now that the catch-up programme has been extended to everyone?  

Yes, however not all GPs are partaking in the catch-up programme due to already pressurised schedules.

“With two-thirds of GPs in the West of Ireland already not able to take on new patients, this is a serious cause for concern. Community Pharmacists are ideally placed to help with MMR catch-up vaccination programme as there is one in every locality.”

Will GPs offer a blood test to check for antibodies if there is no evidence or records available regarding vaccination status for either a child or adult?

“No, blood tests will not be offered if a patient is in doubt as to their vaccination status.

“The official health guidance is for GPs to offer a third booster MMR vaccine as it is more efficient and safer to do so. Blood tests would be costly and time-consuming to do on every unsure parent.

“Many patients now looking for reassurance would have been children when their vaccination did or did not occur. They would have had no autonomy or choice with regards to their vaccination and many of their parents are unsure of their vaccination status or no longer alive to confirm the information.”

I am worried about my baby contracting Measles. Why do I have to wait until they are 12 months old before getting the vaccine?

“Firstly, your baby will most likely have some early immunity to Measles from you, given to them in utero.

“This immunity will be strongest if you have natural immunity from having had measles yourself, rather than simply from your vaccination status. This passive immunity does wane however and so the HSE advise that the first dose of the MMR vaccine is given at 12 months of age.

“The manufacturer advises that vaccination can take place from 9 months however the vaccination programme reflects the fact that the data for vaccination at this age shows only 72.3% efficacy compared to 90.6% at 12 months of age.”

I am breastfeeding, will it give Measles immunity to my child until they are old enough for the vaccine?

“Breastfeeding offers significant protection against measles infection for your baby for as long as you keep it up.

“It will vary from person to person depending on the strength of the mother’s immunity though.”

Do I need to cocoon my young baby now that Measles is officially in Ireland?

“No, that is not necessary. The HSE is encouraging those without sufficient immunity through the first or subsequent booster vaccination to avail of the catch-up programme for the MMR vaccine.

“This will improve overall herd immunity in the community to 95% vaccinated as per WHO guidelines, and this will protect the most vulnerable. If there is a Measles outbreak, the HSE will issue localised advice to the public accordingly.”

I’m pregnant and my blood test showed no or low immunity to Rubella. What should I do if I come into close contact with Measles? 

“If your Rubella immunity was low during pregnancy this can indicate low Measles immunity. If you’re at risk of catching Measles following close contact, a treatment called human normal immunoglobulin (HNIG) can be given within six days of exposure to the virus.

“It can be given to babies under six months of age, pregnant women who have not been fully vaccinated or had measles before, or people with weakened immune systems.

“If you have no reason to believe you have been in close contact with Measles, then your GP can administer a booster dose of the MMR vaccine to you after your baby has been born.”

I’m breastfeeding at the moment, can I get the MMR vaccine?

“Yes, the HSE recommend the MMR vaccine if you showed no Rubella immunity during routine pregnancy health checks, whether you are breastfeeding or not. The MMR vaccine is cautioned by the manufacturer during breastfeeding only due to limited testing, it is not contraindicated for use.

“The MMR given after pregnancy protects against Rubella infection in any future pregnancies. It is a live vaccine, however, and so any new pregnancy must be avoided for one month following vaccination.”

How long will the first MMR vaccination take to work? 

“Antibodies will start to be produced from as early as 2-3 days.

“The MMR vaccine will usually be fully effective from 2-3 weeks, although the official line from the manufacturer is 6 weeks for 90.6% efficacy.”

Can someone vaccinated against measles carry the virus and pass it to someone unvaccinated?

“The virus can live in the air and on surfaces for up to two hours, so it is important to wash your hands regularly if you are around an unvaccinated or immunocompromised person.

“A fully vaccinated person will not replicate it in their body which means they will not be shedding the virus even if they came into contact with it. This makes it very unlikely that they would bring the virus home. 

“The vaccine offers a high level of efficacy, but no vaccination is 100% effective and so ideally, we reach herd, or collective immunity, by achieving the WHO recommendation of over 95% uptake. This is why the current MMR vaccination catch-up programme is so important.”

Do children have to be vaccinated to attend creche? 

“In Ireland, the law does not require a child to be vaccinated to attend a childcare service or educational setting.

“However, vaccination records must be maintained by childcare providers so that they can offer tailored advice and protection to all service users and staff if there is an outbreak of an infectious disease.”

How long is someone with Measles contagious?

“A person with the Measles infection would be contagious for four days before the rash onset and for four days after the rash appeared.

“The first signs of infection are flu-like symptoms, then the spots in the mouth, and finally the skin rash.”

What is the difference between rubella and measles virus?

No, they are different. German Measles is the common name for the Rubella virus.

“Rubella is less contagious than Measles and it is riskiest to those in pregnancy. The MMR vaccine protects you against Measles, Mumps and Rubella viruses.

“Rubella is a notifiable disease and to date there have been no known outbreaks in Ireland.”

Should I get my child vaccinated with their second booster MMR vaccine before they are offered it in junior infants in school?

“No, there is no need to speed up the second vaccination to achieve 99% immunity at the moment.

“If there is a Measles outbreak in Ireland, this advice may change and will be directed at a local level by the HSE. Your child already has over 90% immunity from their first vaccination.”

Can you still get vaccinated against Measles if you have an egg allergy?

“In the past, some children missed out on some vaccinations due to an egg allergy.

“We now know that a reaction to this element of the vaccine is very rare and as a result, children with even a severe egg allergy are routinely vaccinated. However, it is still important to make your doctor or a nurse aware.”

More information about measles symptoms and how to protect you and your family can be found here.