Does Your Child Need The Extra Measles Vaccine?

We’ve been getting a lot of calls from concerned parents regarding the local campaign to vaccinate all schoolkids with measles vaccines. As far as I understand, this is voluntary for students. Firstly, people should understand that there is no crisis of a sudden measles outbreak; this is simply a national campaign to wipe out measles, hopefully for good.

In general, expat children who have had their routine vaccines would not need this extra measles vaccine, although in theory there is no immune system harm in getting a further shot. In the U.S., it is routine to get measles in the combined MMR vaccine at 12 months, and then get a booster at age 4-6 years. Those of you on this schedule would not need extra shots now.

Apparently the main issue is that China’s vaccination levels are good but at 80% are not quite high enough to provide excellent “herd immunity” to protect everyone. So, many children in China are still getting measles, which can still be a deadly disease, and it remains a noble goal to wipe out this disease entirely from the globe.

Here’s the entire press release from the World Health Organization in China:

BEIJING, China, 1 September 2010 – Nearly 100 million children across China will be vaccinated against measles from 11-20 September in one of the world’s biggest such public health undertakings to date. The nationwide campaign will protect millions of children against the disease and bring China closer to reaching the measles elimination goal by 2012 in line with the target set by the World Health Organization’s Western Pacific region.

“China is a priority country in the global fight against measles and we commend the government for its leadership in this life-saving work,” said Dr Michael O’Leary, the World Health Organization (WHO) Representative in China.

In 2009, more than 52,000 people in China were reported to have contracted measles, accounting for about 86% of the measles cases in WHO’s Western Pacific region.

Measles is a highly contagious viral disease that affects both children and young adults. While most individuals recover from measles infection, some may suffer serious complications such as blindness, encephalitis, severe diarrhoea, pneumonia and ear infections. It is a leading cause of avoidable death and disability among children in developing countries. Globally, an estimated 164,000 people died from measles in 2008 – mostly children under the age of five.

The most effective way to prevent the disease is through vaccination. Currently, China offers two doses of measles containing vaccine as part of its routine immunization programme. In addition, 27 provinces have implemented measles campaigns since 2004.  Extensive experience from other countries shows that well-conducted campaigns can ensure that every child, especially those not reached through the routine immunization program, receives measles vaccine.

“However”, said Dr. O’Leary, “Some people living in remote areas and large urban cities, as well as the large migrant population, may have less access to vaccines and healthcare than other segments of the population, and thus not be protected against measles.  In addition, a small percentage of children who have previously been vaccinated against measles may not have developed immunity to the disease. ”

Next week’s mass vaccination seeks to address those gaps.

“This campaign is important for every family in China: in remote villages, in urban areas and in migrant communities,” said Dr Yin Yin Nwe, UNICEF Representative for China. “We encourage all parents to take their children to the closest vaccination clinic during the campaign period. This huge nation-wide effort will produce significant benefits for child survival.”

The measles vaccine is a safe and highly effective vaccine. But as with most vaccines, some children may get fever or mild reactions in the days following vaccination. This means that the vaccine is working to protect the child. Some may worry about their child receiving multiple doses of vaccine. However, a child who has previously received measles vaccination can be given an additional dose of measles vaccine. “The immune system can easily manage multiple or repeated vaccinations,” stated Dr O’Leary.

Vaccinating every child, even those that have been vaccinated in the past is essential in stopping the virus with a wall of immunity in the population. Using this strategy, which was developed by WHO, has enabled countries in Central and South America to eliminate measles.

The measles vaccination campaign takes place in the context of international partnerships and collaborations. WHO has worked with the China Ministry of Health to provide technical support. In addition, China and countries in the Americas have shared experiences through exchanges of experts to ensure that the campaign is conducted according to international standards.

Here’s a bit of info from China Daily:

The country’s routine measles immunization program, introduced in 1978, reaches about 80 percent of the population.

Routine measles vaccinations for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce measles deaths globally.

Two doses of the vaccine are recommended to ensure immunity.

Measles can be eliminated in a country only when more than 95 percent of the population has immunity, Luo said.

“A small percentage of children who receive the vaccine in China don’t develop immunity to measles. But currently there is no easy, cheap and fast test that can tell if a child has immunity to measles or not,” said Vivian Tan, spokeswomen for the World Health Organization’s (WHO) Beijing office.

via Measles jabs declared safe.

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6 thoughts on “Does Your Child Need The Extra Measles Vaccine?”

  1. hi Dr. Saint Cyr, I have a question for you. My kids got the measles booster today at their school, it's a regular Chinese school, not an international one.

    Afterwards it occurred to me that most people in China have a scar on their upper arm, presumably from childhood vaccinations. In the U.S. no one has that scar anymore and I guess it's because we have a different technology for giving those immunizations.

    Do you know what shot is it that's giving kids in China those scars? I want to make sure my kids don't get the scar so I want to get that shot for them in the U.S.

    And please tell me it's not the measles booster because they already got that one here… 🙂

    Many thanks in advance!
    – melanie

    1. I’m pretty sure you’re talking about the BCG vaccine; that’s the one that fights tuberculosis. We don’t get it in America so aren’t familiar with that one…

  2. I’m not aware of any quality control issues with this Chinese vaccine; the WHO closely monitors vaccine production in China and seems comfortable with it.

    As for the vaccination rate, that 99% quote is indeed quite high; I don’t think it’s that high even in America or Europe. The published numbers in the papers for measles coverage are 80% and the goal is to get to at least 95%, which seems to be the threshold for community herd immunity.

    As for serology, it definitely wouldn’t be cost-effective for a relatively poor country like China to test everyone first for antibodies. But I do agree that two shots is enough, no matter what.

    And for serious reactions to the vaccine, any serious vaccine reaction is still far, far less frequent than the actual annual death toll of ~164,000 per year from the actual measles — most of whom are children.

  3. I have been in china since two years , I am an expat and when I arrived my son was 4 months! So I did all regular vaccination in china following European schedule ! Now my baby got MMR vaccination Thai here in chine involves 2 injection not 1 like in Europe. But after the second appointment the doctor scheduled for me a third shot….??? Why?
    After the first shot my son a week later got fever and spot on his neck do I think vaccination really worked!!!
    Please could you help me to understand? I would really like to avoid this third shot MMR !!

  4. Our baby is due for a combined Measles and Mumps shot this week at 8 months old, but there’s also an MMR due at 18 months. Do you think both are necessary? I (her father) had quite a serious reaction to the measles jab as a baby (I ran a very high fever for a week), so we’re a little nervous about it…

    1. I do feel that the MMR vaccine is important, and I’m certainly getting it for my children. Those diseases are still around and are far worse than the usual side effects of the vaccines. A fever after vaccines is quite normal, it shows your immune system is working.

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