Q and A about Measles and MMR vaccines
Measles is a highly contagious illness that begins with mild to moderate fever, cough, runny nose, red eyes and sore throat. Two or three days after symptoms begin, tiny white spots (Koplik’s spots) may appear inside the mouth.
Three to five days after the start of symptoms, a red or reddish-brown rash appears.
The rash usually begins on a person’s face at the hairline and spreads downward to the neck, trunk, arms, legs and feet.
No further doses of measles-containing vaccine are recommended for those who have received two doses of MMR after the age of 12 months, given at least 28 days apart.
The fever of measles may become higher once the rash appears and should disappear within 48 hours once the rash reaches the feet.
Recurrence or persistence of fever may indicate the presence of complications, which occurs in about 30% of patients. These include pneumonia, ear infections and diarrhea. Encephalitis (brain inflammation) is a very rare complication. In a very young child who develops measles, a rare but fatal brain disease called SSPE (subacute sclerosing panencephalitis) may be seen 7-10 years after the measles infection.
Patients who have had measles are immune to the disease throughout their lifetime, unless a severe problem with their immune system occurs.
Should he still receive an MMR vaccine?
Although he does not need the measles vaccine, and since separate mumps and rubella (German measles) are not available, he should still receive two doses of MMR (measles, mumps, rubella) vaccine to protect him against mumps and rubella. MMR in this child may be given as early as 1 year of age.
In cases where vaccination status is unknown, two doses of MMR is still recommended, and it is safe. MMR vaccine can be given within 3 days from exposure to his schoolmate to possibly prevent or minimize the impact of the disease.
When is it safe to say that he did not get infected by his classmate?
If he does not develop measles infection within 21 days after last exposure to the patient who is contagious, then he did not get infected.
Yes, he will have life-long protection after getting measles infection but, there is a high incidence of complications like pneumonia, ear infections, malnutrition, neurologic problems and even death. The protection from live vaccines such as measles is like having the natural infection in terms of inducing immune response but without these complications.