Parts of the U.S. are currently experiencing a measles outbreak, and Hawaiʻi is not immune to the threat. With the state’s measles vaccination rate at 90%, according to the Hawaiʻi Department of Health, it falls short of the 95% needed for herd immunity. This raises concerns about the vulnerability of keiki and immunocompromised individuals.
Philip Verhoef, an associate clinical professor at the John A. Burns School of Medicine at the University of Hawaiʻi at Mānoa, and an intensive care physician, discusses the ongoing measles outbreak and the critical role of vaccinations in protecting public health. With a background in immunology, he provides insights into the importance of measles immunization and how to prevent the spread of the disease.
What is your reaction to the current measles outbreak, and how does it impact Hawaiʻi?
I’m deeply concerned, especially because Hawaiʻi has relatively low measles immunization rates, particularly on the neighbor islands. There are many children who haven’t received the vaccines they need, which puts them and others at risk. We need to do everything we can to ensure our keiki are protected.
Why is measles so contagious and what are the symptoms?
Measles is incredibly contagious—if 10 unimmunized people are exposed, 9 will likely develop the disease. The virus can remain in a room for up to two hours after an infected person leaves, making it easier to contract even if you weren’t in direct contact. Measles starts with high fever, cough, runny nose, and red and watery eyes, followed by a rash at the hairline on day 14. It can lead to complications like pneumonia, brain swelling and increased infection risk.
What is the history of measles and the vaccine?
Before 1957, measles was one of the most common and deadly diseases among children, causing one to three deaths per 1,000 people. The introduction of the measles vaccine in 1957 dramatically reduced cases, marking a major success for immunization efforts worldwide.
What are the long-term health risks for children who contract measles?
Approximately 1 in 5 children who are infected with measles will require hospitalization. Many of them will go on to develop pneumonia and require additional breathing support, such as use of oxygen and mechanical ventilators. In addition, infection with measles can lead to seizure disorders, brain inflammation (also called encephalitis), difficulty with hearing and vision, and death in approximately 0.1-0.3% of children. Finally, infection with measles dramatically alters the body’s immune system, making a child much more susceptible to other infections in the months to years that follow measles infection.
How does the measles vaccine protect individuals and the community?
The measles, mumps and rubella (MMR) vaccine is highly effective—93% effective with one dose and 97% with two. Vaccination not only protects individuals from contracting and spreading the disease but also contributes to herd immunity. To limit the spread of measles, about 95% of the population needs to be immunized, creating a protective barrier for those who cannot receive the vaccine, such as infants and individuals with medical conditions. High vaccination rates reduce the risk of outbreaks and safeguard the most vulnerable members of the community.
When are measles vaccinations typically administered?
The first dose of the measles vaccine is usually given at one year of age, with a second dose administered around age four or five. This schedule ensures that children are well-protected as they grow. Adults who are unsure about their immunization status should consult a healthcare provider. Blood tests can determine if you’re immune, and it’s safer to get vaccinated than risk contracting the disease.
What should people know about the safety of the measles vaccine?
The vaccine is very safe. A mild fever is a common side effect, but this is simply the immune system reacting to the vaccine. The risks of the vaccine are far outweighed by the benefits of preventing a potentially deadly disease.
For more information, visit the HIDOH website.
