What counts as “exposure” to measles?
Measles is transmitted primarily by tiny airborne respiratory droplets, which are emitted when people sneeze, cough, or exhale. A person can catch the measles from breathing air into which the virus has been released or by touching surfaces that have been recently touched by a person with the infection. In other words, transmission can happen between two people who never physically meet.
In 2013 guidelines for prevention and control of measles outbreaks, the Public Health Agency of Canada defined a “contact” as anyone who has: a) spent any length of time in a room or enclosed space with someone who had a confirmed case of measles during their infectious period; or, b) spent time in the same room as a person with a confirmed case of measles during their infectious period within two hours after that person left the room or space.
When is a person “infectious”?
The infectious period starts approximately four days before the onset of the rash and ends approximately four days after the onset of the rash. The rash typically begins about 14 days after exposure (so people become infectious about 10 days after exposure).
People who have compromised immunity (due to a congenital condition or cancer treatment, for example), can be infectious for the duration of the illness.
Who is considered “susceptible” to the measles?
According to the Ontario Ministry of Health and Long-Term Care Infectious Diseases Protocol, the following groups are not considered susceptible to measles:
People born before 1970; they likely had measles as a child.
People born in or after 1970 who are 18 years or older and have received at least one dose of the MMR (measles-mumps-rubella) vaccine. (This does not apply to people who work in health care settings, are military personnel, or are students in a post-secondary educational setting.)
People who work in a health care setting, are military personnel or are students in post-secondary education who have had two doses of the vaccine.
People between the ages of 12 months and 17 years who have received two doses of the MMR or MMRV vaccine, with the first dose given on or after the person’s first birthday and the second dose being given at least four weeks later (if MMR) or six weeks later (with MMRV).
People who are not in one of the above categories are considered susceptible to catching measles.
What if you’re not sure whether you’ve had the MMR vaccination?
Ideally, you have written documentation of your immunization history; in Ontario, it is recorded in a small yellow booklet. If you can’t find it and your doctor has no record, there is no harm in getting the vaccine again. “The wonderful thing about the MMR vaccine is you can have as many doses as you like,” says Natasha Crowcroft, chief of applied immunization research at Public Health Ontario. “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.” *(addendum below)
What is the role of public health agencies in an outbreak of measles?
Local public health units are alerted when a person is suspected of having measles, or is diagnosed with measles. The units then work with the patient (or the patient’s parents) to identify where the patient was and who they had contact with during their infectious period. Public health will then reach out to anyone who had contact with the patient in an effort to identify people who may be susceptible to infection.
For people considered susceptible, public health will make recommendations appropriate to the situation, for example: vaccination, a dose of immune globulin or isolation (more on these measures below).
Crowcroft points out that it can sometimes be hard to reach all the people the patient had contact with, or even to know who all those people are. A person is infectious before the rash appears, and other symptoms (such as a fever) may not keep them at home. That’s when notices go out alerting the public that if they were in a particular mall or airport on a particular day to contact public health. “We really rely on the media to get those messages out,” says Crowcroft.
Should someone who is susceptible and has been exposed to measles receive the MMR vaccination?
The vaccine can provide some protection if it is given within 72 hours of exposure, though “it’s not as good as being immunized beforehand,” Crowcroft says.
Babies between ages six and 12 months can receive the MMR vaccine within 72 hours of exposure, but they must still receive two more doses after age one in order to ensure long-lasting immunity to measles.
The live vaccine is not recommended for pregnant women, for babies under age six months, or for people who have compromised immunity. These groups can receive a dose of immune globulin (IG) within six days of exposure to help reduce the risk of infection.
Can IG help reduce the risk of infection for other susceptible people?
Yes. If a person has missed the 72-hour window for the prophylactic MMR vaccine, immune globulin may help mitigate the risk if received within six days of exposure.
Should a susceptible person who has been exposed stay home from school/work?
If the person does not want to, or has missed the window in which to receive a prophylactic vaccine or dose of IG, they can potentially transmit measles to others. Thus, it is recommended that they: stay away from anyone who is at high risk because they are very young, are pregnant, or have immune problems; that they stay home from daycare, school and work settings; and that they refrain from travel, beginning five days after first exposure and lasting up to 21 days after the last exposure.
Are the recommendations different when it comes to people who work in health care settings?
For people who work in health care who have been exposed to measles and have only had one dose of the MMR vaccine it is recommended that they receive a second dose and have their blood tested for immunity. While they are waiting for the results, it is recommended that they remain home from work from the fifth to the 21st day following exposure.
Does immunity diminish? Is there a way to check?
“It’s a really good question,” says Crowcroft, who researched the issue of waning measles immunity for the World Health Organization. “There is good evidence that your antibody levels wane, but what we haven’t found so far is evidence that they’re currently falling low enough to change how well the vaccine is working.” She explains that when a person is first vaccinated, they have high antibody levels, but these fall over time. “That doesn’t necessarily mean you’re not protected. They have to actually fall down to a pretty low level, and also it’s only one bit of your immune system, because you have cellular immunity as well as antibodies.”
It’s possible to have your immunity tested through blood work, but it may well show low antibodies, says Crowcroft. In which case, the recommendation would be another dose of vaccine. “So then you’ve had a blood test and you have a vaccine anyway,” she says. “Essentially it’s just a lot simpler—and it’s a smaller needle actually—to have another dose of vaccine than it is to be tested. So we don’t generally recommend testing.”
The current understanding, says Crowcroft, is if you’ve had two doses of the vaccine or you’re born before 1970, “you’re good to go.” But the vaccine is relatively new, and it’s still unknown whether it can protect people for a whole lifetime. “There’s no one who’s 80 who’s been vaccinated. Most people in their 50s didn’t get vaccinated, they got disease. We haven’t had communities of people who are in the second half of their lives who were vaccinated.” So there are some questions and concerns about waning immunity in the next couple of generations.
But that’s in the future, Crowcroft emphasizes. “Right now the biggest challenge, not just in Canada but really everywhere, is not that vaccines are failing, but that people are failing to get vaccinated.”
*Update, June 14, 2019: If someone is unsure about their immunization status, says Natasha Crowcroft, it is extremely safe to receive a second or third dose of the MMR vaccine. In fact, the frequency of adverse events such as fever and rash falls with increasing number of doses of live vaccines because once antibodies have been developed they prevent replication of the attenuated vaccine virus (whether measles, mumps, rubella or other live vaccine).
To illustrate, a review of literature conducted as part of a study in Vaccine by Abedi and colleagues found median rates of rash in different studies of 4.8 percent after first dose of MMR, 3.6 percent after second dose of MMR and 0.4 percent after third dose of MMR vaccination. Rates of fever were median 28.9 percent after MMR1, 8.7 percent after MMR2 and 1.3 percent after MMR3. These rates compare with the risk of getting measles, in which typically everyone gets a fever and rash with a measles infection.
In Ontario, a study in Paediatrics & Child Health found that the rates of all adverse events reported to public health in 2012–16 for 1–3-year-olds (the age group in which the first dose is routinely given) is 7.7 per 100,000 compared with 0.5 for 4–9-year-olds (when the second dose is given).
The World Health Organization and the Public Health Agency of Canada Canadian also note falling rates of adverse events with increasing number of doses on the WHO’s vaccine safety information sheet and on PHAC’s Immunization Guide.
The comments section is closed.
Wow Im frustrated. Im not pointing fingers at you though, personally I think that its those that arent motivated to change.
A primary question should be, Why such concern over minor infections when we clearly have a great rise in chronic illness among our children. What is being done to address the fact that todays children are the most medicated but are the least well. Your medicines are failing us and you claim to not know why children now have so many autoimmunity problems. It seems your research is misdirected. We only fear 16 diseases because there are only 16 diseases we vaccinate for today. There are thousands of diseases to fear, why doesn’t the medical field set fear into their patients for the rest of the vital diseases out there? Because there are no vaccines for them and no bonus to profit off of them.
I had measles as a child and I remember when parents were NOT terrified about the measles! Why are we so concerned only about the diseases we have vaccines for today. What about all the diseases we don’t have vaccines for?
Okay, we can start getting terrified of them once we DO have some vaccine made for them:
https://www.facebook.com/paul.turner.39589149/posts/10213338785011808
You only fear 16 diseases because there are only 16 diseases we vaccinate for today. There are thousands of diseases to fear, why doesn’t the medical field set fear into their patients for the rest of the vital diseases out there? Because there is no vaccine for it and no bonus to profit off of them.
I had measles as a child and I remember when parents were NOT terrified about the measles! Why are we so concerned only about the diseases we have vaccines for today. What about all the diseases we don’t have vaccines for?
Okay, we can start getting terrified of them once we DO have some vaccine made for them:
https://www.facebook.com/paul.turner.39589149/posts/10213338785011808
I’m not sure if or when I had this shot . If there is no risk of harm I should get one now and maybe repeat it every year just in case .
You say I can have as many doses as I want
““The wonderful thing about the MMR vaccine is you can have as many doses as you like,” says Natasha Crowcroft, chief of applied immunization research at Public Health Ontario. “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.”
Mrs Natasha Crowcroft: could you refer me to any research to back up this interesting statement?
[What if you’re not sure whether you’ve had the MMR vaccination?
Ideally, you have written documentation of your immunization history; in Ontario, it is recorded in a small yellow booklet. If you can’t find it and your doctor has no record, there is no harm in getting the vaccine again. “The wonderful thing about the MMR vaccine is you can have as many doses as you like,” says Natasha Crowcroft, chief of applied immunization research at Public Health Ontario. “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.” ]
Where is your study data in regard to this said claim and provide the source, Natasha Crowcroft? Produce it, or retract your vaccine insane false propaganda claims!!! You need direct data sources to make all the claims that you do and it must be based on study science. Thousands of children have been MMR vaccine injured after standard does of MMR vaccine, and you have the audacity to make such an obviously false claim.
“Try re-vaccination – It never will hurt you,
For re-vaccination has this one great virtue:
Should it injure or kill you whenever you receive it,
We all stand prepared to refuse to believe it.”
– From a circular signed “The Doctors”, 1876
The agenda of forced vaccination is based on the greed of the pharmaceutical industry! INDUSTRY is a business and is ensuring it will have patients for the duration of the patients lives the earlier it can inject all the toxins into a human being. Court records prove they are not safe and that they contain the live viruses which the outbreaks stem from. As demonstrated from the Brady Bunch episode, measles are a virus that produces a rash, fever and after a week or so disappears! It is not ebola and no deaths arise from contracting it. Forced vaccination utilizing fear tactics are just a tool to propagate the agenda and removes the rights of every parent who has researched and advocates on behalf of their children. These agencies that state the motto of “protection and safety” are doing the exact opposite by pushing known toxins that cause autism, cancers and the very virus they claim to prevent. Vaccines have been found to have HIV, Polio, aluminium, DNA of monkeys, pigs, aborted fetuses and the like. Billions have been paid out in court against Merrick and Bayer as well as the other Pharma giants. The facts and evidence presented prove without any doubt that they are not safe nor effective in preventing and to continue to promote the use is a crime against humanity. Right now the biggest challenge is the false narrative promoted by officials who are being negligent by the continued propaganda put out in favour and on behalf of the pharmaceutical companies that operate for profit only. The eugenics depopulation campaign mandated by the likes of Bill Gates and has been reported world wide and lawsuits filed against the manufactures that have been without conscious killed and maimed millions of innocent people. The agenda to now push this on adults will not stand. We do not consent nor condone the forced vaccination protocol that has been implemented. As a human being you will be held accountable for all the children in Ontario who are forced to receive these in order to attend school and suffer the consequences of those that are ignorant to the life threatening consequences of being injected with them.
This was painful as heck to read-
“The wonderful thing about the MMR vaccine is you can have as many doses as you like,” says Natasha Crowcroft, chief of applied immunization research at Public Health Ontario. “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.”
Um where is the studies and proof of that?
Coorelation does not equal causation – that argument works both ways…
Where is your damn proof?
Because this is what I heard when she let that drivel out of her mouth:
“The Wonderful Thing About Cigarettes is you can have as many inhales as you like,” …
“The Risk Of getting Lung Cancer actually goes down with the number of inhales. So the more inhales you take, the less likely you are to have a side effect.”
Question about this comment:
“The wonderful thing about the MMR vaccine is you can have as many doses as you like,” says Natasha Crowcroft, chief of applied immunization research at Public Health Ontario. “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.”
Certainly you know that the MMR was banned in Japan for the damage and deaths it caused. Is there any evidence or data to support the conclusion that there is an inverse correlation between MMR uptake and adverse reactions? Do you think there would have been less adverse reactions in Japan if more doses were administered?
https://www.dailymail.co.uk/health/article-17509/Why-Japan-banned-MMR-vaccine.html
This is my comment below>>> A primary question should be, Why such concern over minor infections when we clearly have a great rise in chronic illness among our children. What is being done to address the fact that todays children are the most medicated but are the least well. Your medicines are failing us and you claim to not know why children now have so many autoimmunity problems. It seems your research is misdirected. We only fear 16 diseases because there are only 16 diseases we vaccinate for today. There are thousands of diseases to fear, why doesn’t the medical field set fear into their patients for the rest of the vital diseases out there? Because there are no vaccines for them and no bonus to profit off of them.
I had measles as a child and I remember when parents were NOT terrified about the measles! Why are we so concerned only about the diseases we have vaccines for today. What about all the diseases we don’t have vaccines for?
Okay, we can start getting terrified of them once we DO have some vaccine made for them:
https://www.facebook.com/paul.turner.39589149/posts/10213338785011808
I am horrified that an immunization professional would say that getting as many doses of the MMR as possible would do no harm. There is no scientific evidence to back that up. It’s reckless and harmful! My son was injured by his 2nd MMR. They can and do injure. You wonder why people distrust the medical community? We are treated like we’re stupid, by people like that. When we know more than your expert – the medical field loses its respect and its “following”.
Sorry to hear of this Barbara. MMR destroyed my mother’s body. My own flu shot caused aggressive central nervous system demyelination at age 27. I have emailed (and responded here) Dr Crowcroft asking for some evidence of this inverse relationship between MMR uptake and adverse events.
I’m so sorry to read of your reactions to something they are so forceful on people receiving. The flu shot scares me more than anything.
To the families / individuals whose first thought is “autism” when they hear the word “vaccine”:
Unfortunately people are afraid of vaccines because of the rising rates of autism spectrum disorders. Ok first of all a part of me understands this, since a good parent will obviously want to do what is best for their child and they may have received information from sources that are not fully researched and reliable. If the medical community strongly believes that there is absolutely no link between vaccinations and autisum then I welcome a thorough large scale international epidemiological study to please disprove this – and please share the links to the evidence.
We also have to keep an open mind to other factors at play, such as the fact that we are improving our autism screening and diagnostics, which will result in more children being positively identified as “autistic”. There are other environmental, lifestyle, and genetic factors that need to be considered by the medical community as well. If you consider that the rates of autism have risen over the past 10-20 years, is there anything else that comes to mind that may have changed in the developed world over that same period of 10-20 years? I personally would like to see researchers and doctors please start to consider the rise of electromagnetic frequencies (EMFs) – i.e. the exposure to cell towers and wifi. There is evidence coming from Europe that demonstrates positive associations between wifi exposures and childhood behavioural changes. Many countries in Western europe have very strict policies about wifi exposure in primary schools/daycare centres (i.e. no wifi and dial up only) as well as wifi exposure near individual dwellings (i.e. wifi tower needs to be at least 250m away from a person’s home; not on top of a condo building like you see all over big cities). The research is growing but for some reason we here in North America do not discuss or report on this and we are even foolishly getting excited about the prospect of 5G technologies. This is by far the most dangerous of the technologies as the signals are milimeter waves (ie. the lenght of the wave emitted is <0.45 inches in length) and can penetrate human tissue. Many people will laugh and say "microwaves haven't killed me yet" – you are right, the microwave in your kitchen emits wavelengths of the length of 12 cm and this will not penetrate your tissue and will not kill you. The milimeter waves of 5G will penetrate into your tissues, and the sad part is that the 5G will be everywhere since the waves are so short and don't travel as far as our current 2G long waves, you will need the 5G routers simply everywhere to have cell signal available. Research has shown that these tiny waves will disrupt mitochondrial processes and DNA.
Here is one peer reviewed research article of 100s to get you started:
https://www.ncbi.nlm.nih.gov/pubmed/28504324
Please if you disagree with this one article that's fine, I welcome it. Look at others, try to find ones that disprove this, this is the point of debate.
Large scale epidemiological studies have been done but they were only done on one vaccine the MMR, and one single vaccine ingredient, Thimerosal. There were no safety studies in regard to multiple vaccines given over time, or studies in regard to giving 5 and up to 9 or more vaccines in a single day and office visit. So, their vaccine safety data is in fact largely inadequate. There again, where does the reckless and irresponsible claim come from as to multiple doses of the MMR vaccine, that quote, “The risk of getting an adverse effect actually goes down with the number of doses. So the more you doses you get, the less likely you are to have a side effect.” unquote? Where is the study?
No safety studies as well have been done in regard to the molecular mimicry autoimmunity causing effects of vaccine ingredients and worse yet, known serious issues of vaccine contamination. No safety studies have been done in regard to vaccine aluminum adjuvants, while a large amount of study data directly shows the harmful effects of those said adjuvants and to include a link to resulting encephalopathy, over-activation of the brains microglia cells with resulting chronic levels of brain inflammation, and autism.
No vaccine during the clinical trial findings data is ever tested against a true saline placebo in the comparison of systemic effects. That is a red flag as to their actual intent to prove vaccines as being safe. Apparently they do not care, as there exists no legal liability for anyone involved with childhood vaccines. Manufacturer defects as well will hold no merit in a court of law as all of it has now been determined as preempted by the National Vaccine Injury Compensation Program, (Bruesewitz v. Wyeth), determining vaccines to be unavoidably unsafe. No vaccine clinical trial as well ever uses an un-vaccinated comparison control group.
Even the federal vaccine court still uses the epidemiological studies I just mentioned, to deny children compensation for alleged vaccine caused autism. If you also want a well done analysis on those studies, what was found was, flawed study designs, the use of unreliable data, predetermined outcomes unsupported by the data, and as well major conflicts of interest in the studies funding sources being largely the CDC; and clearly none of those studies were independent and/or unbiased.
VACCINES AND AUTISM – WHAT DO EPIDEMIOLOGICAL STUDIES REALLY TELL US?
http://www.rescuepost.com/files/vaccines-and-autism-epidemiology-rebuttal.pdf
9 Questions For The Pro-Vaxers
http://www.dirtybigpharmatruth.com/9-questions-for-the-pro-vaxers.html
Autism is not the primary concern of ex vaxxers. Have you read an insert? Maybe they should find out for sure if vaccines cause cancer or infertility before we shoot it into young vulnerable babies??? Read an insert; it’s not about autism.
In a public health care system such as Ontario and Canada, we pay for health care with our taxes, and we expect to receive health care benefits which are largely paid for by the government.
If the health care system has determined through solid scientific evidence that diseases such as measles can be largely controlled through immunization and that the risk of adverse reaction is far outweighed by the societal benefits, then I believe that vaccination should be required by everyone in the society who is not medically compromised from receiving it.
While there will always be a very small number of adverse reactions, these reactions will be managed by the health care system and the costs of managing those cases will be borne by the system. Overall, the costs of vaccinating everyone and dealing with the adverse cases will far outweigh the system costs if vaccines are not used.
Notwithstanding the economic consequences in a resource limited system, the pain and suffering from the entire portion of the population who would have contracted the disease, will be far less than the pain and suffering of those who suffer adverse reactions.
Personal choice in vaccinations is contributing to a significant decline in the populations overall health, and certainly increasing costs. This is money that could be better spent on treatment of and research towards other diseases.
Jack, they won’t be taken care of if they have a reaction. Did you know that Canada does not have any kind of vaccine injury compensation program? If you are injured by a vaccine in Canada (and not in Quebec), then you do not receive anything. The US has a compensation program for vaccine injury. Actually Canada is the only G7 nation that doesn’t have one.
Where there is risk, there must always be choice.
And who are you to say the adverse reactions to a vaccine are far less worse than the measles? Maybe you should talk to parents with vaccine injured children.
Jack, are you saying that drugs must be force injected into people for the “greater good”? I’m curious if you ever studied what the Nuremberg Code arose from and why the ability to decline a drug of medical treatment has been the cornerstone of not only personal freedom but medical care, “First, do no harm…”. Purposely knowing you will kill or injure some healthy children is essentially virgin sacrifice for the village.
This doesn’t even go into the fact that no vaccine – at least in the US CDC schedule, has been tested against a saline placebo- even when it was a novel vaccine!!! That’s not ethical to force inject a drug that was never properly tested from the start.