Measles outbreaks: A reason to revisit vaccination policies  

While measles was declared “eradicated” in the US by the CDC in 2000, this highly contagious viral illness has been making a comeback in recent years. As the CDC notes, the measles vaccine, usually given as the combination MMR (measles, mumps, rubella) vaccination, is highly effective in preventing this disease. However, community vaccination rates can decrease “herd” immunity and lead to outbreaks such as the one now occurring in Texas and several other states. As of March 13, a total of 301 measles cases have been reported by 15 states. Of these reported cases, 17% have been hospitalized and one child has died. 

It’s been decades since measles was a widespread concern, and many people are not at all familiar with it. Here’s what employers need to know about the disease – along with a checklist for those that would like to take this opportunity to review their vaccination and worksite safety policies. 

Measles symptoms and complications

As defined by the World Health Organization (WHO), measles is a serious, highly contagious, airborne disease caused by a virus that can lead to complications and in some cases death. The virus infects the respiratory tract and spreads throughout the body, displaying symptoms such as a high fever, cough, runny nose, and full body rash. Notably, unvaccinated young children and pregnant women are at a high risk for contracting measles. Additionally, children under the age of five, pregnant women and immunocompromised persons are more likely to have severe complications, such as pneumonia and eye and ear infections, from measles infection.  

There is no specific antiviral treatment for measles. The WHO notes that infected children or adults can receive vitamin A supplements to help prevent certain complications, particularly eye damage, and antibiotics may be used to treat secondary infections such as pneumonia.  

Measles vaccine and immunity 

Given the lack of specific treatment options, community-wide vaccination is the most effective way to address the health risks that measles presents.  The measles vaccine is recognized as a safe, inexpensive, and effective method of preventing the disease. The measles vaccine is combined with mumps and rubella (MMR), or with mumps, rubella and varicella (MMRV); these combinations are equally effective at preventing measles. It is recommended that children receive a first dose between 12 and 15 months of age and a second between 4 and 6 years.  For older children, adolescents, and adults the vaccine is also administered in two doses, with the second given at least 28 days after the first. 

In light of the recent outbreaks, an important question is how long immunity lasts. The CDC states that two doses of the measles vaccine are 97% effective and protect most people against measles for life. However, some vaccinated individuals may contract measles, particularly in communities experiencing an outbreak.  Measles immunity blood tests can check for antibodies against measles, and booster shots may be administered if needed. Employers – particularly those with employees living or working in communities experiencing measles outbreaks – could consider working with their healthcare partners to convey CDC recommendations to their members aimed at reducing the risk of infection.  

Time to review existing vaccination and infectious disease policies?

In the post-COVID-19 pandemic era, infectious disease outbreaks can heighten focus on employer policies regarding vaccinations and worksite safety.  As measles outbreaks gain national attention, it’s a good time for employers to assess their general vaccination policies to consider whether there is an opportunity to enhance protections for their employee populations.  A communication campaign, should you choose to conduct one, might be especially effective at this time and help address employee concerns.  Keep in mind that while the worst of the flu season may be behind us, Covid-19 cases tend to rise in the summer.

Here are some steps to consider: 

• Work with healthcare partners to provide coverage for flu shots, Covid-19 vaccines, and other non-childhood vaccinations.  
• Review and update infectious disease policies, such as disease outbreak control practices, infection surveillance, and sick leave policies.  
• Leverage credible sources of information (CDC, WHO, or state/county departments of health) and relevant partners (such as their medical carrier) to inform any communication. 
• Develop protocols for specific settings (e.g., healthcare facilities, manufacturing plants) such as requiring proof of vaccination or stay-at-home orders when sick.  
• Provide a step-by-step guide for employees that describes how to get vaccinated in their communities. 
• Work with local public health officials, carriers, and vendor partners (such as an onsite or near-site clinic) to facilitate vaccinations for employees. This can take patience and persistence, but it’s paying off for some employers in higher vaccination rates.