12-10-25: Updated measles and MMR information

The Utah Department of Health and Human Services wants to provide clinicians updated information related to the current measles outbreak, focusing on the risk to infants. The highest risk area in Utah for measles continues to be the southwest part of the state, but there is evidence of unrecognized and community spread in many parts of the state. We invite you to join a clinician-focused call at 7 am Friday where we will give an update on the measles situation and answer clinical questions. Please register for this call. If you are unable to attend, but would like the recording, please reach out to: epi@utah.gov.

As this outbreak evolves, we encourage clinicians to discuss the risks and benefits of an early, extra MMR vaccine dose with parents of infants who are between 6 and 12 months of age. While this dose is not generally recommended, there have been a number of recent measles exposure events in Utah that placed young infants at risk of measles. These include a number of situations where individuals with measles exposed others at clinics and child-focused play areas. These events raise the level of concern that additional infants may be exposed to measles despite being in a well protected community. While the individual risk continues to be very low, we understand many parents may want to seek this additional protection. We encourage you to discuss the options with parents. 

Typically, we do not recommend wide-spread administration of an early dose because of the following reasons:

1. The dose is “extra:” This early dose does not count toward the primary series. The child will still require the standard two doses starting at or after 12 months of age.
2. Efficacy concerns: Data suggests that many infants may not derive high levels of protection from this early dose, possibly due to maternal antibodies blunting the immune response.
3. Long-term immunity: There is some evidence that children who receive an early dose may experience a more rapid decay of antibody titers later in life, potentially resulting in lower overall protection as adults. 

In addition to vaccination discussions, we urgently remind all facilities to screen patients for measles symptoms (ex: fever and rash) on or before arrival to the clinic. Individuals suspected of infection should be immediately placed in a room away from others to prevent transmission in waiting areas. Multiple recent exposures have occurred within clinical settings; rapid recognition and isolation are our best defenses.

Please see our website for information about the measles outbreak in Utah, as well as our clinician specific information page. For urgent questions about measles please reach out to our on-call team at 1-888-EPI-UTAH (1-888-374-8824).We appreciate your work to protect the youngest Utahns.