Update: As of January 16, the City of Philadelphia’s health department reported there has been 9 confirmed cases of measles associated with a new outbreak stemming from last month.1
In the early part of last month, a patient presented at the Children’s Hospital of Philadelphia that was diagnosed with measles, and 3 patients who were exposed later tested positive. In addition, a couple of other medical facilities and 1 daycare experienced exposures.1
The city’s health department provided a timeline and locations of where the outbreaks were happening. Here is a full listing of the areas that had potential exposures. Overall, Philadelphia has a fully vaccinated rate of at least 93% for its children against measles by age 6, according to the health department.1
The city’s health department recommended vaccination to those who have not had the measles, mumps, rubella (MMR) vaccine.
“If you have not yet been vaccinated against measles or have not vaccinated your children or are 12 months of age or older, reach out to your health care provider to do so immediately,” said Health Commissioner Cheryl Bettigole, MD, MPH.1
The health department announced that all city health centers have the MMR vaccine which can protect people from measles. Any child in Philadelphia can receive free vaccines and that call center operators can be reached at 215-685-2933 to set up an appointment.
Vaccine-Preventable Diseases: A Growing Concern
This phenomenon of people forgoing vaccines for preventable diseases is vexing, and measles certainly falls into this category. People choosing to not take safe and efficacious vaccines like MMR has become an issue. The Centers for Disease Control and Prevention (CDC) says only about 3 in 100 people will contract measles after full vaccination and being exposed to a person who has the disease.2 This means measles vaccination has a 97% efficacy.
What You Need to Know
The recent measles outbreak in Philadelphia, with confirmed and presumed cases linked to exposures in medical centers and daycares, underscores the critical need for vaccination.
The article highlights a concerning trend of declining childhood vaccination rates in the United States over consecutive years.
FDA Commissioner Robert Califf and Center for Biologics Evaluation and Research Director Peter Marks emphasize the role of health care professionals, including clinicians and retail pharmacists, in educating the public about the benefits of vaccination.
Overall, there has been a trend showing a reduction in children getting vaccinated. Last January, the CDC reported that over the last 2 school years, the national coverage for childhood state-required vaccines among kindergarten students declined from 95% to approximately 93%. During the 2020-21 school year, vaccinations dropped to 94% and during the 2021-22 school year it dropped again to approximately 93%.
And while this does not sound like a large number, it still represents thousands of young children not getting their vaccinations. It is also a disturbing trend as some families may feel they do not need them or are fearful of vaccines.
“Compared with the 2020–21 school year, vaccination coverage decreased 0.4–0.9 percentage points for all vaccines. Although 2.6% of kindergartners had an exemption for at least one vaccine, an additional 3.9% who did not have an exemption were not up to date with MMR,” the investigators wrote in an MMWR last year.
This is the lowest rate of vaccination in over a decade the CDC states. And the MMWR report said that as many as 250,000 kindergartners are not protected against measles.
According to the American Academy of Pediatrics (AAP), there were more than 1200 cases of measles reported in the United States in 2019—the highest number in decades. In 2022, AAP said there was 121 cases of measles.2 In 2023, there was a substantial outbreak in Ohio and Kentucky that had 85 children contract the disease, and 35 of them were hospitalized.3
“Despite the care taken in the development and deployment of vaccines and their clear and compelling benefit of saving individual lives and improving population health outcomes, an increasing number of people in the US are now declining vaccination for a variety of reasons, ranging from safety concerns to religious beliefs,” wrote FDA Commissioner Robert Califf, MD, and Peter Marks, MD, director of the Center for Biologics Evaluation and Research in a viewpoint article in a recent JAMA.4
In terms of trying to turn the tide, Califf and Marks point to the significant trust the public has with clinicians and retail pharmacists, but that everyone in the medical field has a role in educating the public.
“All those working in health care, while being straightforward about the risks, need to better educate people regarding the benefits of vaccination, so that individuals can make well-informed choices based on accurate scientific evidence.”4
References
1. Health Department Update on Measles Outbreak – January 5, 2024. City of Philadelphia press release. January 5, 2024. Accessed January 8, 2024.
2. Questions About Measles. CDC. Last reviewed November 5, 2020. Accessed January 8, 2024. https://www.cdc.gov/measles/about/faqs.html.
3. Red Book Online Outbreaks: Measles. AAP. December 21, 2023. Accessed January 8, 2024. https://publications.aap.org/redbook/resources/15187/Red-Book-Online-Outbreaks-Measles
4. Marks P, Califf R. Is Vaccination Approaching a Dangerous Tipping Point? JAMA. Published online January 05, 2024. doi:10.1001/jama.2023.27685
