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IMMUNIZATIONS

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ilies suspicious or firmly
against immunization, I
recommend trying to first
understand their “why,”
rather than presume it
might be for reasons most
commonly known. This
helps direct counseling
and demonstrates a will-
ingness to listen. I have
found it helpful to share
my personal experience
with measles and how I
have seen it affect chil-
dren. Sharing the current
global and historical im-
pact of the disease some-
times impacts some families.
As the 1992 and now 2019 global measles outbreaks subsequent tion. Finally, we need to remain vigilant for recognizing the clinical
spread to the United States demonstrates, families who fail to vac- symptoms and findings associated with measles to ensure isolation,
cinate cannot rely on the good will of those in the United States testing, and appropriate post-exposure interventions.
who do protect their families, particularly from measles. We must
respectfully remind them how fortunate they are that so many oth- Woodson Scott Jones, MD is a graduate of UT Medical
ers still do vaccinate, given that 9 of 10 unvaccinated people ex- Branch in Pediatrics. He is currently Vice Dean of Graduate
posed to measles get the disease. Due to the highly infectious nature Medical Education at UT Health San Antonio and is a mem-
of measles, immunization rates as noted earlier need to be in the 90 ber of the Bexar County Medical Society.
- 95% range to protect the community. These factors mean the fail-
ure to vaccinate their children puts others, particularly the most vul- References
nerable, severely immunocompromised children who cannot get the Jones WS, Hall BH, Smalley JR, Schelonka RL, Butzin CA, and Ascher
vaccine, at risk. The Immunization Action Coalition, the CDC and DP. Immunization status of preschool children in a military clinic. Arch
others provide remarkable resources to educate families (see refer- Pediatr Adolesc Med 1994;148:986-989
World Health Organization Key Fact Sheet: Measles. 2 May 2019.
ences). The CDC has a summary resource to address Thimerosal
www.who.int/news-room/fact-sheets/detail/measles
concerns. The National Academies of Sciences, Engineering and
Center for Diseases Control and Prevention (CDC). Measles Cases and
Medicine has released multiple reports over the last two decades on
Outbreaks: Measles Cases 2019. www.cdc.gov/measles/cases-
vaccine safety, particularly related to concerns with autistic spectrum
outbreaks.html
disorders and immunization.
Texas Department of State Health Services. Measles 2019. Organism,
In summary, measles is more than a rash. It is a highly infectious Causative Agent, or Etiologic Agent. www.dshs.texas.gov/ IDCU/dis-
illness with its most significant impact on the most vulnerable in ease/measles/Measles-2019.aspx. 2019 Measles Health Advisory.
Bexar County and around the globe. Even though I had significant file:///C:/Users/jonesw3/Downloads/Measles%20 Health%20Advi-
“academic” experience with measles, I was not abreast of what was sory071019.pdf
happening in the surrounding community when I was stationed in Center for Diseases Control and Prevention (CDC). Global Measles Out-
Italy. We all have to stay informed about the current and future out- break. www.cdc.gov/globalhealth/measles/globalmeaslesoutbreaks.htm
breaks in the United States and globally as Bexar County is an in- The Immunization Action Coalition Measles Handouts. www.immu-
nize.org/handouts/measles-mmr-vaccines.asp
ternational community. This recent outbreak reminds us of our
National Academies of Sciences and Engineering: Vaccine Safety Pub-
continued need for diligently educating and immunizing the patients
lications: www.nationalacademies.org/hmd/Global/Search.aspx?q=
we serve. We must not cease in our efforts to combat the misinfor-
measles+vaccine+safety
mation leading families to make poor choices regarding immuniza-
16 San Antonio Medicine • November 2019