Response to Outbreak of Disease : Pediatricians Urging Second Measles Shot

At a time when a measles outbreak is sweeping through Orange County and the nation, the American Academy of Pediatrics has decided that all children entering middle school or junior high school should receive a second measles shot.

The decision represents a major change in position for the prestigious medical group, said Dr. Milton Schwarz, president of the Orange County chapter of the pediatricians’ group.

“Until now, we were responding to epidemics and re-boosting children in those areas where measles was epidemic,” the Santa Ana pediatrician said Monday. Otherwise, children received a single measles shot, usually at about 15 months of age.

300% Increase in Cases

Around the country, 24 states including California have reported measles outbreaks this year, mostly affecting preschool children, according to the National Centers for Disease Control in Atlanta.

Through June 11, there were 5,569 cases of measles, a 300% increase over the same period last year, according to Dean Mason, public health adviser for the Centers for Disease Control.

But because of the epidemic, the academy recommends that all children receive a booster “MMR” shot for measles, mumps and rubella before junior high, he said.

The academy also recommended last week that anyone born after 1957 be re-vaccinated and that colleges and trade schools require documentation that students have had measles or have been vaccinated twice.

In addition, the academy recommended that hospitals require nurses, nursing students or medical staff to present evidence of measles or of two measles vaccines.

Explaining the academy’s new stance, Schwarz said that children age 11 or 12 should receive a booster shot before entering junior high school because that time is a “high risk period” for contracting measles. Despite receiving an initial vaccine, they sometimes no longer have immunity to the disease, he said.

Also in response to the measles epidemic, Orange County pediatricians have taken the advice of the county Health Care Agency and, since January, have given a first measles shot to children at age 12 months, instead of 15, Schwarz said. He noted that measles shots were available at any pediatrician’s office in Orange County or from the Health Care Agency.

As of June 20, 280 people in Orange County had developed measles, the highest total in 11 years.