Ready for the Unexpected

Due to elevated measles cases in the Texas Panhandle, Amarillo Public Health is providing MMR vaccines to insured and uninsured individuals. This policy is subject to change.

The best protection against measles is vaccination with the MMR vaccine.

Children should receive 2 doses of the MMR vaccine:

• First dose at age 12-15 months

• Second dose between age 4-6 years

Consider getting an MMR vaccine if:

• You are uncertain whether you have received the MMR vaccine

• You have only received 1 dose of the MMR vaccine

• You know you have not been vaccinated with MMR vaccine

If you do not have immunity against measles, mumps, and rubella and are exposed to someone with one of these diseases, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, mumps, or rubella, and doing so may possibly prevent later disease.

If you get MMR vaccine within 72 hours of initially being exposed to measles, you may get some protection against the disease or have milder illness. In other cases, you may be given a medicine called immunoglobulin (IG) within six days of being exposed to measles, to provide some protection against the disease, or have milder illness.

During outbreaks of measles or mumps, everyone without presumptive evidence of immunity should be brought up to date on their MMR vaccination. Some people who are already up to date on their MMR vaccination may be recommended to get an additional dose of MMR for added protection against disease.

The Advisory Committee on Immunization Practices (ACIP) recommends that people who don’t have presumptive evidence of immunity to measles, mumps, and rubella should get vaccinated against these diseases.

Presumptive evidence of immunity can be established in any of the following ways:

• Written documentation of adequate vaccines for measles, mumps, and rubella

• Laboratory evidence of immunity

• Laboratory confirmation of disease

• Birth before 1957

Although birth before 1957 is considered acceptable evidence of immunity for healthcare personnel in routine circumstances, healthcare facilities should consider vaccinating healthcare personnel born before 1957 who lack laboratory evidence of immunity or laboratory confirmation of disease.

Healthcare providers should not accept verbal reports of vaccination without written documentation as presumptive evidence of immunity.

Children should receive 2 doses of the MMR vaccine

• First dose at age 12 – 15 months

• Second dose between age 4 – 6 years

Older children, adolescents, & adults

• If you only have 1 dose of MMR or are uncertain, you should receive a dose of MMR

• If you know you have not been vaccinated with MMR vaccine, you should receive a dose of MMR

Symptoms of measles can appear 7 to 21 days after contact with the virus. These symptoms may include:

• Fever — Usually a mild to moderate fever, but can get up to 105 degrees F (severe cases) 

• Cough, runny nose, sneezing, and congestion

• Red, watery eyes

• Small, bluish-white spots inside the mouth (Koplik spots)

  • These may appear 2-3 days after symptoms begin

• Rash that starts at the hairline and spreads downward toward the neck, trunk, arms, legs, and feet

  • This may appear 3-5 days after symptoms begin

  • Begins with flat, faint eruptions with individual lesions becoming more raised as the rash tends to spread downward

• Other symptoms of measles can include loss of appetite, diarrhea (especially in infants), and generalized swollen lymph nodes.

• Complications can include ear infections, pneumonia, swelling of the brain, seizures, and death.

While it is rare that vaccinated individuals develop measles, it can happen. Vaccinated individuals may have atypical symptoms – typically shorter rash duration or atypical rash presentation, and possible lack of fever, cough, runny nose, or conjunctivitis.

• Direct contact with infectious droplets

• Breathing in droplets that are airborne

• Touching surfaces that are contaminated

The virus can remain infectious on surfaces and in the air for up to two hours. Measles is spread when an infected person speaks, coughs, and sneezes. A person contagious 4 days before through 4 days after the rash appears.

• Isolate yourself immediately to prevent spreading the virus to others

• Contact your healthcare provider by phone to arrange testing in a way that minimizes exposure to others

  • DO NOT SHOW UP WITHOUT CALLING FIRST TO LET THEM KNOW YOU MAY HAVE MEASLES

People with confirmed or suspected measles must stay home from school, work, childcare, and other group settings until after the fourth day of rash onset, and they are physically able to return. The day of rash onset is counted as day zero.

Please see the chart below for more information on what to do based on vaccination status.