COLUMBIA, S.C. (AP) South Carolinas top doctor came before a small group of state senators on Thursday to tell them he thinks a bill overhauling how public health emergencies are handled in the wake of the COVID-19 pandemic has some bad ideas, concerns echoed by Gov. Henry McMaster.
As drafted, the bill would prevent mandating vaccines unless they have been licensed by the Food and Drug Administration for 10 years. That means that health care providers would be blocked from requiring flu vaccines or other shots that get yearly updates for ever-changing viruses, said Dr. Edward Simmer, director of the state Department of Health and Environmental Control.
In addition to loosening restrictions on who can visit people in isolation, the measure would also require symptom-free patients to be released from quarantine well before some infectious diseases begin to show outward signs, Simmer said at a Thursday hearing.
There are a number of issues that we believe where this bill would cause harm to the people of South Carolina and would in fact cause unnecessary death amongst people of South Carolina during a public health crisis because it would prevent us from taking actions that could save lives, Simmer said.
The bill passed the Senate subcommittee on a 4-3 vote, but with eight weeks to go in the General Assemblys session, it still has to get through the bodys Medical Affairs Committee and a vote on the Senate floor before it can even be sent to the House.
In a further sign of the hurdles the bill faces, McMaster sent the subcommittee a letter saying placing overbroad restrictions on the authority of public health officials, law enforcement officers, first responders, and emergency management professionals responding to emerging threats and disasterswhether public health or otherwise is a bad idea.
A similar subcommittee met in September, where many speakers sewed doubt about vaccine safety and efficacy, as well as distrust in the scientific establishment.
Members on Thursday listened to Simmer and took up some amendments on his concern and promised to discuss his other worries with the bill.
You are making some good points, Dr. Simmer. Im writing them all down, Republican Sen. Richard Cash of Powdersville said.
The proposal would require health officials to release someone from quarantine if they didnt show symptoms for five days. Simmers said people with diseases like measles, meningitis, bird flu and Ebola are contagious, but may not show symptoms for a week or more.
I dont think we would want after 10 days to release a person known to be infected with Ebola into the public, Simmer said.
Supporters of the bill said they werent happy that during the start of the COVID-19 pandemic hospitals and nursing homes put patients into isolation. Allowing quicker releases from isolation and letting more people to visit someone in quarantine was a response to that issue.
Cash told Simmer that when the pandemic shutdown started, his wife had just endured a 17-hour cancer surgery and he was ordered to leave her bedside.
Whatever shes got, I got. But I still had to go, Cash said.
Simmer said those decisions were made by the private nursing homes, hospitals and health care facilities. He said he had sympathy for decisions that had to be made quickly without much data, but he thought they were still wrong and pointed out the state didnt order anyone to take a vaccine or isolate entire facilities.
We saw the pictures of people seeing nursing home patients through a window. They should have been allowed in, Simmer said. When that didnt happen that was a mistake. That was a lesson learned from COVID.
Simmer asked lawmakers to pay attention to what actually happened during the pandemic and not just what they think happened.
If this bill is designed to address concerns about COVID, we should recognize what did and did not happen during the pandemic, Simmer said.
Governments in Asia and the Pacific imposed some of the strictest and longest-lasting limits on human mobility during the COVID-19 pandemic, triggering a collapse in migration, stranding migrants abroad for months, and prompting mass returns that strained health and reintegration systems. But the region also kept COVID-19 cases and deaths relatively low for the first two years.
To help inform policymakers' preparations for future crises, there is a clear need to better understand the costs and benefits of this region's approach to managing the COVID-19 public-health crisis through strict travel measures.
This report is part of a series of studies by MPI's Task Force on Mobility and Borders during and after COVID-19 that explores opportunities to improve international coordination regarding border management during public-health crises. Other regional case studies in this series look at Europe, the Middle East and North Africa, and South America. Thematic studies consider the role of digital health credentials in facilitating movement, the use of risk analysis to shape border policies, and the rise of remote work and "digital nomads." A final capstone policy brief reflects on lessons for crises.
This article has been reviewed according to ScienceX's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:
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In my mind, the spring season will always be associated with COVID-19.
In spring 2020, the federal government declared a nationwide emergency, and life drastically changed. Schools and businesses closed, and masks and social distancing were mandated across much of the nation.
In spring 2021, after the vaccine rollout, the Centers for Disease Control and Prevention said those who were fully vaccinated against COVID-19 could safely gather with others who were vaccinated without masks or social distancing.
In spring 2022, with the increased rates of vaccination across the U.S., the universal indoor mask mandate came to an end.
In spring 2023, the federal declaration of COVID-19 as a public health emergency ended.
Now, as spring 2024 fast approaches, the CDC reminds Americans that even though the public health emergency is over, the risks associated with COVID-19 are not. But those risks are higher in some groups than others. Therefore, the agency recommends that adults age 65 and older receive an additional COVID-19 vaccine, which is updated to protect against a recently dominant variant and is effective against the current dominant strain.
The shot is covered by Medicare. But do you really need yet another COVID-19 shot?
As a geriatrician who exclusively cares for people over 65 years of age, this is a question I've been asked many times over the past few years.
In early 2024, the short answer is yes.
Compared with other age groups, older adults have the worst outcomes with a COVID-19 infection. Increased age is, simply put, a major risk factor.
In January 2024, the average death rate from COVID-19 for all ages was just under 3 in 100,000 people. But for those ages 65 to 74, it was higherabout 5 for every 100,000. And for people 75 and older, the rate jumped to nearly 30 in 100,000.
Even now, four years after the start of the pandemic, people 65 years old and up are about twice as likely to die from COVID-19 than the rest of the population. People 75 years old and up are 10 times more likely to die from COVID-19.
These numbers are scary. But the No. 1 action people can take to decrease their risk is to get vaccinated and keep up to date on vaccinations to ensure top immune response. Being appropriately vaccinated is as critical in 2024 as it was in 2021 to help prevent infection, hospitalization and death from COVID-19.
The updated COVID-19 vaccine has been shown to be safe and effective, with the benefits of vaccination continuing to outweigh the potential risks of infection.
The CDC has been observing side effects on the more than 230 million Americans who are considered fully vaccinated with what it calls the "most intense safety monitoring in U.S. history." Common side effects soon after receiving the vaccine include discomfort at the injection site, transient muscle or joint aches, and fever.
These symptoms can be alleviated with over-the-counter pain medicines or a cold compress to the site after receiving the vaccine. Side effects are less likely if you are well hydrated when you get your vaccine.
Repeat infections carry increased risk, not just from the infection itself, but also for developing long COVID as well as other illnesses. Recent evidence shows that even mild to moderate COVID-19 infection can negatively affect cognition, with changes similar to seven years of brain aging. But being up to date with COVID-19 immunization has a fourfold decrease in risk of developing long COVID symptoms if you do get infected.
Known as immunosenescence, this puts people at higher risk of infection, including severe infection, and decreased ability to maintain immune response to vaccination as they get older. The older one getsover 75, or over 65 with other medical conditionsthe more immunosenescence takes effect.
All this is why, if you're in this age group, even if you received your last COVID-19 vaccine in fall 2023, the spring 2024 shot is still essential to boost your immune system so it can act quickly if you are exposed to the virus.
The bottom line: If you're 65 or older, it's time for another COVID-19 shot.
Measles cases are surfacing across Canada. Heres what you need to know about what measles is, how it spreads and symptoms to watch out for.
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Measles a highly contagious respiratory illness caused by the rubeola virus. Measles is probably the most transmissible virus affecting human beings, said McGill University professor of medicine Dr. Brian Ward.
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Measles is airborne. It can be transmitted in schools, on buses, even during a passing interaction, Ward said. If youre in a Place des Arts (a major performing arts centre in Montreal) auditorium, and theres one person at the same show as you, and they are starting to sniffle or cough or sneeze with measles, and youre susceptible, you will probably get it.
Before vaccines and routine childhood immunizations were introduced, measles infected most people before the age of 20 and caused more than two million deaths worldwide each year.
The virus lives in the nose and throat mucus of an infected person and spreads through the air when an infected person breathes, coughs, sneezes or talks. According to the U.S. Centers for Disease Control and Prevention, the virus can live for up to two hours in the airspace after an infected person leaves an area.
Infected people can transmit measles to other people from four days before, through four days after the rash appears. On average, an infected person can pass the virus on to 15 to 18 others who havent been vaccinated or are not immune.
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Symptoms include a high fever, cough, runny nose, watery eyes or pink eye. They appear seven to 14 days after contact with the virus.
The telltale measles rash appears three to five days after the first symptoms and typically starts off as flat red spots on the face at the hairline, which then spread downward, from head to toe.
People are infectious before they start to show symptoms, and highly infectious for several days when theyre symptomatic, before the body takes over and clears the virus, Ward said.
Infants who arent old enough to get the measles vaccine, kids and teens who havent gotten two doses of the vaccine, pregnant women and people with weak immune systems are most at risk.
Common complications in children include an ear infection and diarrhea. One in 10 may develop pneumonia. One in 1,000 can developed post-infectious encephalomyelitis, or swelling of the brain, that can lead to permanent neurological deficits like deafness, paralysis or difficulty thinking or speaking.
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One to three of every 1,000 children infected will die from respiratory or neurological complications.
A single dose is about 93 per cent effective against measles; two doses starting after 12 months are about 96 to 97 per cent effective, which means that three to four per cent of those vaccinated can still get measles.
Generally, in Canada, kids are vaccinated at 12 months of age and then again between four and six years of age.
The measles vaccine contains a live, attenuated virus, meaning you dont want to give it to pregnant people, said Dr. Caitlin Dunne, a reproductive specialist with the Pacific Centre for Reproductive Medicine in Vancouver. Women who are planning to get pregnant should wait a month, post-vaccination, before trying to conceive.
If a woman contracts measles during pregnancy, it can lead to birth complications like preterm birth and low birthweight infants, as well as serious pneumonia or respiratory illness in the mother, Dunne said.
When women are planning pregnancy, or are already pregnant, doctors check their blood for antibodies against rubella, or German measles, which can cause serious birth defects, such as brain abnormalities. If someone is not properly immunized or immune to rubella, it may indicate as well that theyre also not immune to measles, Dunne said, which could put the woman or her pregnancy at risk.
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The best advice is to get your vaccines on schedule and if youre not sure if youve been vaccinated, see your health-care provider. They may recommend a booster or a blood test to see your level of immunity, particularly if you are immunocompromised, a younger person or planning a pregnancy.
The vaccines were invented in the mid to late-60s; different provinces introduced the shots at different times. After 1970, basically all provinces were rapidly introducing (measles vaccines), said Ward, of McGill. Because measles was so transmissible, the assumption we work on is that anybody born before 1970 was infected at one point in their lives, and immunity after the disease is considered life-long.
Immunity after vaccination falls off very slowly, Ward said. There are a small number of people who have had two doses of vaccination who will, at some point in their life, become susceptible again, probably not within 10 to 15 years of being vaccinated, but maybe 30 years after vaccination, Ward said.
But if the vast majority of people around you are vaccinated and public health people put that number at around 95 per cent then the chance of you being exposed is very, very small.
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If people are travelling overseas to an area where measles is actively circulating, in most cases the recommendation is to get an extra dose of vaccine, Ward said. If you dont need it your body wont even see it, and if you do need it, itll prevent you from getting a really bad disease while youre overseas, Ward said.
They still have pretty good protection against measles, Ward said. If we start to see larger outbreaks, particularly in younger kids, I think what will happen is that provinces like Ontario that have that second dose at school entry will provide an extra dose earlier on.
People should stay home at least four days after the rash first appears, drink plenty of fluids (water, juice, soup, especially with fever) and get plenty of rest. Get emergency care if your child has a fever higher than 40.5 degrees Celsius, trouble breathing, confusion or clumsiness or a severe headache, according to John Hopkins Medicine.
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Earlier this month, the FDAs Vaccines and Related Biological Products Advisory Committee recommended that all US flu vaccines transition from quadrivalent to trivalent vaccines for the 2024-2025 flu season.1
The trivalent vaccines formula will still contain the influenza A(H1N1), A(H3N2), and B/Victoria-lineage vaccine virus, but omit the influenza B/Yamagata virus because it is no longer actively circulating.
FDA has been engaging and interacting with manufacturers of FDA-approved seasonal flu vaccines and providing scientific and regulatory advice to them to facilitate the timely availability of approved safe and effective trivalent seasonal flu vaccines for the 2024-2025 US flu season, said the FDA in a news release.2 FDA anticipates that there will be an adequate and diverse supply of approved trivalent seasonal flu vaccines for the United States in the coming season.
Each year, scientists review and update the composition of the US flu vaccine to target the strains predicted to be most prevalent in the coming flu season. Based on past reviews, this will not be the first time that patients seeking flu shots will be given trivalent vaccines.
Starting with the 1978-1979 season through the 2012-2013 season, US flu vaccines contained 3 vaccine viruses: influenza A(H1N1), A(h3N2), and a B-lineage vaccine virus either from the B/Yamagata or B/Victoria lineage.1 Quadrivalent flu vaccines first became available in the US during the 2013-2014 flu season and have remained as the standard composition until the current flu season (2023-2024).1
Transitioning from quadrivalent to trivalent vaccines will increase the current production capability by 200 million doses, allowing more patients to be vaccinated from the flu.3 This expansion in access may help alleviate the substantial health burden that the flu exacts on the US this past flu season was classified as moderate severity for adults and high severity for children by the CDC4as well as mitigate vaccine shortages and distribution inequities often experienced by developing countries.3
Each year, the virus causes millions of infections, hundreds of thousands hospitalized, and billions of dollars lost in health care costs and missed days of work.3
Vaccines, which have been long considered a first-line defense against the flu, have been recommended in the US for more than 50 years for everyone 6 months and older, with rare exception.1 They have been clinically proven to reduce the severity of the virus and the risk of developing potentially serious complications.
Some experts say that public health measures to curb the spread of SARS-COV-2 during the COVID-19 pandemic, such as lockdowns, travel restrictions, and mask mandates, might have unintentionally reduced the spread of Yamagata B.3 The strain had not been detected to be actively circulating in global surveillance after March 2020,1 suggesting these measures may have halted its circulation entirely.
Since changes in vaccine composition can sometimes lead to confusion or misinformation, effective communication, such as that conducted through public health campaigns or physician-patient discussions, is crucial to promote vaccine uptake.5 Health care providers and public health officials can ensure patient safety by explaining the rationale behind the composition change and emphasizing trivalent vaccines continued effectiveness against the flu.
In a recent study published in the Morbidity and Mortality Weekly Report (MMWR), researchers from Illinois, the United States of America (US), reported the incidence of five measles cases among unvaccinated children who resided in the same building but did not socialize with each other.
Notes from the Field:Measles Outbreak Cook County, Illinois, OctoberNovember 2023. Image Credit:adriaticfoto/ Shutterstock
Measles is an infectious disease preventable by vaccination and poses a significant health risk. In the US, it is advised that children receive two doses of the measles, mumps, and rubella (MMR) vaccine, typically administered between the ages of 12 and 15 months and again between 4 and 6 years. The present study describes a concerning case of measles outbreak among five unvaccinated children from two families residing in the same building who did not socialize with each other.
On October 5, 2023, Patient A, a 2-year-old immigrant from Yemen, was diagnosed with an unspecified viral illness at the emergency department (ED) of Hospital A, following negative test results for influenza, coronavirus disease 2019 (COVID-19), and respiratory syncytial virus. Patient A had not been administered the MMR vaccine and had symptoms of fever, cough, and coryza. On October 8, Patient A visited Hospital B's ED due to exacerbated respiratory symptoms and tested positive for rhinovirus/enterovirus. Patient A was then admitted again to Hospital A for respiratory distress.
Notably, Patient A developed a maculopapular rash while hospitalized the next day. On October 10, the family disclosed that they had been in contact with an individual diagnosed with measles before entering the US. Measles was confirmed via real-time reverse transcription-polymerase chain reaction (RT-PCR), and the patient was discharged.
Between October 5 and 11, the child was potentially exposed to 247 healthcare workers and 177 patients and kin. This included 13 infants aged under one year, five immunocompromised children, and one unvaccinated child aged over one year. Two of these children were given the MMR vaccine within three days of exposure, while 13 received immune globulin as a precautionary measure.
Patient A's domestic contacts included two siblings who had not received the MMR vaccine and were found to be susceptible to measles through serologic testing. The siblings were Patient B, aged four years and Patient C, aged nine. The siblings contracted measles during quarantine, with varied symptoms. Although patient B required an ED visit for supportive care, neither child was hospitalized. All the residents of the building were alerted on October 17.
On October 30, Patient D (another child aged two years) visited the ED with symptoms and resided on a different floor of the same building as Patient A. The child had not received the MMR vaccine, as its parents objected based on concerns about the side effects of the vaccine. Measles was confirmed through RT-PCR.
Interestingly, despite living in the same building, the families of both sets of patients had different cultural backgrounds and languages. Both families denied having any contact with each other. While their apartment units did not share ventilation, they shared laundry facilities and building entrances.
On October 31, Patient D's unvaccinated one-year-old sibling, named Patient E, was tested due to isolated coryza. The child attended a child-care facility on October 30 while symptomatic and confirmed measles through RT-PCR. Post-exposure prophylaxis was administered to susceptible individuals, including immune globulin for one child and an early second dose of MMR vaccine for others. Patient E did not develop a fever until November 6, and a rash appeared on November 9, nine days after the positive test result and notification of the child-care facility.
While testing for measles is typically done when prodromal symptoms occur, such as cough, fever, coryza, or conjunctivitis, the isolated coryza experienced by Patient E may not have been measles-related. As measles testing before fever onset is uncommon, determining the accurate contagious period for this patient was challenging. Patient E did not need hospitalization.
Five children contracted measles in this outbreak. They were unvaccinated despite being eligible for the MMR vaccine owing to cultural barriers, limited access to healthcare, and vaccine refusal. Outbreaks have been observed previously among close-knit communities, but the present families were not a part of such networks. Public health responses typically involve tailored approaches, like culturally appropriate education materials and translation services. However, these efforts are expensive and time-consuming. This outbreak highlights measles' high contagiousness, even among children not in each other's contact.
In conclusion, the study emphasizes the need for all children and susceptible individuals to receive two doses of the MMR vaccine at appropriate intervals. Clinicians should suspect measles in patients with febrile rash illness and ensure vaccination to prevent future outbreaks.
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Last weeks column on the Florida surgeon generals cavalier approach to controlling his states burgeoning measles outbreak prompted many readers to express a concern that I share: anti-vaccine sentiment is growing and threatens decades of public health progress.
Joseph from Oregon has a different view. Youve been writing that people should gauge individual risk when it comes to covid, he wrote. Why isnt it the same with measles? Your article says that the vaccine is 97 percent protective. Vaccinated kids dont need to worry, so why isnt it up to parents to decide whether to give their kids the shot?
Joseph raises an interesting point that goes to the fundamental tension in public health of weighing individual freedom vs. whats best for society. Individual freedom should generally take precedence, but there are some circumstances where policymakers have to decide in favor of protecting the public.
I was thinking about this question when I took my kids to an indoor play gym over the weekend. For those unfamiliar with the concept, think of a regular jungle gym but bigger and all indoors, with slides, ball pits, trampolines and multilevel climbing structures. The ones in my area become very crowded, with hundreds of kids and parents packed into relatively small spaces.
As soon as I signed my 6-year-old son in, he ran off with some friends and disappeared in the throng of excited kids. I wasnt so worried about keeping an eye on him, but I did worry about my 3-year-old daughter. I knew that if I let her out of my sight, it could take a while to find her.
My husband told me not to worry; in his view, this kind of play is exactly what these indoor gyms are designed for. Another mom who overheard our conversation agreed with him; her young child was playing wherever she wanted, without her mom hovering over her as I was doing with my daughter. On the other end of the spectrum are parents who wouldnt even think to come to these indoor gyms for safety reasons.
All of these are reasonable individual decisions. The fact that they should be made by parents about their own kids is something few would take issue with.
Now lets take a totally different scenario. Lets say that there were a couple of kids who were hitting other kids and pushing toddlers off climbing structures. Even if their parents had no issues with this behavior, they pose a threat to others, and few would argue against intervention.
The question of where measles and covid-19 lie on this continuum of individual choice comes down to three factors: how dangerous is the disease, what is the risk posed to others and how effective are the mitigation measures.
While Joseph is right that the measles vaccine is highly protective, it is not 100 percent effective, which means that some vaccinated individuals might still get infected. Also, there are babies and young children who are too young to be vaccinated. The unvaccinated, if exposed to measles, have a nearly 90 percent chance of becoming infected, and infection poses many harmful consequences including a 1 in 5 chance of hospitalization, permanent neurological defects and death.
Crucially, targeted mitigation measures of boosting vaccinations and quarantining exposed people work to contain measles, as they have in recent outbreaks in New York, Ohio and Pennsylvania. In addition, its possible to stop measles from propagating by achieving herd immunity, which is what the United States has been successful in doing.
This is not the case with covid. The nature of the coronavirus is such that no level of population immunity will stop the disease from circulating. In addition, the coronavirus vaccines, while protective against severe disease, have limited effect on reducing infection. Large-scale population measures such as required masking, vaccines and isolation periods have not contained the virus, and indeed have spawned such substantial backlash that other public health interventions including the measles, mumps and rubella (MMR) vaccination are now harder to implement.
To go back to the indoor play gym analogy, the interventions required to stop measles in Florida are akin to stopping a couple of kids from playing until they are no longer harming others. Yes, it restricts their freedom, but its a temporary measure imposed on a small number of people because the risk to others outweighs the individuals right to self-determination.
On the other hand, using societal interventions to try to control covid at this point would be more analogous to shutting down all playgrounds in perpetuity, knowing that the aggressive behavior would continue outside their premises. The interventions are wrong not only because most would perceive them as government overreach, but because they simply wont work.
This is why it makes sense to me to view risks around covid as individual decisions, and why the risk-benefit calculation is different for preventing the resurgence of previously eliminated deadly diseases such as measles and polio.
As Rose from Minnesota reminds us, I remember all too well the days when every child got measles and chicken pox and our parents kept us out of public pools because they feared we would be next to be paralyzed from polio. We all lined up and got our shots because our parents saw what these diseases can do. We simply cannot afford to go back in time. I couldnt agree more.
As the number of measles cases increases across the country, Chicago has become the latest U.S. city to be at the center of an outbreak.
As of Thursday morning, eight measles cases have been confirmed, with at least seven among children and adults at a new arrivals shelter, according to the Chicago Department of Public Heath.
The Centers for Disease Control and Prevention has sent a team to help public health officials respond to the outbreak, with staff arriving Tuesday, according to the federal health agency.
At least 45 measles cases have been reported across 17 states so far this year, according to CDC data. Due to delays in reporting national data, this number does not include the current outbreak in Chicago. Numbers are now close to the total number of cases -- 58 -- reported for all of last year.
Measles was considered eliminated in 2000 because most Americans were vaccinated against the disease or had some level of immunity. Over the last several years, however, vaccination rates have dipped and pockets of unvaccinated and undervaccinated communities have led to sporadic outbreaks across the U.S.
Public health experts told ABC News these localized outbreaks can be hard to contain.
"As an infection control practitioner and a physician, I just feel like ... you're kind of always waiting for the next measles outbreak," Dr. Jennifer Grant, an infectious disease physician and system medical director for infection prevention and control at Endeavor Health in the greater Chicago area, told ABC News. "It just feels like we have a perfect storm of declining vaccination, that there is always a possibility that a measles outbreak could happen anywhere."
The first measles case in Chicago was confirmed on March 7 in a city resident whose source of infection is unknown, according to the CDPH.
Since then, seven cases have been confirmed at a new arrivals shelter in Pilsen, in the lower west side of the city, health officials said.
Because it can take about 11 to 12 days from someone being exposed to developing symptoms, experts said it might take some time to see the full impact of the outbreak.
"I think it is safe to say that the majority of those who have come down with cases of measles are unvaccinated," Dr. Aniruddha Hazra, an associate professor of medicine in the section of infectious diseases and global health at UChicago Medicine, told ABC News. "I think the big concern is that this is not telling us the fuller picture of the current outbreak in Chicago and likely there are potentially more cases and ... likely more exposures in the city."
A CDC team arrived in Chicago this week to support local officials by providing guidance for monitoring symptoms and quarantine or isolation practices as well supporting the ongoing vaccination campaign, the CDPH said.
Hazra said the CDC has its own epidemiological intelligence service that goes to places around the country where outbreaks are occurring and offers both financial support and manpower support.
"Contact tracing is backbreaking work; it takes a lot of time, a lot of manpower to get done," he said. "There is significant benefit for contact tracing and case investigation with measles, just given the prolonged incubation period and the time between when someone is exposed to when someone actually presents with symptoms and then can be contagious or transmissible to others."
"Being able to capture folks in that window, making sure they're able to quarantine and self-isolate, that is so important to help reduce the spread of outbreak," Hazra added. "So, the CDC being able to deploy additional folks to come here to assist and collaborate with our public health department is really critical."
The CDC currently recommends that everyone receive two doses of the measles, mumps and rubella (MMR) vaccine with the first dose between ages 12 and 15 months and the second dose between ages 4 and 6.
One dose of the measles vaccine is 93% effective at preventing infection if exposed to the virus. Two doses are 97% effective.
If someone has had two doses of the MMR vaccine, they do not need to receive a booster dose and are essentially protected for life, public health experts told ABC News.
For any adult not sure of their immunization status, the experts recommended speaking to a primary care provider. Antibody levels may be drawn to assess immunity, and if someone is not immune, they may be eligible for at least one MMR dose.
It's currently not recommended for pregnant women to receive the MMR vaccine if they are not immune to measles.
"We do recommend discussing with your doctor whether or not [antibody levels] can be drawn and to make sure that you're not in any situation where you might be presented to measles because that could be a very concerning situation" if pregnant, said Dr. Nicholas Cozzi, EMS medical director at Rush University Medical Center in Chicago.
In the case of the measles outbreak at the shelter, experts have stressed not conflating the outbreak with anti-migrant sentiment because many people in these shelters have likely not had access to vaccines or have had barriers to access in their native countries.
"This is really a call for us to be providing better medical care to these populations," Dr. Gary Reschak, a pediatrician at Northwestern Medicine Huntley Hospital, told ABC News. "A lot of these people who are coming here ... did not have access to the same health care and the easy access to vaccines that we take for granted."
Public health experts said there has been a "perfect storm" in the U.S. of vaccine hesitancy, vaccine access and vaccine fatigue.
Grant said during the COVID-19 pandemic, countries around the world, including the U.S., lost a lot of ground when it came to maintaining rates of routine childhood vaccinations due to lack of access and people being fearful of accessing health care settings during the early days of the pandemic due to risk of COIVD exposure.
She added that people may be experiencing fatigue from receiving the original COVID-19 vaccine and subsequent boosters, which may have spilled over into feelings about routine vaccines.
Cozzi also pointed to a now-debunked paper from the U.K. in 1998, which allegedly found that MMR vaccines cause autism. The paper was discredited, retracted from the journal where it was published, and its primary author lost his medical license. More than a dozen studies have tried to replicate the findings and failed to find a link.
Despite no evidence that vaccines cause autism, some parents may still be hesitant for their children to receive the MMR vaccine.
"That was debunked, it was proven to be false, but we see the rise of medical misinformation, and that was one of the earliest signs that that was occurring," Cozzi said.
"Measles as a virus is something that I think a lot of [people] just don't appreciate how extremely contagious it is," Reschak said. "It goes beyond like your colds and your flus."
Measles is highly contagious and can spread through the air when an infected person coughs or sneezes, according to the CDC.
It is so contagious that if an infected person comes into contact with people who aren't protected, 90% of them will also become infected. In a congregate setting, like a shelter, this can mean quick spread.
"So, with this level of contagiousness, it really does spread like wildfire, and that's why when you have outbreaks like this, you have to do very good tracking of the cases and trying to isolate people who may have been exposed and are at risk for spreading measles," Reschak said.
These outbreaks can potentially put a strain on the healthcare system because measles can be deadly.
According to the CDC, one in five unvaccinated people with measles are hospitalized, one in every 20 children with measles contracts pneumonia and one in every 1,000 children with measles suffers encephalitis, or swelling of the brain.
These complications can lead to ear infections, deafness, neurological complications or even death. Nearly one to three of every 1,000 children with measles will die from respiratory and neurologic complications.
"These are just huge, huge numbers that put a major strain on the health care system as well as the families themselves," Reschak said. "So, keeping it as isolated and keeping these outbreaks as sequestered as possible is in everyone's interest."
A November 2023 CDC report found that for the 2022-23 school year, about 93% of children in kindergarten had met the vaccination requirements, about the same number seen for the previous school year but lower than the 94% rate in 2020-21 and 95% rate in 2019-20.
Additionally, exemptions from school vaccination requirements increased to 3% during the 2022-23 school year, which is the highest vaccination exemption rate ever reported in the U.S., according to the CDC.
"Unfortunately, I believe that if we don't start getting more children vaccinated more consistently, we will start seeing more of these outbreaks pop up," Reschak said. "We are really approaching that threshold where, I can't say this with certainty, but I'm concerned that it's possible measles can become endemic to the United States again."
This is why experts say it's so important to receive the MMR vaccine to both protect yourself and those most at risk of severe disease in your community.
"Measles is an equal opportunity virus, irrespective of your legalization status," Cozzi added. "It just concerns itself if you're under-vaccinated or unvaccinated. Measles, if you're unimmunized, is incredibly dangerous."
Windhoek, Namibia
A top Namibian health official tells VOA the southern Africa country is set to begin distribution of the HPV vaccine to adolescent girls in April as a preventative measure in the fight against cervical cancer.
Namibia has a population of about 1 million women ages 15 years and older who are at risk of developing cervical cancer.
Each year, about 375 women in Namibia are diagnosed with the disease, and the fatality rate is over 50%.
The Human Papillomavirus Vaccine, known as HPV, has been proven to greatly lessen the chance of getting cervical cancer.
Ben Nangombe, executive director at Namibias Ministry of Health and Social Services, says health workers will begin vaccinating about 183,000 girls between the ages of nine and 14 next month.
He says the ministry has been allocated $7 million to procure single dose vaccines for this purpose.
Mehafo Amunyela, who works at the #Be Free Youth Program in the capitals Katutura Township, told VOA that vaccine hesitancy could be a hurdle to fully immunizing the target population. She said she hopes that through awareness campaigns, children and their families can be educated about the advantages of getting the vaccine.
We saw the reaction of the public toward the COVID vaccine when it came out, but I think we need to be honest with ourselves and remember that the reason we dont have illnesses like polio is because of vaccines, that they worked then, and they still do now, she said.
The Cancer Association of Namibia says the vast distances between most towns and villages in Namibia could present another logistical challenge in the immunization program.
The association says to achieve the target of immunizing 183,000 girls, awareness campaigns should be undertaken in the different indigenous languages spoken in the country.
With the rollout of the HPV vaccine, Namibia is on the path to do its part in meeting the World Health Organizations goal of vaccinating 90% of girls worldwide by 2030, with the long-term goal of eliminating cervical cancer within the next century.
Although cervical cancer is preventable and curable, the disease claimed 350,000 lives worldwide in 2022 according to the WHO.
Photo Credit: Design Cells
The following is a summary of Immune responses to SARS-CoV-2 mRNA vaccination in people with idiopathic CD4 lymphopenia, published in the February 2024 issue of Allergy & Immunology by Rocco, et al.
For a study, researchers sought to evaluate the immunogenicity of mRNA vaccines in individuals with idiopathic CD4 lymphopenia (ICL) across varying CD4 T-cell counts.
Samples were collected from 25 patients diagnosed with ICL and 23 ageand sex-matched healthy volunteers (HVs) after receiving their second or third dose of mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Anti-spike and anti-receptor binding domain antibodies were quantified, and T-cell receptor sequencing and stimulation assays were conducted to assess SARSCoV2specific T-cell responses.
Among the ICL participants, with a median age of 51 years and a median CD4 count of 150 cells/L, 11 had CD4 counts 100 cells/L. Anti-spike IgG antibody levels were lower in patients with ICL than HVs after 2 and 3 vaccine doses. However, individuals with ICL and CD4 counts >100 cells/L did not significantly differ from HVs in anti-spike IgG levels. Spike-specific T-cell responses, as measured by T-cell receptor sequencing, were reduced in individuals with ICL. Nonetheless, the activation-induced markers and cytokine production of spike-specific CD4 T cells were comparable between ICL participants and HVs after 2 or 3 vaccine doses.
Patients with ICL and CD4 counts >100 cells/L exhibited robust humoral and cellular immune responses following SARS-CoV-2 vaccination. Conversely, those with more severe CD4 lymphopenia showed attenuated vaccine-induced immunity, suggesting the potential need for additional vaccine doses and other risk mitigation strategies.
Reference: jacionline.org/article/S0091-6749(23)01383-0/abstract
