A Doctor Explains What People Should Know About Measles

Summary

Chasing Life: Episode Summary - "A Doctor Explains What People Should Know About Measles" Release Date: February 25, 2025

In this insightful episode of Chasing Life, hosted by Dr. Sanjay Gupta, listeners are provided with an in-depth exploration of the ongoing measles outbreak in West Texas and its broader implications on public health. Dr. Gupta leverages his medical expertise and on-the-ground reporting to dissect the causes, consequences, and preventive measures related to measles, a disease once considered eliminated in the United States.

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1. Understanding the Current Measles Outbreak

Timestamp: [00:36]

Dr. Gupta opens the discussion by detailing his recent experience covering the measles outbreak in West Texas. He paints a vivid picture of the frustration and fear gripping both citizens and healthcare workers. Highlighting the rarity of measles cases in the U.S. since its elimination in 2000, he emphasizes the unsettling resurgence:

"We don't talk about measles much anymore, and that's in large part because it was considered eliminated in the United States back in 2000."
— Dr. Sanjay Gupta [00:36]

He warns that the outbreak is expected to persist for months, potentially affecting several hundred individuals, a stark reminder of the disease's resurgence due to declining vaccination rates.

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2. The Decline in Vaccination Rates

Timestamp: [02:29]

Addressing the root cause, Dr. Gupta explains the factors contributing to the lowered vaccination rates, particularly in insular communities like the Mennonites in Gaines County, Texas:

"Most of the cases are actually occurring in an under vaccinated community... It's largely a Mennonite community. It is rural, it is close knit, it is insular."
— Dr. Sanjay Gupta [02:36]

With vaccination rates around 82% in the epicenter of the outbreak, the community falls below the critical 95% threshold needed for herd immunity against highly contagious viruses like measles. Dr. Gupta underscores that such pockets of under-vaccination can ignite outbreaks, as seen not only in Texas and New Mexico but also in places like Brooklyn, New York, and Disneyland in Southern California.

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3. Has Measles Become More Virulent?

Timestamp: [04:43]

Listener Elizabeth, aged 72, questions whether measles has evolved to become more dangerous:

"Has measles become more virulent?"
— Elizabeth [04:43]

Dr. Gupta clarifies that the measles virus has remained relatively stable over the decades:

"The virus has not become more virulent. In fact, the measles virus has stayed pretty stable over the decades."
— Dr. Sanjay Gupta [04:54]

He reflects on historical data, noting that while complications and deaths from measles were more common before widespread vaccination, the virus itself hasn't grown more deadly. Instead, improved medical care has reduced mortality rates significantly.

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4. Long-Term Protection from the Measles Vaccine

Timestamp: [08:57]

Mary, a 59-year-old listener, inquires about the long-term efficacy of the measles vaccine she received as a child:

"Does the measles vaccine I got as a child still protect me now?"
— Mary [08:57]

Dr. Gupta reassures her and others in similar situations that the measles vaccine provides enduring protection:

"Measles vaccine is typically two doses... Two doses are about 97% effective."
— Dr. Sanjay Gupta [08:57]

He mentions that less than 1% of vaccinated individuals experience waning immunity, and for those concerned, antibody titers can be checked through a blood test. Dr. Gupta shares a personal anecdote about verifying his own immunity to underscore the vaccine's reliability.

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5. Adjusting Vaccination Schedules Amid Outbreaks

Timestamp: [11:01]

Laura questions whether her 2-year-old grandson should receive his second measles vaccine dose earlier than the standard schedule:

"Should my 2-year-old grandson get his second dose of the measles vaccine now instead of waiting until he's four like he normally would?"
— Laura [11:01]

Dr. Gupta advises that in outbreak zones, earlier administration of the second dose can bolster community immunity:

"If he lives in the midst of a measles outbreak... state health officials are now recommending that children over 12 months who have received one dose now get their second dose as soon as possible."
— Dr. Sanjay Gupta [11:11]

He emphasizes the importance of adhering to vaccination schedules, especially in high-risk areas, to enhance protection against the highly contagious measles virus.

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6. Concluding Insights and Call to Action

Timestamp: [11:11]

Wrapping up the episode, Dr. Gupta encourages listeners to remain proactive about vaccinations and to continue seeking accurate health information:

"The most important thing is to be fully vaccinated, because getting that second shot does boost your immunity even more."
— Dr. Sanjay Gupta [11:11]

He invites the audience to submit more health-related questions, fostering an interactive and informed community dedicated to public health and disease prevention.

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Key Takeaways

• Vaccination Rates: Critical for maintaining herd immunity; rates below 95% can lead to outbreaks.
• Community Impact: Insular and under-vaccinated communities are hotspots for disease resurgence.
• Vaccine Efficacy: The measles vaccine remains highly effective long-term, with minimal cases of waning immunity.
• Public Health Measures: Adjusting vaccination schedules during outbreaks can prevent widespread transmission.
• Continued Vigilance: Ongoing public education and vaccination efforts are essential to prevent the return of diseases like measles.

This episode of Chasing Life serves as a compelling reminder of the importance of vaccination and the vigilance required to maintain public health gains achieved over decades. Dr. Gupta's expert analysis and empathetic communication provide listeners with the knowledge and motivation to contribute to healthier communities.

Transcript

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[Dr. Sanjay Gupta]

Welcome to Paging Dr. Gupta. You know, I just got back from West Texas. I was covering the measles outbreak there, and it was really interesting to be on the ground in the middle of all that. There's a sense of frustration among a lot of the citizens, a lot of the healthcare workers that were experiencing this sort of outbreak at all. I think there are people who are really frightened about what is unfolding, especially people who have members of their family or who they themselves are immunocompromised. They're worried about contracting measles. And then I think there's a real sense of just trying to figure out what is going to happen next, like how much is this measles outbreak likely to grow? We obviously don't know the answers to those questions, but I will tell you that if you, if you talk to health officers on the ground, they will tell you that this outbreak's probably gonna last for months and there's gonna be several hundred people ultimately who do get the measles. So that's what they're sort of preparing for. You know, we don't talk about measles much anymore, and that's in large part because it was considered eliminated in the United states back in 2000. That means they hadn't seen a new case of measles for many years. In the United States, many of the doctors who are now caring for these patients with measles, this is the first time they've actually seen a patient with measles. So I think that's the source of frustration, that these are vaccine preventable diseases and here we are taking care of them. A big part of the reason why we're seeing an uptick in numbers is because of lower vaccination rates. That's what allowed these cases to pop up again. And it's also led to a lot of questions. So to start sharing them is one of our producers, Kira. Kira, what's the first one?

[Kira]

Hey, Sanjay. So Kathleen wants to know why is the vaccination rate so low in that part of Texas and New Mexico?

[Dr. Sanjay Gupta]

Yeah, this is a good question. You know, most of the cases are actually occurring in a under vaccinated community, a community which does not traditionally seek traditional health care. It's largely a Mennonite community. It is rural, it is close knit, it is insular. And what we know when we look at the vaccination rates there is that they are close to 82%. That's in Gaines County, Texas, where the epicenter of this outbreak has been 82%. So that means roughly one in five incoming kindergartners, for example, did not get the vaccine in that particular area. Many of them, by the way, are homeschooled, so they're not required to get the vaccine as part of attending a public school. But that is typically what you see, is that you see pockets of under vaccinated communities versus a broad swath of a population that is under vaccinated. But when you have a virus as contagious as measles, one of the most contagious viruses that exists on the planet, you can run into problems once you start to drop below sort of 95% coverage, for example, that is one of the big concerns here. Public health officials want the vaccination rates to be above 95% by the time kids are 4 or 5 years old. By the time they start to attend school, that is the number they're shooting for to try and get herd immunity. Nearby counties stand closer to that, you know, 90 to 93%. But again, the under vaccinated communities in this area can have an impact on the community overall. So that is what we're really running into. And it's not just west Texas, not just New Mexico. There are other places around the country where we see this. Back in 2019, I covered a large outbreak that occurred in Brooklyn, New York. There have been outbreaks in Minnesota. There was an outbreak in Disneyland in Southern California. So it's not just West Texas. But what I just described is typically what drives at least the initial outbreak, and then it just grows from there. Okay, Kara, what's next?

[Kira]

Next, Elizabeth said, I'm 72 years old and had measles as a child, but I don't remember children dying from this disease. So has measles become more virulent?

[Dr. Sanjay Gupta]

Yeah, Elizabeth asks a really important question for a lot of people. Again, they've never seen measles or they don't remember how bad it once was. The virus has not become more virulent. In fact, the measles virus has stayed pretty stable over the decades. Unlike flu, which shifts and drifts every year, or Covid, which has a lot of mutations, measles has been pretty stable. And the average complications of measles or the death rates occur just infrequently enough that the average person may not have been aware of them even before widespread vaccination. So if you go back to the mid-60s, early-70s, when we really started to vaccinate robustly in the United States, There are about 400 to 500 people dying a year. Those numbers had come down from the decades earlier, in large part because of better medical care. We could treat medical care better, but then 400 to 500 people were still dying every year. A lot of people were ending up in the hospital, a lot of people getting sick. If you looked around the world, measles would typically claim around two and a half million people every year. Sadly, two and a half million people would die. These days, the comparative figure is closer to 107,000 measles deaths every year. And those typically occur in countries with low vaccination. So, you know, that's really what you have to sort of keep in mind. A few hundred people were dying every year before vaccination. And after vaccination, there were just a few people, period, dying in the United States every year. So, Elizabeth, it should not be surprising that maybe you did not know people dying of the disease, but it was happening. And because of vaccination, those numbers have come down very, very significantly. There are many vaccine preventable diseases out there. Measles is one of them. And the vaccines really do work. They've been around a long time and they've made a huge difference. Okay, coming up after the break, a question a lot of you have been asking. If you got the measles vaccine as a child, are you still protected?

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[Dr. Sanjay Gupta]

Okay, Kira, who's paging us next?

[Kira]

So, Sanjay, a lot of people actually had this question, including Mary, and she asks, I'm 59 years old. Does the measles vaccine I got as a child still protect me now?

[Dr. Sanjay Gupta]

So, Mary, the short answer to the question is yes, you should still be protected. Now, measles vaccine is typically two doses. One dose around a year of age or so, and the second dose before you start school. So four to five years of age, one dose usually is about 93% effective against measles. Two doses, 97% effective. You've probably heard those numbers, but the number you may not have heard, and this sort of answers your question, is that less than 1% of people who receive those two vaccines will have waning immunity to measles to the point where they are now susceptible to infection. You know, you make antibodies in response to the vaccine. Again, most people, they will maintain those antibodies. You'll still have antibodies years, decades later, but less than 1%. Those antibodies do tend to wane. One thing I'll point out a little nuance is that the first version of the vaccine came out in 1963, and that version was used until 1968. So many people, like Mary and myself for that matter, probably got that first version of the vaccine. The CDC does recommend the people who got the first version of the vaccine get at least one dose of the newer MMR vaccine. Now, if you're wanting to be sure before you do that, you can get your titers checked. It's a blood test, and it basically is checking for your antibodies against measles. I actually had that done recently because I'm working on a documentary about transplant surgery. And as part of being in the operating room with these immune compromised folks, they wanted to make sure that I was still protected against measles. I had my titers checked. I'm in my mid-50s now, and my titers were fine. So if you're curious, if you're worried, if you just want to make sure you can get that blood test done. And also, you know, people who have weakened immune systems, they may in particular want to get this checked out. Okay, we got time for one more question. Kira, what's the last one?

[Kira]

All right, this one's coming from Laura, who asks, should my 2 year old grandson get his second dose of the measles vaccine now instead of waiting until he's four like he normally would?

[Dr. Sanjay Gupta]

Okay, this is a question that I heard a lot even when I was on the ground in West Texas. Again, first dose, 93% effective. Second dose sort of boosts your immunity to 97% protection. The reason that the vaccine schedule exists the way that it does in the United States, which by the way, is different than a lot of other countries around the world. But that first dose given again around a year of age, and then the second dose was to be given before kids start school, so around four or five years of age, because most kids start school shortly thereafter. Now, Laura did not share where her two year old grandson lives, but if he lives in the midst of a measles outbreak, such as Gaines County, Texas, state health officials are now recommending that children over 12 months who have received one dose now get their second dose as soon as possible. Again, the normal vaccination schedule would be for Laura's grandson to get that second dose at four to six years of age. But where an outbreak is occurring, the thinking is let's increase the measles immunity and prevent more occurrence of the disease as much as possible. Now, if your grandson, Laura, or if anybody who's listening, this child does not live in one of the communities impacted here, then waiting for that second shot until 4 to 6 years old is fine. Again, there are countries around the world where they say get a shot at 12 months of age and then another shot at 18 months of age, there's no harm in advancing the timing of that second shot. But the reason they wait is they want to make sure it's given as close to the time as when they're starting school as possible. So bottom line, the most important thing is to be fully vaccinated, because getting that second shot does boost your immunity even more. And it's really important to be thinking about these things, especially when you're in the midst of a measles outbreak. So, Laura, thank you for that question. And that is all for today's episode. You know, we've only been doing this for a few weeks now, and so many of you are sending in questions. I had no idea there were so many questions out there about these topics. So keep them coming in. If you got a health question, I want to hear it. Record a voice memo, email it to asksanjaynn.com or give us a call 470-396-0832 and leave a message. Thanks so much for listening and I'll be back next Tuesday. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Michael, Lori Gallaretta, Jesse Remedios, Sofia Sanchez and Kira Dehring. Andrea Cain is our medical writer. Our senior producer is Dan Bloom. Amanda Seely is our showrunner, Dan Dezulla is our technical director. And the executive producer of CNN Audio is Steve Lichti, with support from Jamis Andrest, John Dionora, Hailey Thomas, Alex Manasseri, Robert Mathers, Lainey Steinhart, Nicole Pessaroo and Lisa Namorow. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Katie Hinman.

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