By Michaela Ramm, Des Moines Register
Vaccine skeptic Robert F. Kennedy Jr. endorses measles vaccine: Health and Human Services secretary, and vaccine skeptic, Robert F. Kennedy Jr. supports measles vaccine after visiting West Texas.
AI-assisted summary
- Health officials are preparing for a potential outbreak in Iowa due to the disease’s contagious nature and the state’s vaccination rates.
- Iowa’s MMR vaccination rates are below herd immunity levels, increasing vulnerability to outbreaks.
- Health experts emphasize the MMR vaccine’s effectiveness and safety, debunking claims made by anti-vaccine groups.
As measles cases continue to rise nationwide, local health officials are taking steps to prepare their response to the disease.
Measles has not yet been detected in Iowa. However, given the highly contagious nature of the disease and the state’s current vaccination rate, health experts say Iowa faces a very real risk for a potential outbreak.
So far, more than 600 cases of the disease have been detected in 22 states, including Kansas and Minnesota. The vast majority (97%) of those infected were unvaccinated or had an unknown vaccine status.
The current outbreak in West Texas has resulted in at least two deaths, according to the U.S. Centers for Disease Control and Prevention.
The disease could spread very quickly in Iowa, especially if a case is detected in communities with a high enough concentration of under-immunized or unimmunized residents.
As a result, local health care providers and public health officials are planning for when — not if — a case arrives in the area.
“I do think it’s likely we will see a case in the near future, particularly because we’re seeing those outbreaks happening now in Kansas and in Minnesota,” said Juliann Van Liew, director of the Polk County Health Department. “As it starts to hit contiguous states, I think all of us need to make sure that we’re actively preparing for what may come, even sooner than later.”
Why are health officials alarmed about measles?
Measles is an illness caused by a respiratory virus, and its symptoms include a widespread rash, fever and other flu-like symptoms.
It’s also a highly contagious. Droplets from an infected person coughing or sneezing can stay airborne and live on surfaces for hours, which means one infected person can infect up to 10 others if they are not protected against the virus, according to the CDC.
It’s estimated up to 90% of people who haven’t had measles or have never been vaccinated will become infected when exposed to the disease.
“Measles is the most contagious disease on the planet. Unless there’s very active efforts to make it slow down, it has a good chance to keep going. The longer it goes on, the greater the chance it has to impact Iowa,” said Dr. Nathan Boonstra, a Des Moines-based pediatrician and chair of the Iowa Immunizes Coalition, a group that advocates for greater vaccination rates across the state.
The disease causes severe illness, especially in infants who are too young to be vaccinated, said Dr. Joel Waddell, pediatric infectious disease physician at Blank Children’s Hospital.
The Des Moines-based doctor said he helped care for infants and children infected with measles during two separate outbreaks during his training. He saw firsthand how sick his patients became.
“It’s definitely not a regular viral infection. It is much more serious,” Waddell said.
Complications from a measles infection can include dehydration, pneumonia and encephalitis, or swelling of the brain. Waddell said some patients can also develop a rare but deadly infection of the nervous system called subacute sclerosing panencephalitis.
Measles also causes complications that can linger long after a patient has recovered from the disease.
Waddell said one rare post-infection complication is called immune amnesia, a phenomenon in which a person’s immune system temporarily forgets how to fight off germs it learned from previous infections.
As a result, some patients can become very ill from other diseases in the years that follow.
Local preparations underway to identify, respond to measles
The Polk County Health Department and local health care systems say they are working to be prepared to identify and respond to potential measles cases in the area.
“As a health care system, we are taking the threat of measles extremely seriously,” Waddell said. “We are doing a broad spectrum of preparations for measles to help protect our communities, because when an outbreak happens, it’s a concert effort between health care providers and public health to work together very quickly to keep us all protected.”
For local hospitals, that includes educating health care providers on how to screen for and identify measles, since many clinicians have never seen a case firsthand.
Waddell said leaders are ensuring policies and procedures are in place to care for an infected patient in the hospital. Because the disease is so contagious, patients need to be placed in a negative-pressure room, a specialized room that ensures airborne viruses such as measles do not spread.
The county public health agency is also working to spread awareness about measles to the community by educating its partners, including local school nurses, on the signs and symptoms, Van Liew said.
Polk County Health Department is prepared to ramp its contact tracing efforts to reduce the spread of the disease, once a case is detected. Given that measles can infect up to 10 other people, Van Liew said “it’s really, really important that as much as we can, we stop transmission as quickly as we can.”
Massive overhauls at government agencies and budget cuts at the federal level have raised concerns among some health experts about local public health agencies’ ability to respond to measles and other potential outbreaks.
Waddell said if Polk County or other local health agencies saw significant funding cuts, it could “dramatically impede” any prevention or response efforts.
“It would almost certainly directly correspond to increased cases of measles, or whatever infectious disease you’re talking about,” he said.
Van Liew said her department is watching those potential cuts closely.
“There’s nothing imminent that I need to be concerned about as the county health department director, but it’s just a continually changing tide,” she said. “We’re just going to watch it really closely and make sure that we’re doing what we can on the back end to keep all of our services running.”
Suspect you have measles? Call your doctor before going to a clinic
Polk County Health Department is warning residents to not got to a clinic or emergency room if they think they have measles or suspect they’ve been exposed to measles.
Instead, Van Liew said individuals should call ahead to the hospital or clinic and speak to health care providers about their possible condition. Those facilities will be able to guide the patient through next steps to get them seen in person by a health care provider.
Van Liew said doing so will help limit further exposure of the disease to others, such as other patients in the waiting room.
“The most important thing to do someone thinks they may have measles is to stay away from others, because we don’t need that spread happening unnecessarily,” Van Liew said.
Iowa’s vaccination rate below herd immunity levels
Local health experts say the measles, mumps and rubella (MMR) vaccine is the most effective way to prevent serious illness and death from an infection.
One dose of the MMR vaccine is 93% effective against measles, and two doses are 97% effective, per the CDC.
It’s recommended children get the first dose of the MMR vaccine between the ages of 12 to 15 months old, and the second between 4 to 6 years old. Most individuals do not need a booster or additional dose of the vaccine to be protected from the disease.
“There are very few kinds of deaths that are more easily preventable than a measles death, because the vaccine is so very effective,” Boonstra said.
Local health experts are encouraging parents and guardians to make sure their child is up-to-date on all of their childhood immunizations, including MMR. They’re also encouraging adults to check their vaccine records to make sure they’re also up-to-date on all of their shots.
A population needs to reach at least a 94% vaccination rate to achieve herd immunity against measles, which means enough people in a population are immune to a disease and make it difficult for it to spread, according to health officials. Without it, Van Liew said measles can become endemic, meaning a disease can regularly occur in a community or area.
Current vaccination estimates in Iowa show immunization rates among young Iowans — who would be most at risk for an infection — have not reached the level necessary to achieve that protection.
In 2024, 84% of 2-year-olds and nearly 86% of adolescents between the ages of 13 and 15 had completed the two-dose MMR vaccine series, according to state public health data.
The CDC estimates approximately 89% of kindergartners in Iowa were fully vaccinated against measles during the 2023-24 school year.
Van Liew said Polk County has seen consistent declines of fully vaccinated school-aged children since 2018.
School immunization reports for the 2023-24 school year show about 6% of all students in Polk County, or about 5,500 students, were not fully vaccinated. That’s compared with 2,600 students in the 2018-19 school year.
Van Liew said the county has seen those rates increase in nonpublic schools, where about 88% of students are fully vaccinated.
“I do worry about those spaces where we’re dipping below herd immunity,” she said.
Threat comes after years of few measles cases
There have been no measles cases reported in the state since 2019, according to state public health officials. A major outbreak occurred that year, resulting in measles cases nationwide.
Iowa has had sporadic measles cases over the years but has avoided major outbreaks in recent memory.
However, growing vaccine hesitancy nationwide has helped contribute to a dramatically changing landscape for states. The World Health Organization declared measles eliminated in the United States in 2000, but in the years since, the disease has reemerged nationwide with more frequency in recent years.
“We shouldn’t have any outbreaks,” Boonstra said. “Just as it’s easy to prevent death, it’s easy to prevent measles. If everyone was immunized the way you’re supposed to be immunized, we wouldn’t have to worry about this.”
Why vitamin A isn’t effective against measles
Vaccine skeptics such as Robert F. Kennedy Jr., the nation’s health secretary, have touted unproven treatments and other alternative therapies that do not effectively treat measles.
A popular therapy promoted by these groups is vitamin A, which will not stop measles.
“First and foremost, vitamin A cannot prevent you from getting measles, not even a little bit,” Waddell said. “And it cannot treat measles to make measles go away, so it is not an effective infection prevention method. The only way to prevent measles is to get vaccinated.”
Doctors do give vitamin A as part of measles treatment. However, without guidance of a health care provider, vitamin A supplements can be harmful to children.
“I would recommend that no one give extremely high doses of vitamin A without the direction of a healthcare provider,” Waddell said.
The truth about the measles vaccine and autism
The MMR vaccine is still the most effective way to prevent a measles infection, and to reduce the risk of serious illness from the disease.
Waddell emphasized that the MMR vaccine does not increase a child’s risk of getting autism, a claim that has also been promoted by anti-vaccine groups.
“There are fewer things in medicine that have been studied this well,” he said. “Hundreds of thousands of children have been studied to see if MMR increases someone’s chance of developing autism, and it does not.”
Michaela Ramm covers health care for the Des Moines Register. She can be reached at [email protected] or at (319) 339-7354.
Stay in the know with stories that matter — visit HolaAmericaNews.com for the latest news, culture, and community updates!
Facebook Comments