Should babies get a “bonus” measles vaccine? Doctors say it depends

Like many anxious parents, Beth Spektor has spent the last few weeks to worry about how to protect her little daughter from the first deadly measles epidemic to hit the United States in a decade.

Her 9 month old child was too young for the first dose of measles, mumps and rubbing vaccine, generally given to American toddlers shortly after their first birthday.

But when his New Jersey Whatsapp group began to buzz over a dose of MMR as an early bonus for babies, Spektor decided to ask his pediatrician anyway.

“I guess she would say:” It’s up to you “, or” it’s not a bad idea “, something a little less definitive,” said the mother.

Instead, the doctor urged her to take the additional blow, a movement he recommended to all infants after three linked cases were reported in their region.

“(The doctor) said that she hoped that (American secretary for health and social services Robert F. Kennedy Jr.) would modify the calendar to recommend that all babies for 6 months get the dose of bonus,” said Spektor.

It is unlikely, say the experts. Despite the current epidemic, measles is still rare in the United States, and although MMR is safe for babies as young as 6 months, it is more effective in toddlers. Most pediatricians always recommend holding back until a child’s first birthday, with a few narrow exceptions.

Meanwhile, Kennedy spent this week to boast oil and codliver IUDs, alongside lukewarm approval of vaccines.

However, even if the record number of parents delays or reduces inoculation, pediatricians and public health experts said they had seen an increase in premium doses after the death of a six -year -old child in western Texas last week.

When reports on an infant from the infected orange county carrying measles via Los Angeles International Airport began to circulate on Friday, that curiosity turns to panic in certain households.

“There has been a notable increase in parental concerns concerning measles, especially among those who plan to travel with young children or who have ages in daycare,” said Dri Priya R. Soni of Cedars Sinai Medical Center, assistant professor of pediatric infectious diseases. “Some parents ask for an early mmr vaccination, which is an appropriate strategy in certain high -risk situations.”

The so -called “zero” or “additional” doses of MMR have long been recommended to jet infants who will go to countries like Ireland, Sri Lanka or the Philippines before their first birthday.

While most people survive an infection of measles, the disease kills more than 100,000 children each year worldwide, leaves 60,000 blind children and thousands of others with permanent brain damage.

Serious risks is the reason why the first shots are also given to babies living near domestic epidemics. The Texas Department of Public Health currently recommends bonus doses for infants from six counties, including sheaths, where the largest epidemic emerged.

“This is one of the most contagious diseases we know,” said Dr. Meghan Martin, a pediatric emergency doctor at Johns Hopkins All Children’s Hospital in Saint Petersburg, Florida, which helps explain infectious diseases to its 2.3 million followers in Tiktok.

Martin obtained a dose of bonuses from his own daughter before a visit to New York during an epidemic of measles there in 2018. But she said that most parents should give him up less that their babies are heading for a high-risk country or live in a region of the epidemic.

Dr. Eric Ball, pediatrician of the County of Orange and president of the American Academy of Pediatrics California section, said that he had recommended bonus doses to his patients in 2014, at the height of the Disneyland epidemic. But without active epidemic in the region, he advises patients to wait.

But some doctors said they were open to early vaccinations, even for infants including daycare comrades traveling abroad, as well as families in communities where many parents avoid or spaced vaccines.

“In fact, I recently had a conversation with a parent (who said):” We move our child of almost a year in a place with a lot of vaccination hesitation, so we would like to make an early MMR “,” said Dr. Nelson Branco, assistant clinical teacher of pediatrics at the UCSF, who sees patients in the county of Marin. After searches the local vaccination rate of kindergarten, “I said:” It is not strictly recommended, but I would give it if you wish. “”

Doctors agree that the first Jabs are not as effective as the later, which is why they do not count for the two -doses series that all children need for kindergarten.

This has not dissuaded certain pro-inoculation parents on Tiktok and Reddit to negotiate advice on how to take additional photos for trips to Disney World, even if anti-vacuum parents lead them as toxic and fatal on the same comments.

“Looking through messages (on Reddit), I continued to see him,” said Angela Owens, a mother for the first time in Maryland who underwent a stem cell transplant in 2022 and had not yet obtained a replacement mmr when she got pregnant. “Seeing these messages continuously is like:” Am I quite worried? ” Am I too worried? »»

Doctors said their experience was the same in the clinic.

“I will be in a room, and I will speak to a patient for 30 minutes to convince him to get a vaccine, and I will go to the neighboring room and have someone who is impatient to give their children an additional vaccine,” said Ball, the pediatrician of Orange County.

The practice of putting bonus doses paused for certain experts.

Dr. Paul Offer, pediatrician and director of the Vaccine Education Center at the Philadelphia Children’s Hospital, said that it had reminded him of the first days of the vaccine, with part of the country refusing vaccination and part of the country by collecting so many strokes that they “should have had a loyal Pfizer card.”

“The advantages of waiting until the age of 12 months are greater than the largely theoretical risk that you will be exposed to a person with measles”, even in a daycare center where a baby could be exposed to other children who travel abroad, he said.

Babies obtain their first “vaccines” from their mother, in the form of blood proteins that cross the placenta in the third quarter. These maternal antibodies protect infants while their immune system matures. But they can also blunder the effect of the measles vaccine, neutralizing the weakened virus before the baby’s body mounted an answer.

“There is no simple formula,” said Dr. William Moss, Executive Director of the International Center for Access to the Vaccines de Johns Hopkins. “If you wait longer, a higher proportion of children will develop a protective response. We weigh this with the risk of the child to obtain measles. »»

In places where measles is common, the World Health Organization recommends the first vaccine at 9 months, when the vast majority of infants develop immunity. Where it is rare, the recommendation is between 12 and 15 months where almost all children will do.

“There were very early studies … who suggested that children who obtained a first dose of the measles vaccine had less response to a later dose,” said Moss. “My point of view on this literature is that it has been defective and there have been a number of subsequent studies that have not demonstrated it.”

But new studies have complicated the image in another way, he said.

The current directives were developed at a time when many mothers had the immunity of measles infections. Now, most of them have immunity from the vaccines themselves. Although babies still inherit these maternal measles antibodies, they are weaker and decline earlier than those of wild -type measles, according to studies.

The World Health Organization has supported previous inoculations in certain cases, noting in 2020 that babies in countries like the United States “can become sensitive to measles long before vaccination age, but they can also be more likely to develop protective immune responses when they are vaccinated.”

Babies often receive measles from school brothers and sisters, which means that the hesitation in vaccines is spreading – including the practice of spacing or delay of vaccines – the same goes for danger.

“We see many more children in practice that are not vaccinated,” said Martin, Florida’s doctor. “Maybe only 85% of the (2 years) I see in practice are vaccinated, which is worrying.”

She and other experts have agreed, the best defense for babies is that everyone gets her photos in time.

“The online message is that people should be vaccinated,” said Moss. “If enough of the general population is vaccinated, we will protect infants from measles thanks to the immunity of the herd. This is what worked.