1. Beal, Judy A. DNSc, RN, FNAP, FAAN

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From January 1 to March 6, 2015, there have been 173 reported cases of measles from 17 states and Washington, DC (Centers for Disease Control and Prevention [CDC], 2015b). Most of these cases (127 cases [73%]) are part of a large, still evolving outbreak linked to Disneyland in southern California where >26 measles cases were documented with at least 8 of those infected not vaccinated. This is not the first outbreak of measles in recent history. Several months prior, there were 382 cases of measles in Ohio after unvaccinated missionaries returned infected from the Philippines (CDC, 2015b). According to the World Health Organization (2015), measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available; in 2013, there were 145,700 measles deaths globally, about 400 deaths per day or 16 deaths every hour; and vaccination significantly reduced deaths worldwide from measles by >75% between 2000 and 2013.


The measles vaccine has been widely available in the United States since 1963 and up until recently there have been no known outbreaks. Vaccination rates vary among states and even counties within states. This latest outbreak has resulted in much debate, including among politicians and 2016 presidential hopefuls. California legislators proposed a bill that would mandate all school agers to be vaccinated. Mississippi and West Virginia are the only other states with such statewide policy.


So why do some parents refuse to vaccinate their children? The vaccine has clearly demonstrated safety and efficacy (CDC, 2015a), but a 1998 report in the British Medical Journal generated panic and misinformation that immunizations may make children more susceptible to autism. Even though that report was later retracted and labeled fraudulent, fears still linger today among some parents. Another perspective might be helpful in answering the question of why some parents opt not to vaccinate their children. According to Dr. Nathan Litman (2015), professor of pediatric infectious diseases in New York City, "We are victims of our success; people don't remember how bad measles was, how frightening it could be... People say, why should I bother (to get my child vaccinated), it's not around."


What should nurses tell parents? This generation of parents is reliant on the Internet for advice. On-line advice for parents about measles from the CDC (2015a, 2015b) is readily available. The CDC (2015a) fact sheet notes the best way to protect against measles is the measles-mumps-rubella (MMR) shot. The fact sheet includes details of when children should receive the MMR; reasons why children should get the MMR vaccine; rare and very mild, if any, side effects of the MMR; how dangerous contracting measles can be and how it is spread; and is clear there is NO link between the MMR and autism (CDC, 2015a). The Institute of Medicine review of more than 67 studies concluded there was strong evidence of no significant correlation between the MMR and autism (Maglione et al., 2014). This article, along with CDC (2015a, 2015b) data and new information from the American Academy of Pediatrics (2015), will promote up-to-date professional knowledge that can be the foundation of discussions with parents. Measles can be life-threatening. Some parents are not fully aware of the implications of their children contracting measles. As pediatric nurses, we can help promote accurate parental knowledge and encourage them to vaccinate their children.




American Academy of Pediatrics. (2015). Early release from Red Book: 2015 Report of the committee on infectious diseases. Elk Grove Village, IL: Author. [Context Link]


Centers for Disease Control and Prevention. (2015a). Measles and the vaccine (shot) to prevent it (Fact sheet for parents). Retrieved from Updated February 5, 2015. [Context Link]


Centers for Disease Control and Prevention. (2015b). Measles cases and outbreaks. Retrieved from[Context Link]


Litman N. (2015). In measles outbreak, we are "victims of our own success." CBS News (February 5, 2015, 6AM). Retrieved from Accessed February 10, 2015. [Context Link]


Maglione M. A., Das L., Raaen L., Smith A., Chari R., Newberry S., ..., Gidengil C. (2014). Safety of vaccines used for routine immunization of U.S. children: A systematic review. Pediatrics, 134(2), 325-337. doi:10.1542/peds.2014-1079. [Context Link]


World Health Organization. (2015). Measles (Fact Sheet). Geneva, Switzerland: Author. [Context Link]