Pediatrics

Measles vaccination

synonym

Measles: Morbilli

Measles vaccination: MMR vaccination

introduction

Measles is one of the typical childhood diseases. The cause of this disease is the so-called measles virus, which evolved from the rinderpest virus.
Measles is a highly contagious infectious disease that spreads rapidly among those who are not vaccinated. The first signs of a measles infection are the appearance of red spots on the skin (so-called measles rash), a high fever and a rapid decrease in general well-being. In addition, if treatment is not given early enough, life-threatening pneumonia and brain infections can occur.

Classically, the diagnosis is made based on the clinical picture just described and an antibody test in the blood. Once infected with measles, treatment can only be purely symptomatic, for example by administering antipyretic medication; there is currently no real therapy against the measles virus. In Germany, all measles cases that occur are subject to the general reporting requirement.

You might also be interested in this topic: Vaccination against rubella

Vaccines

The drug known as the measles vaccine is a drug measles, mumps, rubella-Combination vaccine. This means that there is no vaccination against measles alone, but a combination vaccination against all three diseases. Read about this: Vaccination against rubella

The vaccine used in Germany is a so-called Live vaccine, of the weakened viruses or pathogens unable to reproduce contains. It is an active vaccination in which the immune system is stimulated to build up pathogen-specific immune competence without having to endure the infectious disease itself.

Measles, mumps and rubella vaccination (MMR vaccination)

As a rule, the measles vaccination is given in combination with the mumps and rubella vaccination.
The combination of various modified pathogens, which can no longer cause disease, but can prepare the immune system for infection with the germ, repeatedly discourages parents from vaccinating who feel that they are feeding their child too many germs at once .
However, the practice of triple vaccination means that fewer auxiliary substances, so-called adjuvants, have to be given to the child. Adjuvants strengthen the immunization and thus reduce the number of viruses or virus particles that have to be administered in the vaccination.
The timing of the MMR vaccination is similar to the measles vaccination described above.
The first vaccination should be given at the age of 11-14 months, the second vaccination after 4 weeks.
Here, too, the vaccine should be administered by the age of 23 months.

Read more on the topic: Live vaccination

Measles vaccination in children

As a rule, the measles vaccination (actually measles-mumps-rubellaVaccination) Children aged 12 months through a subcutaneous (under the skin) or intramuscular (into the muscle) injection.
About four to six weeks after the first injection becomes a second immunization carried out. This second vaccination is not, like many other immunizations, a so-called booster. Rather, in the specific case of measles, mumps and rubella vaccination, it is necessary to ensure the necessary vaccination dose. Comprehensive vaccination protection for children can only be guaranteed with this second injection.

If you are wondering whether vaccination makes sense, read: Should I get my baby vaccinated?

When can vaccinations be started?

The vaccination against measles usually comprises two partial vaccinations, as studies have shown that after the first vaccination there is a 90% immunization against the virus and almost 100% immunization with the second vaccination.
So it is not about a refresher, but about the necessary step towards absolute resistance to the pathogen.
The first vaccination should between the 11th and 14th month of life be done.
In special cases (the sibling is contagious or similar) the vaccination can also be brought forward to the 9th month.
The second vaccination should be done 4 weeks after the first vaccinationto allow safe immunization against the virus.
The immunization through the two partial vaccinations should take place up to the 2nd year of life.
If the child is likely to be infected, the vaccination can also be given 3 days after infection. However, vaccination in advance is more advisable, as the protection is more reliable and the 3-day time window in which the disease is not yet confirmed represents a risk of infection for parents and other unvaccinated people.

Measles vaccination in adults

Although measles is a typical childhood disease, adults who do not have adequate vaccination protection can become infected quickly. People who work with children in kindergartens, schools, daycare centers or in other ways are particularly at risk. Regular measles vaccination is also recommended for hospital staff. In contrast to children, for most adults a single injection of the vaccine is sufficient to ensure adequate vaccination protection.

Read more at: Measles in adults

refreshing

Most vaccinations guarantee full protection not immediately after the first vaccination, but only after two or three times and others have to be refreshed at certain intervals throughout your life, such as tetanus and diphtheria. But why is that?

The answer is in ours immune system. It is designed in such a way that it reacts a little sluggishly on first contact with a pathogen and cannot fight the intruder as effectively and quickly as with subsequent infections with the same pathogen. To that antigen (that which the body has recognized as "foreign", e.g. bacterium or virus), you have to find a suitable one antibody be found with which the enemy can be fought. It takes a few days. If the pathogen is defeated, they form Memory cellswho remember the pathogen precisely and recognize it in the event of a second infection. The Immune response now runs clearly faster and stronger since the right antibody does not have to be searched for, but is already available. In addition, it can then be mass-produced. Exactly this situation becomes the body with a Booster vaccination simulated.

First, a Basic immunization carried out (first vaccination) and then a another gift of antigen the Secondary response evoked. This leads to the result that a large number of antibodies are formed very quickly and are therefore available for a potential infection. Should an infection actually occur, the intruder has no chance of establishing itself in the body because the body recognizes it immediately and can react to it sufficiently.

How often do I need to be vaccinated?

You have to be vaccinated twice against measles. The first vaccination represents a Basic immunization dar, after which already a Protection from 94 to 95% consists. This vaccination is recommended between the 11th and 14th month of life, but it can also be carried out in older children or adults without any problems. In the Second vaccination will the Secondary response evoked, that is, the Immune response is accelerated and strengthened. Only very small amounts of vaccine are necessary for this, as the body has already formed memory cells after the first vaccination. After the second vaccination there is a Vaccination protection of over 99%. Although there is a relatively high level of protection after the first vaccination, the booster is strongly recommended and can be carried out later if the appointment for the booster is missed. Between the first and second vaccination should be one Four weeks apart be respected. It should not be undercut because the measles vaccination is a live vaccination. This means that living, weakened pathogens are injected into the body and trigger the immune response. The vaccination interval should be observed so that too many viruses do not enter the body at too short intervals. However, more than these four weeks is not necessary, on the contrary.

After the second vaccination, there is lifelong immunity to the measles virus.

Adverse drug effects / side effects

With measles vaccination, as with all vaccinations, various side effects can occur. Typical side effects of the measles vaccination are redness in the area of the puncture site, which, however, usually disappears on its own after a few days. In the first few days after the vaccination, there may also be swelling, overheating and a slight burning sensation in the area of the injection site. As the measles vaccination is an active vaccination, as already mentioned, typical signs of infection may appear within the first week after the vaccine has been administered.

Read more on the topic: Vaccination side effects

A slight malaise, headache and fever should not be misinterpreted as warning signals. It is a normal reaction of the organism, which begins with the intended antibody production. Occasionally (about five out of a hundred cases) skin rashes called vaccine measles may be seen about a week after the vaccine has been given.

Fever after the measles vaccination

After the measles vaccination, as with all other vaccinations, you may develop a slight fever. This is basically not to be assessed as an undesirable side effect, but rather a good sign that the vaccination worked.
When antigens are supplied, such as the weakened viruses in the MMR vaccination, the body reacts with an immune response. This means that antibodies are formed which render the virus harmless in the event of a subsequent infection immediately after entering the body.
The defense cells that are involved in the immune response emit so-called cytokines when they come into contact with the virus. These cytokines are antibodies that put the body on alert in the event of an infection, e.g. Increase the core body temperature to fight pathogens. It is precisely this process that leads to the slight temperature rises after vaccination.
If you have a fever above 39 ° C (measured rectally), which cannot be permanently reduced even with antipyretic agents (such as paracetamol suppositories every 4-6 hours), a visit to the pediatrician or a children's outpatient department is recommended.

Is Measles Contagious?

The measles is a highly contagious and airborne (Droplet infection) communicable disease, there is therefore a risk of infection when speaking, Sneeze or to cough. Anyone who comes into contact with affected people is very likely to get sick themselves.

In the vaccination is this at no time given. As a vaccination complication, the so-called "Vaccine fibers“, Which are visually similar to measles. But you are not infectious, people who have not been vaccinated need not be afraid of becoming infected at any time.

Are you contagious after a measles vaccination?

After the measles vaccination you are not infectious.
In about 10% of those vaccinated, the immune response to the vaccine leads to a slight skin reaction, the so-called vaccine fibers. Even in those cases in which vaccine measles occur, there is no risk of infection.

Measles vaccination during pregnancy

Live vaccinations should not be given during pregnancy. MMR vaccination before pregnancy is recommended.

Especially during the pregnancy it can be particularly dangerous for the expectant mother and her unborn child not to be vaccinated against measles.

Acute measles infection during pregnancy leads to an increased risk of spontaneous Abortions.
Premature births or miscarriages can occur. According to some studies, deformities in the unborn child are not caused by the measles virus.
Nevertheless, the expectant mother can be life-threatening with measles infection during pregnancy Lungs- or Inflammation of the brain get sick.
For this reason, if you wish to have children, you are advised to urgently check your vaccination status.

Getting a measles, mumps and rubella vaccination before pregnancy protects the mother-to-be and the unborn child from possible complications or consequences of a measles infection.

In addition, the antibodies formed by the mother are able to penetrate the child's body via the umbilical cord and effectively protect the newborn from infection during the first few months of life.

Measles vaccination while breastfeeding

All vaccinations recommended by the STIKO (Standing Vaccination Commission) with the exception of Yellow fever put for breastfeeding women and their babies no danger and can be carried out without any problems. There have been isolated reports of yellow fever in which breastfed infants developed meningoencephalitis (inflammation of the brain and meninges) after their mother had been vaccinated against yellow fever.

Only during the pregnancy is from live vaccinations like the MMR or Varicella basically from theoretical considerations advised against.

At Dead vaccines as in Influenza, tetanus, diphtheria, Pertussis, Hepatitis A and B Even pregnancy is no obstacle, the influenza vaccination, also known as Flu shot, is even recommended.

Contraindication / When should I not be vaccinated?

As a rule, all healthy people may be vaccinated against measles and a combination vaccination against mumps, measles and rubella receive. If at the time of the vaccination appointment, slight illnesses such as to cough or sniff can still be vaccinated without hesitation.

Postponing the measles vaccination is only necessary for febrile patients. Pregnant women, immunocompromised patients, or people taking immunosuppressive drugs should not be vaccinated under any circumstances. In addition, patients who have had allergic reactions to a previous vaccine dose should not receive any further measles vaccination.

Pros and cons

The MMR (mumps, measles, rubella)-vaccination is still controversial. Recommended by some, rejected by others, but who is right?

The arguments of the vaccination critics are that vaccination against measles not absolutely necessary because the disease is not dangerous in the vast majority of cases. That's right, it only becomes dangerous when complications arise. This includes Pneumonia (Pneumonia), inflammation of the brain (Encephalitis) and the Meninges. The latter really only occurs rarely, namely in 0.1% of cases, but 15-20% are fatal and in 20-40% permanent brain damage remains.The worst complication can be the Subacute Sclerosing Panencephalitis (SSPE) occur. Fortunately, this occurs only very rarely (1: 100,000 - 1: 1,000,000), but it is definitely fatal after a few months. The opponents of the vaccination continue to argue that the complications are not only rare, but can also be treated well. That is also correct, but one should be aware that the complications are still very dangerous and people still die from them, albeit very rarely. Stand against it Vaccination Complications on average 1:1.000.000 up, so they are as good as nonexistent and, above all, do not end fatally. A Measles complication occurs against it on average 1: 10.000 on.

Vaccination advocates argue against it that vaccination makes sense solely because measles is a purely human pathogenic virus is. This means that the virus only affects people, so that it covers the whole area vaccination the disease could be eradicated. The vaccination would create a so-called herd immunity, which is especially important for people who are immunocompromised. For them, a live vaccination like the MMR vaccination is too dangerous, an illness would even be life-threatening.

The argument of the vaccine opponents to protect infants from unnecessary interventions such as the MMR vaccination is also incomprehensible from the point of view of many medical professionals, as they keep their children from injections but expose them to the risk of measles for the rest of their lives. In addition, is a Measles complication by a factor of 100-1000 more likely than a vaccination complication.

Also is measles a highly contagious Illness. It is contagious five days before a visible outbreak of the disease - anyone who comes into contact with sick people will certainly get sick too. How many people would be affected and how often this would lead to complications is beyond the imagination of many.

But why is it so controversial when vaccination is as useful as just described? This is due to a 1998 article by Andrew Wakefield. Its aim, with the support of the pharmaceutical industry, was to create three individual vaccines from the MMR vaccine, which can be sold much more expensively. To achieve this goal, he had to prove that the combination vaccine was harmful by allegedly showing in a study that the MMR vaccine caused autism. That is not the case at all, as proved by another large American study years later. As a result of this scandal, however, the mistrust of vaccination grew in society, which has not yet been completely dispelled, although the connection between vaccination and autism has been clearly refuted.

So one should be aware that the vaccination got a bad reputation due to a scientific scandal and Notbecause they are dangerous is.

Which arguments are decisive for you, however, remains left to everyone, but one should think twice and examine and critically question both sides of the coin.

Measles vaccination costs

The cost of the Mérieux vaccine from Sanofi Pasteur MSD, which is aimed exclusively against measles viruses, is € 33.43.

Who bears the costs?

As with all vaccinations recommended by the STIKO (Standing Vaccination Commission), the vaccination costs in Germany fully covered by the statutory health insurance.
For privately insured persons, the assumption of the costs or the assumption of partial costs is based on the individually selected tariff.

Measles vaccination in the GDR

In the GDR the measles vaccination was introduced in 1970, in the FRG only three years later, in 1973. In the GDR since the introduction of the vaccination - in contrast to the Federal Republic - vaccination has been compulsory.
Although this was not always consistently adhered to, it basically ensured high vaccination rates and a sharp decrease in measles cases. However, the vaccine protection was not quite as effective as it is today, as only a monovalent vaccination was carried out. That means it was only vaccinated once instead of twice until 1986.
Even today people are thinking about introducing compulsory vaccinations in order to finally be able to eradicate measles.