By Sara Bondell - April 17, 2019
According to the Centers for Disease Control and Prevention (CDC), more than 550 cases of measles have been confirmed in the United States since Jan. 1 across 20 different states
For cancer patients with compromised immune systems, the recent outbreak raises greater concern.
Because their immune systems cannot mount an appropriate defense, cancer patients infected with measles have a high mortality rate. If you are undergoing treatment and have not had the MMR vaccine (measles, mumps and rubella), you should check with your physician for recommendations. You should also avoid being around anyone who is sick or young, non-immunized children. If you are exposed to measles, notify your physician as soon as you are exposed.
The 2013 U.S. Advisory Committee on Immunization Practices (ACIP) recommendations state that severely immunocompromised patients who have been exposed to measles should receive intravenous antibodies called immunoglobulin, regardless of vaccination status.
If you have not had the measles vaccination, the ACIP does not recommend being vaccinated while undergoing cancer treatment. Live vaccines—ones that use a weakened form of the germ that causes the disease—should be given at least four weeks prior to starting treatment, and inactivated vaccines—ones that use the killed version of the germ that causes a disease—should be given at least two weeks prior. The MMR vaccine is a live vaccine.
Live vaccinations can be dangerous for cancer patients because they carry the risk of vaccine-driven infections. Inactivated vaccines should also generally be avoided, as they may be ineffective during treatment.
Upon completion of treatment, patients may receive inactivated and live vaccines if they are in remission, haven’t received anti-B cell antibodies and haven’t had chemotherapy in three months.
The majority of people born after 1957 have received the MMR vaccine. However, a small subset of adults may need to be revaccinated. Those individuals include:
- Adults who do not have evidence of immunity. These individuals should get a booster (one dose) of the MMR vaccine
- Students at post-high school educational institutions who do not have evidence of immunity. These individuals will need two doses of the MMR vaccine, separated by at least 28 days.