Can Older People be Vaccinated Against Measles? Who has already taken the vaccine? Experts answer questions

This month, the Ministry of Health warns against measles because of the end of the World Cup in Russia and the return of the Brazilians who have moved to watch the matches, since the l '. Europe had 400% of the increase in cases of the disease in 2018 compared to last year.

Worldwide, the number of registered cases has increased by 30% last year. According to the report of the Ministry of Health, it is necessary to pay attention with symptoms for individuals "with a history of traveling abroad in recent years."

30 days or have had contacts, in the same period, with someone who has traveled abroad. "

This orientation, in fact, predates the World Cup and concerns imported cases of measles, since the indigenous cases in which the disease is contracted with the circulation of the virus in the country have not occurred since 2000.

All persons with the exception of pregnant and immunized women should be vaccinated between the age of six months and the age of 49 years who have never been vaccinated against measles or who do not know if they have been vaccinated

Regarding suspected cases, the Ministry draws attention to the following symptoms: fever, conjunctivitis, red patches on the skin, cough and coryza. four days after the onset of symptoms, these persons must be isolated to avoid contaminating those around them.

"Suspected cases should be reported immediately to the health authorities, as measures may be e taken to prevent the spread of the disease. "Says Bruno Oliveira, an infectious disease specialist and doctor at Brasilia's hospital for maternal children.

BBC News Brazil has received information from the authorities on measles transmission and vaccination and answers the main questions on the subject. 19659012] Brazil has a measles epidemic

Yes, according to a document published in March by the Pan American Health Organization (PAHO).

The epidemic in Brazil is currently concentrated in the states of Amazonas and Roraima, but the virus has begun to spread in other regions: in Rio de Janeiro 2 cases have been confirmed and 14 are studied. Seven cases have already been confirmed in Rio Grande do Sul, in addition to two cases in Mato Grosso and one in São Paulo. A total of 995 measles cases were recorded in Brazil between 1 January and 23 May, of which 475 were confirmed, with 3 deaths.

Measles has been considered eradicated in the Americas since 2016, according to a certificate from the World Health Organization (WHO).

How to prevent measles?

There are measures to prevent measles, but vaccination with vaccines is the only effective measure against measles. Therefore, the Ministry of Health seeks to vaccinate 95% of the population from 6 months to 49 years.

In addition to vaccines, people can take other measures such as: to sanitize hands with water and soap before meals; eyes, mouth and nose, as well as coughing, sneezing, going to the bathroom or greeting people. When you cough and sneeze, protect your mouth and nose with disposable tissues and never sneeze into your hands; If you do not have a disposable tissue, it is recommended to sneeze on the forearm near the elbow. Avoiding agglomerations and maintaining ventilated environments are other measures to prevent the transmission of measles.

Measles kills?

According to Oliveira, yes. "Measles can be extremely serious, especially in the respiratory and central nervous systems, which can lead to death."

Measles is a serious infectious disease, extremely contagious, that can affect anyone, of any age, who has no antibodies against the disease.

Among the many complications that the virus can cause are pneumonia and neurological changes, such as seizures, mental confusion, hallucinations, weakness and loss of sensation. These complications are usually more severe in malnourished children and less than a year old.

The disease can also leave severe consequences for the rest of life. "The most common are neurological and can occur during the disease or even years after the infection," reports the infectious doctor.

What is the name of the vaccine against measles?

There are two measles vaccines: the triple virus, which also protects against rubella and mumps, and the tetravalent virus, which includes immunization against a fourth virus, chickenpox, known as chickenpox.

Where can I find the vaccine?

The triple viral vaccine and the tetravalent viral vaccine are available free of charge throughout the year in basic health units for the entire population. There is also the possibility of taking these vaccines in private clinics, but not for free.

Can I take measles through vaccination?

Researcher FioCruz explains that measles vaccines are made from weakened virus

"This hypothesis of contracting measles during vaccination is unlikely because vaccine studies have shown seroconversion (production 98% to 100% of vaccinated people, "says Noronha

Pregnant women can take measles vaccine

"Pregnant women should not receive the vaccine and there is an indication to avoid pregnancy for at least 28 days after vaccination because of the theoretical risk of harmful effects on the fetus, although this risk has never been proven. . The advice for pregnant women who have never taken measles vaccine is to vaccinate them during the postpartum period to indirectly protect the newborn by badfeeding and to avoid contracting the virus.

Yes, but only infants older than six months can be vaccinated against measles.

I took a dose in childhood. Am I protected?

"Those who have not taken two doses from the age of 12 months are not sufficiently protected, they are still at a certain level of susceptibility. If you doubt that you are totally protected or not it's better to dismiss, "says the president of the Society.

Can everyone get vaccinated?

Two groups should not take triple-dose antiviral vaccine without a prescription: pregnant as explained above and people with low immunity.

"The measles vaccine is not recommended for people immunocompromised by a disease or drug treatment., Which can develop measles from the vaccine virus, since the vaccine is made from weakened viruses."

How old is the age to take a vaccine?

The MMR must be taken 12 months of life.

"Under the National Immunization Program, adults under 29 years of age should receive two doses of the MMR dose vaccine," says epidemiologist Tatiana Noronha, a researcher at the University of Toronto. Bio-Manguinhos unit of FioCruz, one of the producers of MMR vaccine

Is it forbidden at any age to take a measles vaccine?

Yes, newborns and infants under six months should not take any of the vaccines against the virus.

With the exception above, if you have not been vaccinated at the correct age, any one can take the virus, there is no age limit, although the Ministry of Health alert up to 49. The explanation of the limit announced by the Ministry is that people 50 years of age or older may have been in contact with the virus and thus be immunized against measles.

"A dose may be recommended for s elderly, but it's at the discretion of the doctor, taking into account the history of the patient, "says Noronha

I had measles. I have to get vaccinated

Measles is taken once in a lifetime: anyone who has ever been infected with the virus will never have the disease again.

"The measles infection generates lifelong protection," says Ballalai. "But before deciding not to get vaccinated, you have to be absolutely certain that you have had measles, because other diseases have very similar symptoms. Still: if in doubt, it is better to vaccinate, because you do not do it. "

The vaccine has side effects?

According to Ballalai, side effects are rare, but can occur between five and 21 days after vaccination, especially at the triple dose of viral vaccine.

Vaccination may cause mild symptoms similar to those of the disease: high fever of five days in 5% to 15% of red spots vaccinated on the body about two days in 5% of the swollen and vaccinated glands have already been observed in less than 1% of vaccinated, "says the president of the Brazilian Society of Vaccination, noting that local reactions such as burns, redness, pain and nodules can also occur, as it s is an injectable vaccine.

How is measles transmitted?

Transmission of the measles virus can occur in two ways: direct, from person to person, coming into contact with secretions expelled by coughing, sneezing, speaking; and indirect, by air: as the virus can be suspended for a long time in the air, it is not necessary to come into direct contact with the patient, it is sufficient to to be in the same environment as him to be infected.

Is there treatment for measles?

According to Oliveira, there is no specific treatment against the measles virus. "There is only one supportive treatment for the sequelae that the disease can leave," he says.

The doctor explains that patients must remain at rest, have a balanced diet, ingest a lot of fluids and avoid bulky environments.

Because the virus still circulates in large numbers in many parts of Europe and America, and has returned circulating in Brazil with migrations and international travels. In other words, we re-import the virus.

In addition to returning to Brazil, the virus has benefited from the poor immunization of Brazilians, who have stopped vaccinating and vaccinating their children in recent years.

According to Ministry of Health data, Brazil's triple viral immunization coverage reached 100% from 2004 to 2011, but has started to decline since then.

According to data from Datasus badyzed by BBC News Brazil, the second dose of measles vaccine has not reached the goal of vaccination, by 95%, since 2012. In 2016, only 76.74% of children with 15 months of life

In an interview with BBC News Brasil, the National Immunization Program Coordinator of the Ministry of Health, Carla Domingues, badured that there was no such thing. 39; clear explanation on the decrease in immunization coverage

According to the coordinator, the explanation may be in a possible forgetfulness of people about certain diseases, previously common in the country,

"The adult population Today must remember that measles and poliomyelitis kill and if they do not kill, they will leave severe sequelae for the rest of their lives, such as infantile paralysis, deafness, blindness, neurological problems, etc. "