With measles resurgent in the US, many adults are concerned that they are insufficiently protected and may need a booster shot.

Here’s a short and sweet (and shareable) answer. Thanks to Dr. Paul Offit for sharing his wisdom with me on this. And here’s a CME episode (you can claim CME if you are a Facebook Supporter) on recognizing and managing measles.

One clarification: the test for circulating antibodies (titers) can be falsely NEGATIVE as some people have immunity via memory B and T cells but no circulating antibody. This is another reason Paul does not recommend routine testing of titers. 

Also, the MMR vaccination does NOT cause autism. Full stop.

– What’s up everybody? It’s Dr. Zubin Damania.

Okay, everybody’s asking should I get a booster measles vaccination because there’s an outbreak around the country, worst in recent memory. And the answer is maybe. And here’s the details that you can share broadly with everybody. I asked my homie, Dr. Paul Offit about this and this is what, and he knows his stuff about vaccines, this is what he said.

People born before 1957 were likely naturally exposed to measles, which means they have lifelong immunity. The data shows that they’re pretty much immune for life. They are off the hook for the most part. Between 57 and 89, if you were born in that era, you probably got one dose of the measles vaccine, MMR, and that means about 92% of people who got that dose will be immune and it’s felt that that immunity lasts pretty much for your life. So most people in that era are gonna be okay.

What’s interesting is people born between 67 and 76, actually have the highest rate of actually being less immune. So up to 20% of them actually may not have seroconverted and developed antibody. That’s an interesting fact and I’ll tell you why. Because in 89, if you were born in 89 or later, what started happening is we started using two doses of MMR. And the reason is what they found is that if one dose makes you about 92%, 92% of people will be immune, two doses bumps that up to 98 or higher percent. So after 89 if you were born after 1989, chances are you are okay with the measles immunity.

All right, but it’s those people in between who were born before 89 and after 57 that may have gotten one dose that there may be some holes in immunity. Does that mean you go rush out and get another MMR vaccine? Probably not, because again, most people will be okay. The exception is if you’re going into an endemic area, like the Philippines, or I don’t know, Brooklyn, believe it or not, because of anti-vaxxers is now an endemic area for measles. In that case, there’s absolutely no harm in getting a booster MMR vaccination which will bump you up. Worst case scenario, you didn’t need it, it will actually boost your existing immunity. There is absolutely no harm in doing that if you’re going to an endemic area.

Now what about people who ask, well should I be tested to see if I’m immune? Those are things called titers where you test for antibody levels. In almost all cases, you don’t need to do that. And the reason is there can be false negatives, it costs just as much as getting the booster. So if you’re concerned, just get the booster.

Now the exception may be health care professionals where you do want to test and make sure they’re immune because they’re gonna be in a potentially exposed. Those kind of things, I know I was tested for that reason. But for most people you don’t need titer. So here’s the bottom line when you share this video with people you care about. Most people will not need a booster of MMR unless you’re going to an endemic area, and you were born between 1957 and 1989. Most people now get two shots of MMR after the age of 12 months old and that leads to over 98% immunity and if you ever had measles, you are immune for life. Measles is not benign. We’ve done shows on this. Please check those out, hit share, hit like, if you like the way we educate join our supporter tribe where we go in deeper. We out, peace, thanks Paul Offit, you my man.

– [Tom] Cut!

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