For Sarah McGinnity, an Overland Park mom, it made sense to get her two-and-a-half-year-old daughter Caroline the second dose of the measles, mumps and rubella vaccine ahead of schedule.
Normally, a child receives their first dose of the MMR vaccine at about one year old, followed by a second dose at four or five before they start kindergarten, in accordance with state vaccination requirements.
But, in the face of an ongoing measles outbreak that began in western Texas in an under-vaccinated community and has now spread to more than 25 states, including Kansas, McGinnity was worried that her youngest daughter wasn’t fully protected against the contagious illness.
She began talking to her pediatrician, Dr. Megan Loeb from Leawood Pediatrics, about possibly getting Caroline the second dose early when the first cases started popping up in the U.S. in January.
McGinnity recalled an outbreak in 2018 that started at a child care center in Johnson County and turned out to be the state’s worst measles outbreak in three decades. From that outbreak, which took months to get under control, there were more than 20 confirmed cases, and it eventually spread to neighboring Miami and Linn counties.
At the time, her three older children were all fully vaccinated against measles. When the first cases started emerging in Kansas this year (so far only in southwestern and south-central Kansas) she wanted the same for Caroline.
“I called, and they got her in,” McGinnity said. “We have the confidence that she’s fully protected.”
And, with an upcoming family vacation planned for the end of the month, she said she has “extra assurance” that she’ll be safe if they happen to cross paths with someone who has measles.
The McGinnity family isn’t alone.
Loeb said she’s been hearing from parents who want to get their young children started with a first dose early or get them the second dose of the MMR vaccine ahead of schedule.
“I see more families actually that are coming in saying, ‘Hey, can my child get their measles vaccine early?” Loeb said, “or ‘Can my child get their MMR booster sooner?’ as well.”
As McGinnity puts it, “there’s no downside” to choosing to get the booster dose early for her daughter as long as enough time has passed since the first dose.
“This fully protects her for life,” McGinnity said. “We trust science, and I think it’s my job as a parent to do everything I can to protect my kids.”
Who needs a MMR vaccine?
Because the measles virus itself doesn’t have a known treatment protocol, prevention is considered the best tool, said Dr. Doug Swanson, an infectious disease physician at Children’s Mercy. And that means getting two doses of the MMR vaccine.
The vaccine has been available in the U.S. for decades now, and several generations of children have received a version of it. It is safe, too, with side effects rare and mild, Swanson said.
In Kansas, children are required to have two doses of the MMR vaccine before starting kindergarten, in line with several other states, including Missouri, Oklahoma, Nebraska and Colorado. That requirement takes care of a lot of the population.
However, some adults might want to make sure they’re adequately protected against measles.
Charlie Hunt, director of the Johnson County Department of Health and Environment, said people who have received the vaccine since 1968 are adequately protected against measles. Additionally, anyone born in 1957 or earlier is also considered immune to measles because it was so prolific back then.
That leaves a group of people born in the 1960s who may want to talk to their doctor about getting a booster because the version of the vaccine on the market at the time was less effective.
Hunt also encouraged people who work in health care settings to make sure they have proper documentation of having an MMR vaccine since they could have a higher risk of exposure.
Vaccination as a “civic responsibility”
Given how contagious measles is when it gets into an unvaccinated population, local doctors say it’s important to get vaccinated. Swanson calls it a “civic responsibility.”
“If you can vaccinate your children, it can help prevent transmission from your child to people who are more vulnerable, like children who are too young to be able to be vaccinated or individuals who are immunocompromised,” he said.
Swanson also said that “a little bit of hesitation or resistance or refusal” can have serious impacts on the wider community.
Hunt with JCDHE agreed, saying that not getting vaccinated “puts other people at risk.”
“That personal choice argument has to be weighed against the risk that it presents to other people,” he said.
In Johnson County, JCDHE doesn’t keep track of countywide data for MMR vaccination rates like it did for COVID-19 vaccines. Instead, it relies on data from the Kansas Department of Health and Environment, gathered by local public school districts that report kindergarten immunization rates.
In the preceding five school years, the collective MMR vaccination rate among kindergarteners in Johnson County’s six public school districts hovered around 95%, widely considered the threshold needed for community immunity against measles. Still, in some school years, that countywide immunization rate slipped below 95%.
For the current school year, every Johnson County public school district meets that 95% threshold for MMR vaccination community immunity, except Spring Hill. That district — which covers portions of Johnson and Miami counties — reports a MMR vaccination rate of 94%.
Under Kansas law, students must provide documentation of having received two doses of the MMR vaccine before starting kindergarten. However, there are some exceptions, specifically carve-outs for medical and religious exemptions.
In Johnson County public schools, hundreds of students have been given exemptions to vaccines including for religious reasons. In SMSD, for instance, 485 students have exemptions, though the district doesn’t distinguish between religious and medical exemptions. In Olathe, roughly 1.6% of students have exemptions, totaling about 455 students, the vast majority of which are religious exemptions.
Hunt said exemptions “are something that we’re always concerned about,” because they can create gaps in the community’s collective immunity to measles.
In addition to being contagious, measles can be serious, Swanson and other local doctors have warned.
“Any one death is tragic when we are talking about this disease, which is so easily stopped with this most safe and efficacious vaccine,” Dr. Dana Hawkinson, an infectious disease physician at The University of Kansas Health System, said during a recent medical update video on social media.
Doctors try to dispel misinformation about MMR vaccine
Part of the challenge, local health officials and doctors have said, is misinformation about vaccines and how to dispel that effectively when you encounter it.
One prominent figure known to spread misinformation about vaccines and other aspects of health is Robert F. Kennedy Jr., who is now the Secretary of Health and Human Services for the Trump Administration. He has touted the long-debunked theory that vaccines cause autism and has backed unproven medical treatments.
Loeb, from Leawood Pediatrics, said “good, educated conversations” are what’s needed to dispel that at an individual level. Because she’s been involved in children’s care from the beginning, she feels she’s earned a lot of trust with their families.
“I want them to know that I am the person that they come to when they have questions,” she said. “And that’s why, as a pediatrician, we build these relationships, right? Because we want them to feel like we’re a person that both has knowledge and that they trust.”
Additionally, JCDHE puts out research-backed information about vaccination frequently, Hunt said, but he agrees that primary care providers are in a unique position to hammer home the message.
“It’s helpful if people have a health care provider that they trust and have a good relationship with to talk to them about the vaccine,” he said.
Loeb said she feels that at least some of the problem stems from a misunderstanding about how serious measles can be
Some people don’t understand that the reason the disease has become rare is because of vaccinations. If too many people fall behind on vaccinating their children, society runs the risk of measles returning, Swanson warned.
With that in mind, Loeb wishes grandparents and seniors would speak openly about their memories of how the disease affected their lives and the lives around them in the middle part of the last century.
“We have this false sense of security because our current generation just hasn’t seen these diseases, so it’s hard to have the high level of respect for the problems that those diseases can cause,” Loeb said.
To put it in perspective, Dr. Gregory Poland, a Mayo Clinic vaccinologist and physician, said during a recent KU Health update video on social media that before a vaccine for measles was available in the U.S., “essentially every child got it.”
An estimated 48,000 of those kids would be hospitalized, 1,000 would experience illnesses so severe that their brains would swell, and somewhere around 500 kids would die each year, he said.
“That’s what ‘natural immunity’ gets you,” Poland said.
“I also have a responsibility to my community”
For McGinnity, the Overland Park mom who got her youngest child the second dose of the vaccine a couple of years ahead of schedule, it can be “maddening” watching people argue about the safety of vaccines.
The daughter of a scientist herself, she knows the value of vaccines, not just for her family but also for the community. It’s an issue she’s so passionate about that her two sons, who are now 13 and nearly 11, were part of a pediatric vaccine dosing trial for COVID-19.
“I also have a responsibility to my community and other people’s kids that by vaccinating them, we’re reaching that herd immunity level,” McGinnity said.
She encourages other parents to talk to their pediatrician about vaccines if they have questions and to consider getting their younger children a second dose of the MMR vaccine ahead of schedule if they can.
“You trust them with all the other care, and we trust science and medicine with so many other facets of our kids’ care, why would we not trust them in vaccines?” McGinnity said.
Keep reading: 50 years ago, this Olathe woman had measles. She’s still living with its complications
