As the number of measles cases continues to rise, Metro Detroiters are piling into physician’s offices for testing and MMR vaccines.
By Stacy Gittleman
As the number of measles cases climbed to 34, concerned Metro Detroiters born after 1957 are learning a new vocabulary word: titer.
In medical terms, titer (pronounced tīdər) is defined as the concentration of an antibody as determined by finding the highest dilution at which it is still able to cause agglutination of the antigen. In plain-speak, it means whether one’s immune system has enough antibodies to fight certain diseases.
The Oakland County Health Department (OCHD) advises that adults born in 1957 or later should receive at least one dose of MMR vaccine unless they have other acceptable evidence of immunity.
A second dose of MMR vaccine is needed for adults who may have been exposed to a measles case or those who are students in colleges/universities, work in health care or plan to travel internationally. Check with your health care provider to see if you need to be vaccinated.
A quick check of a West Bloomfield doctor’s office drew an estimate of close to 30 people daily getting titers checked with a simple blood test before knowing whether they needed a booster shot.
However, Lindsay Stern Cox, 35, of Farmington Hills skipped the test and received a booster shot from her internist. She is glad her mother got her titers checked and is immune, and that her 3-year-old son got an early second dose of the MMR vaccine.
“My pediatrician was very matter of fact and said to just bring him in,” Cox said. “My internist said a booster shot for me couldn’t hurt even if I was already immune.”
Britt Dresser of Royal Oak was shopping at the Target on Southfield Road with her very young infant on March 20, a spot listed by health authorities as a point of exposure. Her 3-year-old attends preschool at Temple Emanu-El in Oak Park. Fearing her young children had been exposed, she took them to her pediatrician’s office in Birmingham last week, where her toddler got his second immunization for MMR a year earlier than planned.
Dresser said many mothers in her circle of friends are also getting advice from their pediatricians to push ahead their vaccination schedules and to keep infants who have not been immunized home and out of public spaces for 21 days counting from the first date of exposure if they are still too young to receive immunizations.
In normal situations, the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend children receive the measles, mumps and rubella (MMR) vaccine at age 12-15 months, and again at 4-6 years. Children can receive the second dose earlier if it is at least 28 days after the first dose. High immunization rates protect those who are immunosuppressed or are too young to receive an immunization.
Dr. Udi Kapen, a pediatrician in Bingham Farms, says there are immunization changes for very young infants during a disease outbreak. “If there’s any question of exposure, a baby as young as 6 months can receive the vaccine,” he said. “Younger than that, they can get a dose of measles immune globulin, which would likely be administered at the health department.”
Pediatrician Dr. Lisa Klein said Merck, the nation’s supplier of the MMR vaccine, has been very responsive to her office’s vaccine supply needs. Though she said things have quieted down since the outbreak was first reported, it could pick up again soon because of the disease’s 21-day incubation cycle.
According to the Oakland County Health Division (OCHD), anyone who has not received two documented doses of MMR or has not had a confirmed case of measles can get measles. If exposed, approximately 90 percent of people who have not been vaccinated or previously had measles will develop the disease. Since the first case was confirmed March 13, the OCHD has given more than 2,000 vaccinations.
Laura Hirschhorn, 52, of Huntington Woods got her MMR booster for free during a quick visit to the OCHD without getting her titers checked. Many of the points of exposure, from the Kroger to the Westborn Market, are all places she frequents, and she fears the low immunization rate records of her school district as reported in 2016. She says she thinks being immunized is the responsibility of every citizen to protect those who for medical or age reasons cannot be immunized.
“I travel a lot for my job,” Hirschhorn said. “I would feel horrible if I spread the disease to someone who is immune-compromised. There is no reason that this outbreak should be happening.”