More Texas children are getting vaccinated early against measles

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More Texas parents are opting to vaccinate their babies early against measles, nearly a 4.5-fold increase so far this year compared to 2019, according to the Texas Department of State Health Services.

From January through April, 7,107 children between the ages of 6 months and 11 months were vaccinated for measles, which is typically reserved for infants about to travel internationally or living in a measles outbreak area. Otherwise, doctors usually administer the first dose of the vaccine when they turn 1 year old.

For the same period in 2019, only 1,591 children between 6 months old and 11 months old were vaccinated for measles.

Researchers and public health officials attribute the rise to more awareness and the availability of the earlier vaccination option in a region where there have already been two deaths attributed to measles. They say parents are more fearful now.

The increase comes as the state battles a measles outbreak in West Texas, where 722 cases have been reported, most of them involving children. It is the largest outbreak since 2000..

“It does show that parents really are scared, and that parents don't want to wait,” said Nina Masters, a senior applied research scientist at Truveta, a Washington-based company that is studying Texas’ vaccination data. “They don't want to wait 12 months to get their child vaccinated. They want to wait six months and one day, and they want to do it as soon as they can.”

And, since state data only reflects vaccine information parents voluntarily give to them, the number of babies receiving the vaccine early is probably higher. Masters’ company estimates an 11-fold increase in the number of early measles vaccine shots in Texas between 2019 and 2025, according to a study released this week.

The Truveta study found that in March and April of this year, 20% of all first measles vaccine doses given to 2-year-olds and younger were in babies who were 6 months old to 11 months old.

“This is a really big jump,” Masters said.

Increased vaccine uptake is among the reasons local health officials have seen the number of new measles cases drop in recent days. Last week, only nine new cases were reported, the lowest number over a 7-day period since February. Other factors contributing to the slowdown include natural immunity, quick identification of cases by providers and public health workers, and more infected people staying home because of better measles awareness, officials say.

The hazy data on vaccinations

Texas vaccine data typically comes with caveats because it is anything but complete.

Even Truveta’s vaccine data doesn’t reflect statewide totals since they only access medical records kept by five major health systems in Texas: AdvanetHealth in Central Texas; Baylor Scott & White in Central Texas and Dallas-Fort Worth area; Providence, which operates in El Paso Lubbock and Waco; and Memorial Hermann and CommonSpirit, both in Houston. Together, they represent 90 hospitals and associated ambulatory/outpatient clinics.

Most states automatically record every immunization given unless the patient decides to opt out of the reporting.

Of the 64 immunization registries operating in the United States, 43 have immunization records of all patients unless that patient specifically opts out.

But Texas is in the minority. Patients, or their parents, if they are a minor, have their vaccination data automatically excluded from the state’s immunization registry unless they specifically opt in.

So it’s not clear what percentage of Texans are included in the state’s immunization data.

“You would have to know the total number of people vaccinated to produce the percentage of vaccinated people who have opted into the registry,” said Lara Anton, a spokesperson for the Texas Department of State Health Services. “We don’t know the total number of people who have been vaccinated.”

Spreading the vaccine message

The state’s childhood vaccine schedule includes two measles-mumps-rubella shots by age six with the first administered once a child reaches their first birthday. Even if a child receives their shot early, doctors recommend they still follow the vaccine schedule and receive two more doses.

Because children younger than one have less developed immune systems, the “zero” or earlier dose is weaker than a regular vaccine and offers just enough protection to cover the child, but not enough to offer lifelong protection, said Katherine Wells, Lubbock’s health director.

Wells said if she had a 6-month-old child, she would have them vaccinated with an earlier dose.

For the past few months, Texas health officials have asked parents to consider this earlier dose if they plan to travel or live in the outbreak area or plan to travel internationally.

West Texas public health officials have posted flyers throughout the region and held press conferences and vaccination clinics to encourage more people to vaccinate against measles, which is the most effective way to prevent infection. Pediatricians in West Texas have been emailing and texting patients to let them know they can vaccinate children earlier than 12 months old.

Lubbock, where 53 measles cases have been reported, is 75 miles from Gaines County, where the measles outbreak began in late January. Wells said Wednesday her department has distributed 500 more measles doses than they normally do this year, mostly to children. She said pediatricians in the area are responsible for about another 2,500 more than normal and private physicians have administered most of the early doses to babies.

Measles, once considered eliminated from the United States, is highly contagious and can cause rash and flu-like symptoms but it has more serious complications like brain inflammation and pneumonia and can cause death. In Texas, two school-age girls have died from measles so far.

“I think this does really remind us and help normalize that even though we're in a climate of increased vaccine hesitancy and conversations about changing vaccine policies and vaccine access, the majority of parents still believe in vaccination and vaccinate their children,” Masters said.

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