Europe is suffering a measles outbreak that breaks records. In the first two months of 2019, 34,300 cases of measles have been recorded in 42 European countries, 2018 being the year with the most people infected with measles in the last decade, tripling the 2017 cases that were already high.
If you are going to travel with your baby to affected countries and plan to stay for a long time, it is important to evaluate the vaccination to avoid contagion. Remember that measles is a very contagious disease that can present really serious complications and even cause death in people who are not vaccinated.
The triple viral vaccine that protects against measles, rubella and mumps is applied at 12 months the first dose, so if your baby is under one year old and that is why he has not yet received it, and you have planned a trip , you should know the official vaccination recommendations of the main medical societies.
The countries most affected by the outbreak are: Ukraine, with more than half of the total registered cases in Europe, Serbia, France, Israel, Italy and Russia.
When is the vaccine usually given?
In the usual vaccination schedule, the triple viral vaccine is administered in children with one year of age to fight measles, rubella and mumps. It is included in the vaccination schedules of all the Autonomous Communities in Spain. From the Spanish Association of Pediatrics the administration of two doses is recommended, one at 12 months and another as a souvenir between 3 and 4 years of life.
If you are traveling a few days for tourism, it is not necessary to change the vaccination schedule.When is the vaccine given in case of an extended stay?
What do medical societies recommend:
In the case of extended stays (more than one month) to countries at risk affected by the outbreak, when the baby has not yet received the vaccine for being under 12 months, immunization should be assessed.
Last month we met the recommendation of the Spanish Association of Pediatrics which advises vaccinating measles for children under one year of age who travel with extended stays to countries affected by the outbreak.
But from what age? According to the official statement of the AEP:
In the case of infants of 6 to 11 months old (that have not been vaccinated, since in all Spanish calendars it is vaccinated once 12 months of age is reached) that need to travel with extended stays in the countries cited at highest risk, before the need to receive an extra dose of triple viral vaccine should be assessed (measles, rubella and mumps), preferably at least 3-4 weeks before the trip. In any case, upon reaching 12 months of age they should receive a new dose, the usual calendar, since the one administered before the year completed should not be counted for calendar purposes (this dose of 12 months must be separated at least 4 weeks from the extraordinary dose set before).
Vaccines that include the measles component (triple viral, whose commercial preparations are Priorix and M-M-RVAXPRO), are authorized for administration from 9 months of age, but In exceptional cases such as the one discussed in this text, it can be used after 6 months of age, as recommended by organizations such as WHO or the US CDC.
Minimum recommended age, nine months
However, the General Directorate of Public Health, Quality and Innovation of Ministry of Health, in its statement of July 25 (two days after the AEP) does not mention the recommendation to advance it to six months. It is recommended to do so at the minimum age of application stipulated in the medication file, 9 months:
In Spain, two vaccines are sold, MMRVaxPro® (MSD) and Priorix® (GSK). Both vaccines are authorized for use from 9 months of age, as reflected in its data sheet.
We have looked for the data sheet of both vaccines and, in fact, they are recommended for babies from 9 months of age, since the efficacy and safety of them have not been proven before this age:
The Ministry of Health reports in its official recommendations:
As a general rule, in children under 12 months of age who are going to take an international trip in which a high risk is anticipated in relation to measles, it will be valued to administer a dose of triple viral vaccine from 9 months of age. In this case, it should be borne in mind that the dose administered is not part of the vaccination schedule established in the common vaccination schedule, so the doses of 12 months and 3-4 years of age should also be administered.
For its part, the Interterritorial Health Council issued its own statement on July 24, following the recommendation of the AEP, in which it considers that it is not necessary to modify the pattern:
The current epidemiological situation in Spain and in the countries of the European Union does not justify changes in vaccination recommendations. No European country has modified the vaccination schedule against measles.
And he adds, in a clear message to the AEP, that it is the health authorities who are responsible for vaccination recommendations in case of travel:
Scientific societies are reminded that vaccination recommendations for the general population and on international trips are the responsibility of the Health Authorities.
So, vaccinate or not and when?
If your baby has more than nine months and you plan to travel to affected countries for a long time, both the AEP and Public Health recommend advancing the vaccination, since the vaccine is authorized from that age and a possible infection can be prevented. It would be a vaccination out of the calendar, so in this case, at the age of 12 months the dose provided in the calendar and another booster should be applied later. Remember to vaccinate at least 3-4 weeks before the trip.
What if the baby is between six and nine months old? In this age range the doubt arises when seeing the recommendations of the AEP and those of the Ministry of Health. The first recommends advancing it in exceptional cases at six months, while the second refers to the vaccine's technical file, indicated as safe and effective after nine months. If this is your case, it is best to consult with the pediatrician who will inform you and can help you out of doubt.
