CDC Letter To Health Care Providers-Adult MMR Vaccination

CDC has a new “Dear Provider” letter to help clarify recommendations for adult MMR vaccination and assessing immunity.  The letter addresses the following important points in more detail:

  • Providers do not need to actively screen adult patients for measles immunity. This is because of high population immunity and low risk of disease among adults in non-outbreak areas in the U.S.
  • Providers should make sure patients have measles protection before international travel. U.S. residents traveling internationally are at high risk for acquiring measles abroad. They can also transmit measles to susceptible persons, such as infants, when they return home.
  • If a patient is traveling internationally and measles immunity is unknown, providers should vaccinate, unless there are contraindications. Serologic testing for measles immunity is not recommended.
  • During outbreaks, providers should consult with local health departments for the most up-to-date recommendations for their community. This may include additional doses of MMR for your patients.

Measles Overview-COCA Webinar

On May 21, 2019, CDC’s Emergency Preparedness and Response held a webinar called “Most Measles Cases in 25 Years: Is This the End of Measles Elimination in the United States.” This webinar was extremely informative and we would encourage all to view this and to share with your partners.


In 2000, measles was declared eliminated from the United States. However, the number of measles cases so far in 2019 exceeds the number of annual cases during any entire year since the declaration was made. The number of case reports continues to climb. As of May 10, 2019, 839 measles cases have been confirmed in 23 states. Of these cases, 621 (74%) were reported in children, with 109 (13%) in infants aged <12 months; and 738 (88%) cases have been associated with close-knit communities, primarily in New York. Despite a national measles, mumps, rubella (MMR) vaccination coverage level of about 95%, 1 in 12 children in the United States is not receiving their first dose of MMR vaccine on time, underscoring considerable measles susceptibility across the country. The majority of measles importations into the United States are from unvaccinated U.S. residents who become infected while traveling abroad. Healthcare professionals should remain vigilant about measles.

During this COCA Call, clinicians will learn what makes 2019 a historic year for measles and what they can do to help identify cases and stop measles transmission.

The webinar is not yet available and slide set can be found here:

Suspect A Patient Has Measles?

Important information for clinicians and local heath department staff: If you or your staff suspect that a patient may have measles, follow the steps outlined in this quick guide. This is meant to be a quick reference guide. We encourage you to print and post it where you staff will see it. We also asl that you share it widely with your staff.

Important: Immunity Testing for Measles

If a serum sample is collected for immunity testing for a patient who is asymptomatic for measles disease, only an IgG serology test should be ordered and sent to a commercial lab for testing.

For LHDs-The Measles Overview Webinar and Checklist

On Monday May 6, 2019 the Immunization Program presented a measles overview webinar for LHD staff. The webinar is now archived on our measles webpage under information for local health departments.

Also on the PCA Portal the Public Health Emergency Plan has Section F Biosurveillance which includes Public Health Surveillance and Epidemiological Investigation Response Checklist. This checklist provides a good road map to responding to measles.