RxPharmacist

How Pharmacists Can Make a Difference Amid the Rise of Measles  

Reference image: Unsplash

By the beginning of June 2025, the Centers for Disease Control and Prevention (CDC) has reported over 1,000 confirmed cases of measles in the United States. Given that disease control depends on vaccination efforts, pharmacists play a key role in preventing and reducing the spread of measles outbreaks. In many states, pharmacists are authorized to administer the Measles, Mumps, and Rubella (MMR) vaccine to eligible patients without a prescription. Furthermore, an outbreak of measles serves as an indicator for health disparities within a community. Pharmacists following trends in outbreaks can identify these gaps in immunization programs and address these challenges early on. 

What is Measles?  

Measles is one of the most contagious diseases, according to the World Health Organization (WHO). Measles is caused by the measles virus, which spreads by airborne transmission or after contact with contaminated surfaces. Almost everyone without immunity will contract the disease if they have been exposed to the virus. One person infected with measles can infect nine out of 10 of their unvaccinated close contacts. Although the measles virus can infect anyone, children are the most affected.

Reference image: Centers for Disease Control and Prevention 

Common symptoms include fever, cough, runny nose, conjunctivitis (red, watery eyes), and a characteristic maculopapular rash. Symptoms usually begin 10-14 days after exposure. Measles diagnosis is confirmed by using laboratory methods.

Measles can be fatal due to complications from the disease. On average, 3 out of every 1,000 cases will end in death from complications. Complications from the disease include ear infections, severe diarrhea, pneumonia, or permanent neurological damage from encephalitis (swelling in the brain). Individuals most at risk for complications are unvaccinated young children (<5 years old) and those who are pregnant.  There is no antiviral therapy or other FDA-approved agent indicated for the treatment of measles, and treatment largely consists of supportive care. 

Vaccine Overview 

The Measles, Mumps, and Rubella (MMR) vaccine is indicated for the routine immunization of children and adolescents by the Food and Drug Administration (FDA). Disruptions to routine vaccination activities during the COVID-19 pandemic have left millions of children vulnerable to measles. This is believed to be a major contributor to the current resurgence of the disease. 

The MMR vaccine is formulated with live attenuated viruses. This means that although the virus is alive, it is a weakened or modified version. Because it is attenuated, the vaccine is harmless and less virulent but remains highly effective. The vaccine works by stimulating the immune system to protect against measles, in addition to mumps and rubella.  

The vaccine requires a two-dose series, which is typical for attenuated vaccines in order to achieve lifetime immunity. Regarding measles specifically, there is 95% effectiveness after the first dose, and 99% after the second dose. The first dose is typically administered to individuals aged 12-15 months, followed by the second dose given between the ages of 4-6 years. 

Although it is preferred to have the 2-dose series completed prior to school entry, the vaccine can be administered in 2 doses in individuals aged 12 months to 12 years old. Booster doses after appropriate vaccination are not necessary. Adults should also be up to date on MMR vaccinations, unless they have presumptive evidence of immunity. This is often the case for individuals born before 1957. 

The Measles, Mumps, Rubella, and Varicella (MMRV) vaccine is not recommended for children aged 12-47 months, per the CDC. The MMRV is typically given as a preference to parents or caregivers. Ten percent of vaccine recipients experience adverse effects to the MMR vaccine. The most common side effects being fever are redness and pain at the injection site. Less than 10% experience a rash and/or severe fever. 

The vaccine is not indicated for everyone. The MMR vaccine should not be administered to the following populations: 

  • Pregnant individuals  
  • Patients on long-term immunosuppressive treatment with high doses of steroids 
  • Patients with Human Immunodeficiency Virus (HIV) and patients with severe immunocompromised conditions
  • Individuals with a family history or confirmed immunodeficiency  
  • Patients on chemotherapy or who have solid tumors  

Prevention 

The WHO reports that maintaining high population immunity is required in order to prevent outbreaks. Those who are eligible for the vaccine should receive it to protect themselves as well as the individuals who are not able to be vaccinated (see above in MMR vaccine overview). This contributes to herd immunity, indirectly protecting those who are not immune.  Post-exposure prophylaxis with the MMR vaccine or immunoglobulin may be indicated for individuals exposed to the virus who do not have immunity. The MMR vaccine should be given within 72 hours after exposure. Immunoglobulin should be given within 6 days after exposure. 

Measles can be transmitted from an infected person up to 4 days prior to the onset of their rash, and up to four days after the rash erupts. To prevent spreading the virus, it is crucial for someone with measles to isolate themselves, especially from high-risk individuals. 

How Pharmacist Can Make a Difference 

To prevent outbreaks, vaccination efforts must be made. As highlighted from the COVID-19 pandemic, pharmacists provide an invaluable contribution to vaccination activities. In the case of parents or patients who are hesitant to vaccinate, pharmacists can address individualized concerns. Their clinical expertise can provide accurate information and dismiss misinformation. Furthermore, pharmacists have access to pertinent information that can be used to identify patients who are eligible for the MMR or MMRV vaccine. This allows pharmacists to streamline the vaccination process and opens an opportunity to answer questions and provide education.  

Pharmacists also play a key role in monitoring outbreak trends to help protect their communities. If confirmed measles cases are reported near their area, pharmacists can provide timely public health interventions. As members of interdisciplinary healthcare teams, they bring strong collaborative skills, enabling them to effectively partner with local health systems to strengthen vaccine programs. 

Timely vaccination is needed to prevent measles and reduce the risk of severe complications associated with the disease. The role of the pharmacist supports outbreak prevention by encouraging widespread immunization and educating patients about the disease. 

Cierra L., APPE student

References:  

  1. Hübschen JM, Gouandjika-Vasilache I, Dina J. Measles. Lancet. 2022;399(10325):678-690. doi:10.1016/S0140-6736(21)02004-3  
  1. Centers for Disease Control and Prevention. Measles (Rubeola): Data and Statistics. Updated June 6, 2025. Accessed June 9, 2025. 
  1. Texas Department of State Health Services. Measles: Frequently Asked Questions. Updated March 18, 2024. Accessed June 11, 2025. https://www.dshs.texas.gov/measles/measles-frequently-asked-questions#:~:text=Call%20your%20doctor%20before%20going,readily%20kill%20the%20measles%20virus 
  1. World Health Organization. Measles and Rubella Strategic Framework 2021–2030. World Health Organization; 2021. Accessed June 11, 2025. https://www.who.int/publications/i/item/measles-and-rubella-strategic-framework-2021-2030 
  1. Johns Hopkins Medicine. Measles: What You Should Know. Johns Hopkins Medicine website. Accessed June 11, 2025. https://www.hopkinsmedicine.org/health/conditions-and-diseases/measles-what-you-should-know 
  1. Patel P, Tobin EH. MMR Vaccine. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; January 2025–. Updated May 5, 2025. Accessed June 11, 2025. https://www.ncbi.nlm.nih.gov/books/NBK554450/ 
  1. Centers for Disease Control and Prevention. Measles, Mumps, and Rubella (MMR) Vaccination: Recommendations for Healthcare Professionals. Updated February 5, 2018. Accessed June 11, 2025. https://www.cdc.gov/vaccines/vpd/mmr/hcp/recommendations.html#:~:text=Post%2Dexposure%20prophylaxis-,Measles,dose%20of%20MMR%20or%20MMRV
  1. PowerPak CE. Managing measles resurgence and stemming the tide. Accessed June 11, 2025. https://journalce.powerpak.com/ce/managing-measles-resurgence-and-stemming 

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