Measles is a viral respiratory illness characterized by runny nose, fever, conjunctivitis, cough, and by a flat, red spotted rash.

Prior to the introduction of the very first measles vaccine in 1963, nearly all children had measles by the time they reached 15 years old. While many infectious diseases in eras past had notoriously high mortality rates, this was largely due to poverty, malnutrition and overcrowding–factors which increase the overall vulnerability of a person to a range of diseases.

By the 1950s and 1960s, the living conditions and nutritional status of children had improved to the degree that measles became a mild, but obligatory, part of childhood–like chickenpox in the 80’s. Even the 1960’s TV show The Brady Bunch time capsuled the prevailing attitude at the time about measles in an entire episode where all six kids ‘got the measles.’

Infections with measles virus range from completely asymptomatic, to mild, to more severe, including fatal–the predictors of severe outcomes often have to do with host susceptibility and conditions (nutritional status / vitamin A deficiency, overall health, underlying conditions, HIV status, etc). Severe measles outcomes are typically rare in a healthy, well-nourished child who doesn’t have a serious underlying medical condition.

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JUMP TO SECTION

• Measles Signs and Symptoms
• Measles Transmission / Contagiousness
• Seroprevalence / Asymptomatic / Subclinical Infection
• Possible Origins of the High (90%) Attack Rate
• Measles Severity / Complications
• Measles Treatments
• History of Measles
• Potential Benefits of Measles
• Measles and Immune Amnesia
• Breastfeeding / Maternal Protection / Passive Immunity
• Natural Immunity
• Vaccination
• Vaccination Adverse Events
• Breakthrough Infections
• Resources / Research

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According to the CDC:

“In the decade before 1963 when a vaccine became available, nearly all children got measles by the time they were 15 years of age. It is estimated 3 to 4 million people in the United States were infected each year…among reported cases, an estimated 400 to 500 people died.”

 

Measles Signs and Symptoms

Measles (also called rubeola) is characterized by fever, cough, runny nose, inflamed eyes (conjuctivitis), and the characteristic flat, red, bumpy rash. Also, tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik’s spots may occur.

The symptoms of measles generally appear about 7 to 14 days after a person is infected; the rash typically appears 14 days after a person is exposed to the virus.

The rash usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.

Signs and Symptoms:

• Fever
• dry cough
• runny nose
• red, watery eyes (conjunctivitis)
• 3-5 days after symptoms begin, a rash appears
• tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek–also called Koplik’s spots

 

 

Measles Transmission / Contagiousness

A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days. A person is most contagious when they have a fever, runny nose, and cough.

Measles is often said to be ‘one of those most contagious viruses ever.’ It is spread through the air when an infected person coughs or sneezes. It’s often repeated without citation that ‘9 out of 10 people exposed will get measles (if they are not protected),’ however pre-vaccine estimates hover around 75% of susceptible contacts.

In 1944, the measles attack rate was studied during an epidemic in New York City and they found that 75% of 266 intimately exposed susceptible contacts whose ages ranged from 1 month to 14 years of age developed measles. Age was the principal factor influencing the secondary attack rate of intimately exposed children: the attack rate was lowest in infancy, and highest for those ages 1-7 years of age, and then sharply lower for ages 10-14 years. Most adults were assumed to be immune.

Seroprevalence / Asymptomatic / Subclinical Infection

Exposure to measles does not automatically result in an apparent measles infection in everyone exposed, or 9 persons out of 10, regardless of their vaccination status or medical history. These inapparent measles viral infections, or subclinical infections, may be happening more often than we realize because we don’t routinely test for it.

But observational studies have picked up on these inapparent measles infections more often than is conveyed by public health officials:

A 2001 study titled Detection of Measles Virus Genome in Lymphocytes From Asymptomatic Healthy Children the authors write “asymptomatic measles infections occur with unexpectedly high frequency.” The study made some very important observations:

1. In this study, measles virus genome was detected in 11 (23.4%) of 47 in group 1, having no history of measles immunization or natural infection. Group 1 consisted of 47 individuals, aged 2 months to 3 years, having no history of measles immunization or natural infection and 32 were accommodated in the welfare home.
2. Measles virus genome was detected in 36 of 78 individuals (40 of 159 samples) who had been immunized more than 2 months before and in all cases was identified as a wild strain.
3. “We identified asymptomatic infection by RT-PCR with unexpectedly high incidence.” 

 

Another study from 2004 examined 133 close contacts of 6 confirmed measles cases during several outbreaks, and found 8% of the close contacts had serological evidence of recent measles virus infection, despite having no symptoms of disease. Of the 133 close contacts, 12 had no history of vaccination and they were not at an increased risk for inapparent infection compared to vaccinated contacts (nor did they develop apparent measles).

Another study found that 23% of an exposed cohort of bus tour participants had serological evidence of recent measles virus infection, and none had classic symptoms consistent with measles (therefore did not qualify as measles diagnosis). Seven of the 10 had been previously vaccinated; 3 of the 10 had prior infection.

This 2020 study found serological evidence of measles infection in completely unvaccinated populations, with no record of disease. This study of children 6-59 months of age in the Democratic Republic of Congo remarkably found that 40% of the unvaccinated children were seropositive for measles despite no history of measles infection.

Overall, 62% of the unvaccinated children ages 2-under 5 years were seropositive for measles. Interestingly, of vaccinated children with a dated card, only 78% of those without history of measles infection were seropositive, compared to 95% of children with both dated card and prior measles infection. About 83% of unvaccinated children with history of measles infection were seropositive.

This study has many interesting data points:

1. The vaccine effectiveness in this particular population was 49.7%
2. The attack rate was 10 per 100 for unvaccinated, and 5 per 100 for vaccinated.
3. 40% of the unvaccinated who did not have history of measles had seroprotective antibody values.
4. Children breastfed in the past represented a higher percentage of individuals seroprotected versus children currently breastfed.
5. The unvaccinated group of children’s seropositivity increased with age (so not purely the result of maternally acquired antibodies).
6. Only 83% of the unvaccinated children with history of measles were seroprotected: were the 17% the result of misdiagnosis?

This 1999 study found that subclinical infections are common in both vaccinated and unvaccinated persons. And despite being close contacts, only 1 in 5 of those exposed developed clinical measles. Of interest were the titers of 36 vaccinated and 87 unvaccinated children who were close contacts of index cases during a West African measles outbreak.

“Of the 123 children who had a blood sample taken both at exposure and 1 month later, 21 (17%) developed clinical measles.”

Out of 123 children, clinical measles occurred in (20/36) 56% unvaccinated and (1/87) 1% vaccinated children; whereas (4/16) 25% unvaccinated and (39/86) 45% of vaccinated children had subclinical measles (defined as a four-fold rise in titers without clinical symptoms).

A seroprevalence study in the Lao People’s Democratic Republic found that a high proportion of unvaccinated children were seroprevalent to measles and/or rubella:

“A high proportion of unvaccinated children at both study sites (24.4% and 38.4%) were positive/borderline for measles and/or rubella.”

The study concludes:

“A high prevalence of measles and rubella antibodies was found in unvaccinated children, indicating widespread circulation of both viruses and underreporting of cases. The high proportion of vaccinated children still susceptible to measles suggests problems with vaccine immunogenicity, emphasizing the need for regular evaluations of vaccine efficacy and management.”

 

Possible Origins of the High Attack Rate (90%)

The high estimate of infectiousness for measles may stem from this 1985 study:

Measles Outbreak in a Pediatric Practice: Airborne Transmission in an Office Setting.

The paper documents a 12 year old boy who was vaccinated against measles at 11 1/2 months of age was in the office for one hour on the second day of rash. He coughed vigorously in the exam room, and the air in his exam room was dispersed throughout the pediatric practice. Of 57 persons who visited the practice that afternoon, 7 secondary cases of measles occurred: 6 children and one mother of a child who did not have measles, for a secondary attack rate of 12.2%. Out of 5 infants less than 15 months of age who were mmr-unvaccinated, 4 (80%) developed measles, compared with 2 of 27 (7.4%) children aged 15 months and older, all of whom had been vaccinated. Only one of 25 (4%) adults developed measles.

Interestingly, the unvaccinated adults over 21 had a lower attack rate (4%) than adequately vaccinated 15 mo to 20 yr olds (7.4%).

A few things this study fails to explore are: how many of the infants were currently being breastfed? Were the infants in for a sick visit? Or were they getting other vaccinations at that time? How does lack of breastfeeding, current illness, or vaccination affect transmission rates of measles? For example, an injection given during subclinical poliovirus infection increases the likelihood of paralysis. We would need to explore this further, but 80% (4 out of 5) infants in this indoor setting isn’t exactly representative of transmission rates in all settings.

Or this 1993 study:

High attack rates and case fatality during a measles outbreak in groups with religious exemption to vaccination may be an extreme example as it documents an outbreak (486 cases) in a religious community that had 1% vaccination rate and who rejected all medical interventions and did not seek any medical care even for their higher risk children: the overall attack rate in this group was 54%; and when stratified by age: 32% in infants under 1; 94% in children 1-4 years; 91% in children 5-14 years; 31% ages 15-19. A total of 9 children died of measles out of 1424 reported cases (including non-church community); 3 in the non-church (938 cases) and 6 in the church community; most deaths were associated with underlying medical conditions or total lack of medical care.

Measles Severity / Complications

Vitamin A deficiency is associated with severe measles-related complications in children and adults, delaying recovery and promoting xerophthalmia, corneal ulcer, and blindness. Acute measles precipitates vitamin A deficiency by depleting vitamin A stores and increasing its utilization, leading to more severe ocular injury. Vitamin A supplementation given to children with measles has been associated with reduced severe disease and death rates.

A 1992 study examined the vitamin A levels of 89 children younger than 2 years old with measles in New York and they found that vitamin A levels decrease during measles even in children who were not deficient, and that children with low levels of vitamin A were more likely to have high fever, have a fever for 7 days or more, and more likely to be hospitalized. Children with low vitamin A also had lower measles-specific antibody levels.

Common to rare measles complications

• Diarrhea and vomiting. (8% of cases) Diarrhea and vomiting can result in losing too much water from the body (dehydration).
• Ear infection. (7% – 9% of cases)
• Bronchitis, laryngitis or croup. Measles may lead to irritation and swelling (inflammation) of the airways (croup). It can also lead to inflammation of the inner walls that line the main air passageways of the lungs (bronchitis). Measles can also cause inflammation of the voice box (laryngitis).
• Pneumonia. (1% – 6% of cases) An infection of the lungs.
• Encephalitis. (1 in 1,000-2,000 persons) Encephalitis is irritation and swelling (inflammation) of the brain. More common in people with weakened immune systems or other underlying conditions. Typically manifests with a triad of symptoms comprising fever, headache and altered level of consciousness.

• Subacute sclerosing panencephalitis (SSPE) is a rare (1 per 100,000 cases) and fatal degenerative central nervous system disease caused by a persistent infection with a mutant measles virus. The onset is several years after the episode of measles (on average seven years) and most affected children had measles before two years of age.
• Pregnancy problems. If you’re pregnant and get measles, some complications could include premature birth, low birth weight and fetal demise. This is one reason why nature intended us to get measles in childhood.

 

Measles complications are also changing over time, now that we are dealing with vaccinated populations, and erasure of natural immunity. Attack rates are shifting to more vulnerable subsets of the population, such as infants, who benefit from less passive immunity born from a vaccinated mother, compared to a mother who acquired measles naturally.

According to this study, The Resurgence of Measles in the United States, 1989-1990, a total of 18,193 measles cases were reported in 1989 (of which 37% were vaccinated), and in 1990 a total of 27,786 cases were reported (of which 19% were vaccinated).

“The measles epidemic of 1989-1990 was due primarily to widespread transmission of virus, particularly among unvaccinated preschool-aged children of racial and ethnic minority groups living in inner-city areas.

In this age group, the incidence of measles among blacks in 1989 and 1990 was 142 and 87 per 100,000, respectively, and among Hispanics it was 121 and 164 per 100,000, respectively, compared to 16 and 23 per 100,000 among non-Hispanic whites.

Measles susceptibility of infants less than one year of age may also have increased. The mothers of many infants who develop measles are young, and their measles immunity may be due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody is transferred across the placenta to the fetus, compared to mothers who have higher antibody titers that result from wild virus infection. The lower quantity of antibody may wane more rapidly, making infants susceptible at a younger age today than infants in the past.”

A provisional total of 41 measles-associated deaths were reported in 1989 and 89 deaths reported in 1990; eight percent had been vaccinated; 60% of all deaths were under 5 years and 28% were over 20 years of age. Twelve percent of deaths had a serious underlying illness, including seven who were infected with HIV.

Comment: The case fatality rate for this 1989-1990 measles epidemic is higher than expected, or observed in the period before the vaccine was introduced. Several factors could be influencing the higher case fatality rate: total cases were underreported (in fact many surveys from this period indicate that around 29% of cases were ever reported); the shift in cases to children under 5 and over 20 (when historically measles was more common in school-aged children); inappropriate medical care (were hospitalized cases given vitamin A?).

Persons presenting with severe measles infection should be assessed for vitamin A deficiency and assumed to have low levels.

Measles Treatments

Vitamin A

Vitamin A deficiency is associated with severe measles-related complications in children, therefore adequate vitamin A is critical for supporting the immune system, clearing out the virus, preventing worse outcomes, and restoring liver stores of vitamin A.

A double blind trial in a low-income country found that vitamin A supplementation during measles is associated with:

• Halved rate of pneumonia
• Shorter duration of diarrhea
• Halved rate of croup
• Fewer days in the hospital (for hospitalized children)
• Halved rate of death or serious complication

 

 The WHO recommends vitamin A for all children with acute measles regardless of their country of residence. 

 

However, according to the NIH, a pooled analysis of population-based surveys from 138 low-income and middle-income countries found that 29% of children aged 6 months to 5 years had vitamin A deficiency in 2013. Deficiency rates were highest in sub-Saharan Africa (48%) and South Asia (44%). In addition, approximately 10% to 20% of pregnant women in low-income countries have vitamin A deficiency. Globally, 30% of children less than 5 years of age are deficient in vitamin A. Could this be one reason why measles is more severe in these countries?

Vitamin A for treatment of measles is administered once daily for 2 days, at the following doses:

• 200,000 IU for children 12 months or older;
• 100,000 IU for infants 6 through 11 months old;
• and 50,000 IU for infants younger than 6 months.

 

An additional (eg, a third) age-specific dose should be given 2 through 4 weeks later to children with clinical signs and symptoms of vitamin A deficiency. Even in countries where measles is not usually severe, vitamin A should be given to all children with severe measles (eg, requiring hospitalization). Parenteral and oral formulations of vitamin A are available in the United States.

RESEARCH SUPPORTING VITAMIN A

“Vitamin A for treating measles in children”

• There was a 64% reduction in the risk of mortality in children who were given two doses of 200,000 IU of vitamin A (RR=0.36; 95% CI 0.14 to 0.82) as compared to placebo.
• Two doses of water based vitamin A were associated with a 81% reduction in risk of mortality (RR=0.19; 95% CI 0.02 to 0.85) as compared to 48% seen in two doses of oil based preparation (RR=0.52; 95% CI 0.16 to 1.40).
• Vitamin A supplementation was associated with a 74% reduction in the incidence of otitis media (ear infections) (RR=0.26, 95% CI, 0.05 to 0.92)

“Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis“

• Vitamin A supplementation was associated with a 27% reduction in deaths from diarrhoea.
• Overall, there was a 15% decrease in diarrhea incidence and a 50% decrease in incidence of measles.
• Vitamin A also reduces precursors to blindness.

“Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age”

• Vitamin A supplementation is associated with a clinically meaningful reduction in morbidity and mortality in children. 
• At longest follow-up, there was a 12% observed reduction in the risk of all-cause mortality for vitamin A compared with control using a fixed-effect model.

“Severe Measles, Vitamin A Deficiency, and the Roma Community in Europe”

• We describe 6 adults from the Roma community in Marseille, France, who had measles and low levels of vitamin A; 2 of these persons had severe measles.
• We conclude that all adults who have measles should be assessed for vitamin A and retinol-binding protein levels and should be considered for vitamin A supplementation, as are children.

Sources of Vitamin A:

• Cod liver oil
• liver, fish
• Eggs
• Milk products
• Orange and yellow-colored vegetables and fruits.
• Other sources of beta-carotene such as broccoli, spinach, and most dark green, leafy vegetables.

Measles Immune Globulin

• Immune globulin is made from donated human blood plasma that contains measles antibodies.
• Must be given within 6 days of exposure to measles.

Additional Treatments:

 Rest 

Whenever you’re sick, whatever it is that you caught, rest is always best. It’s nature’s way of imposing a quarantine to prevent spreading the virus to others who may be more vulnerable than you. Many children with measles are more sensitive to light, so make sure to rest in a dimly lit room.

 Get Respiratory Relief 

As measles is a respiratory infection similar to influenza, you may want use a humidifier, sip tea with honey, and drink plenty of liquids for a runny nose, sneezing, cough and sore throat.

 Drink Fluids 

Hydration is always key with every sickness, especially those with fevers. Drink fresh organic juices such as orange and lemon and pineapple for extra vitamin c content.

 Turmeric 

Turmeric has antioxidant, antiseptic and anti-inflammatory properties that can reduce the symptoms of measles. Mix one tablespoon of honey and one tablespoon of ground turmeric in one glass of warm milk (coconut or almond or cow’s milk).

 Vitamin C 

Ascorbic acid or sodium ascorbate is a very important antioxidant that helps treat flu-like symptoms and helps the body repair damage. High doses of vitamin c have been shown battle many viruses including measles.

 Elderberry 

Elderberry has anti-viral properties and is an immune boost. Rich in vitamin c and antioxidants. 1/2 tsp per day.

 Barley 

Barley is very effective home remedy when it comes to skin irritation and itching because it is packed with minerals, Vitamin C and antioxidants. Also it is rich in zinc which can speed up the healing process. Use barley like a tea and drink multiple times per day.

 Baths 

A warm bath can be soothing for the skin. Add 1/2 cup of baking soda to a warm bath. Oatmeal, or the essential oils of lavender, german chamomile and tea tree along with milk (can be almond, hemp, cow, goat, coconut etc.) can all be added in small amounts to bathwater. A few drops of essential oil to one tablespoon of milk.

History of Measles

Mention of measles dates back to the 7th century. Persian physician known as “Rhazes” delineated between smallpox and measles in the 10th century, but Europeans would continue to confuse both smallpox, measles and other exanthema such as chickenpox.

After the turn of the 20th century, there was a large decline in mortality from nearly all infectious diseases, including measles, that coincides with many advances in living conditions, infrastructure and nutritional status.

In the 1930s, British physician Joseph Bramhall Ellison performed a case control study in a London hospital and supplemented one cohort of measles patients, mostly children, with vitamin A, and another cohort of measles patients received standard treatments. The results were that the vitamin A supplemented children had a 58% reduction in mortality compared to the non-supplemented children.

Ellison observed that measles:

“afflicts most heavily the children of the poorest classes, since most of them are suffering from a lack of suitable fats in the diet, it is natural to suppose that they are insufficiently furnished with vitamins A and D.”

Poverty, malnutrition and overcrowding have been fertile grounds for disease for centuries. The discovery of vitamin A’s usefulness in measles coincides with the increased awareness of other nutritional deficiency diseases: rickets, caused by inadequate vitamin D; scurvy, caused by lack of vitamin C; beriberi, caused by inadequate thiamine; and pellagra, caused by niacin deficiency.

Potential Benefits of Measles

For decades, there have been observations and anecdotes that people with a history of febrile illnesses have a reduced risk for certain cancers and health conditions, or have other health benefits. One obvious health benefit to natural infection is naturally acquired immunity which is longer and more durable than vaccine-induced immunity.

• Could there be unknown or unidentified benefits to viral infections?
• Do we even know the purpose of viruses, and can we reconcile the paradox that many infections with viruses are completely asymptomatic, while severe complications are often the result of host susceptibility, either through poor nutrition or co-morbid conditions–compelling me to speculate that viruses may have a beneficial purpose after all?
• I mean, where in nature do we have an example of a piece of an ecosystem that doesn’t serve a purpose or a function?

 

Read the benefits below:

Better, Longer Immunity

This 2021 observational study has some really interesting findings: Long-term immunogenicity after measles vaccine vs. wild infection: an Italian retrospective cohort study:

• At enrollment, 6% of the ‘history of disease’ group and 20% of the vaccine group had no measles immunity, which was statistically significant.
• Because the vaccine group was still relatively young (medical students) this finding means about 1 in 5 young adults who were vaccinated against measles (2 doses) as a child has no circulating immunity to the disease. The vaccine continuously wanes, so it would follow that older ages would have less immunity.
• 12.9% of the disease group had a chronic condition vs. 14.6 of the vaccine group. While this 13% increase in chronic disease in the vaccine group isn’t a huge increase, this is just one vaccine we are looking at. I am assuming the ‘history of measles’ group had many other vaccines. What would the rate be if they had no vaccines? Or very few vaccines?
• 29.4% of the disease group had “allergy” compared to 31.0% of the vaccine group. It’s pretty close, but again, this is one vaccine, and they are pooling all allergies–would love to see this teased out more.

Lower Rates of Cancer

This study was a prospective cohort of 1,142 individuals born in Newcastle-upon-Tyne in 1947, to assess the impact of various childhood infectious diseases on cancer mortality during ages 15-60 years. Childhood history of measles and influenza, were both independently associated with lower cancer mortality during ages 15-60 years (adjusted hazard ratios = 0.39, 95% CI 0.17-0.88 and 0.49, 95% CI 0.24-0.98 respectively).

This study found that negative history of measles was associated with development of immunoreactive diseases, sebaceous skin diseases, degenerative diseases of bone and cartilage, and certain tumours.

Other studies found that history of certain infectious disease was associated with a lower rate of ovarian cancer. The paper wrote:

Thus in our patients, as in other series, two protective factors against ovarian carcinoma appear to be operative, a history of pregnancy and of infection by mumps, measles, rubella, or chicken pox. It might have been expected that a virus affecting the ovary would increase the risk of initiating changes resulting in tumour growth therein.

Another study found that the number of febrile infectious diseases decreased one’s cancer risk for all cancers studied except breast cancer.

Our retrospective study showed a significant association between FICD and the risk of developing cancer. The number of FICD decreased the cancer risk, in particular for non-breast cancers. 

Spontaneous Remissions in Cancer

There have been mentions of spontaneous remissions of cancer after people contracting chickenpox, I wanted to know if there were similar reports for measles. Currently, scientists have adapted the measles vaccine virus to target cancer in experimental studies–could the wild virus do the same thing?

In 1971, two Ugandan doctors wrote a letter to the editor detailing a case of Regression of Burkitt’s lymphoma in association with measles infection in an 8 year old boy.

In 1973, a physician wrote to the British Medical Journal describing a case of spontaneous remission from Infantile Hodgkin’s disease in a 2-year-old after a bout with measles that lasted 6 months. The child became symptomatic again and after several doses of irradiation of the neck was still symptom free after 18 months.

Regarding cancer, this 2021 study Seroprevalence of Measles and Mumps Antibodies Among Individuals With Cancer had some interesting findings within it, even though it’s main purpose is to encourage vaccination (and several of its authors have hefty pharmaceutical industry sponsorship). Cancer patients over 60 years old (and had presumed natural infection with measles) had significantly higher protective levels of measles antibodies (seroprevalence) than younger age groups. For example, 49% of 30-39 year olds were seropositive for measles, compared to 90% of 70-79 year olds, and 95% of people over 80.

Instead of interpreting that measles vaccination must step in and protect cancer patients, what about naturally acquired nutritionally supported infections in childhood, as its clear that natural infection produces longer lasting, durable protection (and even protects people after the development of cancer). Also, as there were fewer people enrolled in the study who were over 60, it leaves a question as to whether there is a higher incidence of cancer in 30-40 year olds due to absence of naturally acquired measles in childhood? Or is this just a phenomenon of the selection process. Either way, we would need to investigate if the prevalence of cancer in 30-40 year olds is higher today, than 50 years ago.

This study from 1987 specifically looked at the outcomes of children with a malignant disease who also developed measles. Of 17 who were diagnosed with measles, 5 cases died. Factors associated with a favorable outcome were typical rash and Koplik’s spots. It is unknown why vitamin A was not administered to this population, but given the year of the study it could have not been widely known.

Measles Virus and Immune Amnesia

Many reports have investigated whether measles virus infections are related to a transient suppression in the immune system, sometimes called immune amnesia. It’s a temporary phenomenon and considered a paradox of measles: on the one hand an infection with measles virus ‘suppresses the immune system’ by preferentially infecting memory B cells and T cells (which reduces the total circulating antigen-specific antibodies); and on the other, an infection with measles virus results in a strong virus-specific immune response, resulting in life long protection. Some papers like this industry funded report Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens found:

“Measles caused elimination of 11 to 73% of the antibody repertoire across individuals. Recovery of antibodies was detected after natural reexposure to pathogens.”

The article argues for widespread vaccination (typical of an industry funded paper) but it led me to ask the question: if this were even true, wouldn’t this immune amnesia or a wiping out of antigen-specific memory B cells invariably have a potentially positive effect on food allergies, allergic disorders, asthma, atopic dermatitis, etc.? Is there a hidden or undiscovered purpose or function for this phenomenon, given that measles has infected humans forever, often in childhood.

Because, for one, B cells are fundamental in both developing food allergies and gaining oral tolerance (which protects against IgE food allergies):

“B cells play a pivotal role in IgE-mediated food allergies, as a result of their unique ability to produce allergen-specific IgE antibodies that sensitize mast cells and basophils by binding to their high-affinity IgE receptors.”

Tetyana Obukhanych, Ph.D. dismisses the idea of immune amnesia altogether and makes really great points, as well as provides ample support that a history of measles infection may result in less asthma and allergic diseases:

“And if the measles and chickenpox viruses already do just that – kill memory T cells – shouldn’t that lead to a reduced risk of asthma and other allergic diseases following these childhood diseases? Indeed, it should.  And there are publications documenting such effects for measles in Africa and Europe, and for chickenpox in the USA.“

The 2009 study Allergic disease and atopic sensitization in children in relation to measles vaccination and measles infection studied 14,893 children in 5 European countries (Austria, Germany, the Netherlands, Sweden, and Switzerland) and concludes:

“Our data suggest that measles infection may protect against allergic disease in children.”

A 1993 case report describes the spontaneous improvement of five food-sensitive atopic dermatitis patients after natural measles virus infection.

A 1986 case study documents a 5 year old boy with hyper IgE syndrome who had a temporary remission of disease and disappearance of skin lesions related to measles infection.

Toxicologist Ashley Everly points out that the immune amnesia described by vaccine enthusiasts may be a consequence of vitamin A deficiency.

Peter Aaby has wondered whether the measles-induced immune amnesia (MIA) explained why in certain African countries why receipt of measles vaccine was associated with a decreased mortality, compared to DTP and polio vaccines. And he shares some interesting findings:

However, in children over 6 months of age, the MIA hypothesis is contradicted by several epidemiological patterns: First, in community studies that adjusted for MV status, children surviving acute measles infection had lower mortality than uninfected controls (44%(95%CI: 0-69%)). Second, in six randomised trials and six observational studies comparing MV-vaccinated and MV-unvaccinated children, the benefit of MV changed minimally from 54%(43-63%) to 49%(37-59%) when measles cases were censored in the survival analysis, making it unlikely that prevention of measles and its long-term consequences explained much of the reduced mortality. 

Their conclusions are:

Conversely, the hypothesis that MV has beneficial non-specific immune training effects is compatible with all available data. Consideration should be given to continuing MV even when measles has been eradicated.

However, I would argue that the benefits of the measles vaccine stem from the measles virus itself. In a well-nourished child viruses are often extremely mild, and it may come to be known that there are many benefits for the body to having viral infections, such as resetting the immune system, reducing auto-immunity and IgE allergic disorders, removing cancerous cells, and reducing risks for a range of diseases.

The hygiene hypothesis describes how lack of exposure to germs can protect against allergies and strengthen the immune system. In order for our immune systems to work as intended, it needs exposure to a range of microbes, including viruses.

Breastfeeding & Maternal Protection

If a mother has contracted measles naturally, there is a peak of measles-specific IgG antibodies that are transferred through the placenta in the third trimester, and additionally her breastmilk contains IgA antibodies against measles which provides passive immunity to her infants and nursing children.

The passive immunity may avoid or spare a newborn and breastfed child’s symptoms of measles. Naturally acquired measles is correlated with higher levels of passive immunity than vaccine-induced immunity.

In this study, Decay of maternally derived measles antibody in central Turkey, 94% of the mothers were seropositive for measles, and all had naturally acquired measles, based on their birth year. Of their infants, 74.1% of the infants were seropositive at birth, waning to 37.8%, 19.2%, 19.5% at 4 months, 5-6 months, and 7-9 months respectively.

In another study, Measles antibodies in women and infants in the vaccine era:

Of 202 mother-infant pairs, 30% of mothers and 17% of their infants were seronegative (EIA < 0.16). Mothers born before 1963 and their infants had significantly higher mean EIA absorbency values than mothers born after 1963 and their infants (P < 0.002). The percent seropositive for measles antibodies by EIA for mothers born before 1963 and their infants, 87% and 94%, respectively, was significantly higher than the percent seropositive for mothers born after 1963 and their infants, 61% and 69%, respectively (P = 0.0001).

The very first milk a mother gets, colostrum, is extremely rich in vitamin A–more so than even mature human milk. Interestingly, colostrum’s color is a rich yellow or orange color because of it’s high amount of beta carotene, which is converted by the body into vitamin A.

“Colostrum appears typically enriched in vitamin A, C, and K compared to maternal serum, possibly indicative of active mammary gland transport mechanisms.”

A 2009 study Breast-feeding and a subsequent diagnosis of measles found that breastfeeding for more than 3 months was associated with a 31% reduced odds of having measles compared to ‘never breastfed’. The study gathered information on people up to 10 years of age.

“We speculate that breast-feeding may result in a milder form or sub-acute measles infection, reducing the likelihood of diagnosis.”

The same study found that measles vaccination was associated with a 67% reduction in measles beginning at 5 years of age, but notably Table 1 reports that 31% of the children who reported measles vaccination also reported having measles.

It almost seems like Nature knew what it was doing! There is no other way to say it, vaccination is crippling us in the long run by creating larger gaps in our immunity than ever would have been possible with natural acquired immunity. Given that the vaccines wane, or that some people don’t sero convert in the first place, this leads to these large groups of non-immune people, or not immune when it counts, ie. during pregnancy. This is created by vaccinating, which creates an imperfect immunity, in contrast to not vaccinating, which would enable infection during optimal phases of one’s life, ie. during childhood.

Natural Immunity

People born before 1957 who lived through several years of endemic measles prior to the introduction of the vaccine in 1963 are presumed to be naturally immune to measles.

Vaccination

Vaccination against measles is achieved through 2 doses of the live attenuated MMR vaccine or MMRV vaccine, which is a combination shot that contains the viruses of measles, mumps and rubella (and varicella for the MMRV). Immunity provided from 2 doses of the measles-containing vaccine declines within 10-15 years based on observational studies, however the CDC website lists immunity as “probably lifelong in most persons,” without any citation.

Approximately 15% of people do not develop measles immunity after the first dose of the vaccine, a phenomenon known as primary vaccine failure.

A 2019 study titled Seroprevalence of measles, mumps & rubella antibodies among 5-10 years old children in north India found that despite all children having received ≥ one dose of mmr vaccine, 60% of children did not have protective immunity against measles.

A German cross-sectional analysis published in 2021 found that birth cohorts in the pre-vaccine era had the highest seroprevalence compared to those born in the vaccine predominant era (born prior to 1940: 99%; 1945-1949: 98.5%; compared to 1965-1969: 89%; 1975-1979: 75%; 1985-1993: 74%.) The study is poised at encouraging adult vaccination because of waning immunity inherent with vaccination.

MMR-II is an attenuated live measles virus, derived from Enders’ attenuated Edmonston strain and propagated in chick embryo cell culture given subcutaneously. The first dose is administered at 12-15 months of age, second dose 4-6 years of age.

• MMR-II package insert

 

ProQuad® is a live, attenuated measles, mumps, and rubella virus that also contains live, attenuated varicella-zoster virus. The first dose is administered at 12-15 months of age, second dose 4-6 years of age. The subcutaneous injection is produced in chick embryo cell culture. 

• ProQuad® package insert

Description:

M-M-R II vaccine is a sterile lyophilized preparation of (1) Measles Virus Vaccine Live, an attenuated line of measles virus, derived from Enders’ attenuated Edmonston strain and propagated in chick embryo cell culture; (2) Mumps Virus Vaccine Live, the Jeryl Lynn™ (B level) strain of mumps virus propagated in chick embryo cell culture; and (3) Rubella Virus Vaccine Live, the Wistar RA 27/3 strain of live attenuated rubella virus propagated in WI-38 human diploid lung fibroblasts. {20,21} The cells, virus pools, recombinant human serum albumin and fetal bovine serum used in manufacturing are tested and determined to be free of adventitious agents.

Ingredients:

After reconstitution, each 0.5 mL dose contains not less than 3.0 log10 TCID50 (tissue culture infectious doses) of measles virus; 4.1 log10 TCID50 of mumps virus; and 3.0 log10 TCID50 of rubella virus. Each dose is calculated to contain sorbitol (14.5 mg), sucrose (1.9 mg), hydrolyzed gelatin (14.5 mg), recombinant human albumin (≤0.3 mg), fetal bovine serum (<1 ppm), approximately 25 mcg of neomycin and other buffer and media ingredients. The product contains no preservative.

Duration of protection:

The duration of protection of MMR-II is considered by the CDC to be lifelong for measles and rubella, however, it is not evidence based. Many measles outbreaks include twice vaccinated persons.

Non-Clinical Toxicology:

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

M-M-R II vaccine has not been evaluated for carcinogenic or mutagenic potential or impairment of fertility.

Vaccination Adverse Reactions

The MMR vaccine contains live attenuated measles virus. According to the CDC, 5-15% will have a fever higher than 103°F, 5% of recipients will experience a rash, approximately 5-12 days following vaccination.

Up to 25% of adult women may experience joint pain.

Measles-Like Rash and Illness

This case report details a 15-month-old infant who:

“…Presented to his paediatrician’s office with irritability, a fever (38.8°C), a cough and conjunctivitis. The child had a five-day history of illness that began with an elevated temperature and a raised, sandpaper-like rash that originated at the occiput, and eventually spread to and covered the torso. There was mild cervical lymphadenopathy, and no rhinitis or Koplik spots. The child was not immunocompromised and had no significant medical history. Just 12 days before presentation to his paediatrician, the child was immunized with the M-M-R II vaccine (Merck Canada Inc). …..the laboratory reported the measles virus in both samples as being genotype A – 100% identical to Genbank entry #FJ2111583 (the Edmonston-Enders vaccine strain).”

Seizure

Receipt of MMR vaccine is associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83; 95 percent confidence interval, 1.44 to 5.55). The MMRV vaccine is associated with a higher rate of seizure in the post-vaccination period compared to MMR + Varicella vaccine given separately.

Febrile convulsions during recovery after anesthesia in an infant with history of MMR vaccination: A case report

Seizure Risk with Vaccination

Vaccines for measles, mumps, rubella, and varicella in children

Risk of febrile seizures after first dose of measles–mumps–rubella–varicella vaccine: a population-based cohort study

Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura (ITP) is an adverse event that has a demonstrated cause-effect relationship with the measles, mumps and rubella (MMR) vaccine that can occur in 1 to 3 children every 100,000 vaccine doses or 1 in 22,300 doses occurring in the six week post-immunization period. 

Immune thrombocytopenia (ITP) is a blood disorder characterized by a decrease in the number of platelets in the blood, can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Vaccine administration and the development of immune thrombocytopenic purpura in children

Other adverse reactions of interest:

Bilateral Hearing Loss after Measles and Rubella Vaccination in an Adult

Reports of sensorineural deafness after measles, mumps, and rubella immunisation

Unilateral total deafness as a complication of the measles-mumps-rubella vaccination

From the package insert:

• Panniculitis;
• atypical measles;
• fever; syncope;
• headache;
• dizziness;
• malaise;
• irritability.
• Digestive System Pancreatitis;
• diarrhea;
• vomiting;
• parotitis;
• nausea.
• Hematologic and Lymphatic Systems Thrombocytopenia;
• purpura;
• regional lymphadenopathy;
• leukocytosis.
• Immune System Anaphylaxis,
• anaphylactoid reactions,
• angioedema (including peripheral or facial edema)
• bronchial spasm.
• Musculoskeletal System Arthritis;
• arthralgia;
• myalgia.
• Nervous System Encephalitis;
• encephalopathy;
• measles inclusion body encephalitis (MIBE)
• subacute sclerosing panencephalitis (SSPE);
• Guillain-Barré Syndrome (GBS);
• acute disseminated encephalomyelitis (ADEM);
• transverse myelitis;
• febrile convulsions;
• afebrile convulsions or seizures;
• ataxia;
• polyneuritis;
• polyneuropathy;
• ocular palsies;
• paresthesia.
• Respiratory System Pneumonia;
• pneumonitis; sore throat;
• cough;
• rhinitis.
• Skin Stevens-Johnson syndrome;
• acute hemorrhagic edema of infancy;
• Henoch-Schönlein purpura;
• erythema multiforme;
• urticaria;
• rash;
• measles-like rash;
• pruritus;
• injection site reactions (pain, erythema, swelling and vesiculation).
• Ear Nerve deafness;
• otitis media.
• Eye Retinitis;
• optic neuritis;
• papillitis;
• conjunctivitis.
• Urogenital System Epididymitis;
• orchitis

Breakthrough Infections

When the measles vaccine was first introduced, it was a one dose series. The reason why it became a 2-dose series is in response to ‘breakthrough infections,’ an infection that breaks through the vaccine, or the vaccine received years prior is no longer durable, ie. vaccine waning. Every single vaccine wanes. Back when smallpox was a public health threat, re-vaccination was done every 2 years. This constant vaccinating (and the repeated side effects that came with each dose) is one of the impetus of the original antivaccine movement of the 1800s.

But back to measles, in the 1990s, a second dose was added to the schedule because the first dose wore off after a few years. A breakthrough infection will only be counted as measles if it’s a non-vaccine strain virus (the vaccine strain is genotype A).

The same playbook happened for varicella vaccine (chickenpox) as well. It originally was a one-dose series, which turned into two doses as children in school were developing chickenpox. We can easily see the same thing happening with both pertussis, and of course, COVID-19.

“Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011“

A fully vaccinated 22 year old developed measles and transmitted the infection to 4 secondary cases, who either had 2 doses of measles-containing vaccine or a past positive measles IgG antibody.

“Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures“

An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures.

Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak. 

“A limited measles outbreak in a highly vaccinated US boarding school“

We identified 9 laboratory-confirmed cases at the school: 8 students and 1 staff member. Among them, 2 had never received any doses of measles-containing vaccine (MCV), 1 received 1 dose of MCV, and 6 received 2 doses of MCV. Three of the 6 who received 2 doses of MCV received both doses outside the United States. 

“Mild Measles and Secondary Vaccine Failure During a Sustained Outbreak in a Highly Vaccinated Population”

The occurrence of secondary vaccine failure and vaccine-modified measles does not appear to be a major impediment to measles control in the United States but may lead to underreporting of measles cases and result in overestimation of vaccine efficacy in highly vaccinated populations.

“Nonclassic measles infections in an immune population exposed to measles during a college bus trip”

Ten persons (23%) were IgM positive for measles, indicating recent infection. Mild or asymptomatic measles infections are probably very common among measles-immune persons exposed to measles cases and may be the most common manifestation of measles during outbreaks in highly immune populations.

The 2015 California Disneyland measles outbreak that spawned several bills that ultimately removed personal exemptions to vaccination in California documented only 45% of California cases as unvaccinated; the remaining were either partially or fully vaccinated, or their vaccination status was unknown or undocumented.

Of the 194 measles virus sequences obtained in the United States in 2015, 73 were identified as vaccine sequences, thus many vaccinated persons present to physicians with measles-like illness yet is also ultimately vaccine derived.

Resources / Research

Decreased measles antibody response after measles-mumps-rubella vaccine in infants with colds

Measles outbreaks in the United States, 1987 through 1990

Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age.

Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis

Vitamin A for treating measles in children.

Measles Outbreak in a Highly Vaccinated Population – Israel, July-August 2017.

Vaccine associated measles in an immunocompetent child

Partial third nerve palsy after Measles Mumps Rubella vaccination

Measles outbreak in a vaccinated school population: epidemiology, chains of transmission and the role of vaccine failures.

Erythema Multiforme Following Live Attenuated Trivalent Measles-Mumps-Rubella Vaccine

Post-vaccine measles in a child with concomitant influenza, Sicily, Italy, March 2015.

Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013

Measles Pneumonitis Following Measles-Mumps-Rubella Vaccination of a Patient with HIV Infection, 1993

Bilateral acute profound deafness after MMR vaccination–report of a case

Pancreatic pseudocyst after measles, mumps, and rubella vaccination

Seizure Risk with Vaccination

A longitudinal cohort study of childhood MMR vaccination and seizure disorder among American children

Measles virus for cancer therapy

For more studies, please visit the Vaccine Studies Page.