The measles epidemic continues to make victims: this time, it is a child of one year and six months, from Constanța, an apparently healthy boy, without comorbidities and immunized at the age of one with a single dose of MMR vaccine. We are therefore talking about a death that normally should not have happened. Two doctors explained to “Adevărul” the possible causes of this tragedy.
Measles is a highly contagious infectious disease. Photo source: archive
“Sometimes we have unrealistic expectations in the sense that any maneuver we perform must be 100% guaranteed to achieve the desired effect. What is false, erroneous”, said family doctor Gindrovel Dumitra, coordinator of the vaccinology group within the National Society of Family Medicine.
Regarding the death situation in Constanța, we are talking about a very rare case, continues the specialist. “We give children the first dose of MMR vaccine at one year and the second at 5 years precisely because the effectiveness, i.e. the number of people who obtain protection from the total number of vaccinated people, is between 95%-96%. After the second dose, we are already talking about a percentage that can even reach 99%. That means that by vaccinating 100 children, three, four, five of them will not develop sufficient protection so that they have 100% defense against the disease. But, after the administration of the second dose, the one from 5 years, this number of children is reduced to one. So, it will remain, however, a child who will not be fully immunized will not get sufficient protection“, said the doctor.
Then, he continues, there are the so-called situations of temporary immunosuppression. “If a child immunized or not against measles gets an infectious disease or receives certain drugs, it is possible that when they come into contact with the virus, they will be in a state where the body cannot produce enough antibodies. When this child has low immunity and comes into contact with a sick person, he risks getting sick too. Even if he has been vaccinated before. Here, therefore, is one more reason for parents to vaccinate their children to protect them and those around them.”
3 out of 10 vaccinated people can get sick
One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps and 97% effective against rubella. Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps.
However, Dr. Emilian Popovici, vice-president of the Romanian Society of Epidemiology, also draws attention, “some people, although immunized with even two doses of the vaccine, can still get measles, mumps or rubella. That, obviously if they are if they are exposed to the viruses that cause these diseases”. Experts aren't sure why this happens. “According to the Centers for Disease Control, 3 out of 100 vaccinated people may get measles after vaccination. But, in general, we are talking about average forms of the disease. Also, the possibility of transmitting the disease in the case of these people is also lower. The reasons? It is possible that the immune system of these patients does not respond as we would like to the stimulus generated by the vaccine. Then these patients may have an immune system that cannot fight the infection,” stated Dr. Emilian Popovici. Regarding the cause of death in Constanța, the epidemiologist is reserved. “Only after an autopsy can we say exactly what happened, what were the real causes of death”.
Romanians, the sick of Europe
Romania ranks first in Europe in the number of measles cases, but the situation is alarming in many countries on the continent. According to the European Center for Disease Prevention, in April the number of illnesses was lower than in March but increased by more than 1,000% compared to the same period last year. Specifically, in April of this year, Romania, Poland and Belgium reported the highest number of cases: 957, 84 and 96, respectively.
Belgium was next, with 76 cases, followed by France, with 71 and Austria with 43. “We are talking about a comparison with countries where prevention is much easier to access. If we look, for example, at Austria and compare the vaccination coverage for a single dose, they are better than us, but not enough!”, states Dr. Gindrovel Dumitra. And one more aspect, ami draws the attention of Gindrovel Dumitra. In Austria, the population accepts the idea of prevention much better. He accepts it and implements it.
The ranking continues with the Netherlands, which in April registered 12 cases, Ireland, with 9 cases, Spain with 8 illnesses and Portugal with seven. Sweden, Lithuania and Cyprus have reported five infections, while Denmark and Greece have reported three cases. In Croatia and Hungary there were two infections, and Estonia recorded only one.
In Romania, according to the National Center for Surveillance and Control of Communicable Diseases within the National Institute of Public Health, between January 1, 2023 and June 2, 2024, 17,378 cases of measles were registered. The most illnesses were reported in the counties of Brasov (2,031 cases), Mureş (1,213 cases) and Bucharest (1,620 cases). Also, 17 deaths were recorded: 4 in Bucharest, 4 in Brasov county, 3 in Giurgiu County, two in Argeş County and one each in Mureş County, Sibiu County, Buzău County and Constanţa County.
The first dose of MMR vaccine is normally given at the age of 12 months, but with the declaration of the measles epidemic on 5 December 2023, GPs can vaccinate babies from the age of 9 months. The second dose of MMR vaccine is given at the age of 5-7 years.
Brits advised not to go on holiday with unvaccinated children
Following outbreaks of measles in Europe, British parents are being urged to vaccinate their children against measles before going on holiday abroad. “If you're going to Europe this summer, don't ruin your vacation by risking your little ones getting sick, which could lead to hospitalization“, Professor Helen Bedford, from University College London, told “The Sun”.
“Cases are increasing in popular holiday destinations such as Spain. “Rmumps is incredibly contagious and can also be very serious, especially in young children and adults. The only way to protect yourself is vaccination. There is no upper age limit to get this vaccine“, warned the expert.
