Measles has been making headlines recently, with 121 cases reported in the U.S. so far this year. To understand the level of concern for myeloma patients, it’s important to put this number into context.
Since 2001, the U.S. has seen up to 220 cases of measles annually, according to the Centers for Disease Control and Prevention (CDC). For example, in the first eight months of 2013, 159 cases were reported, with 157 linked to exposures outside the U.S., primarily in Europe. Since October 2014, more than 300 measles cases have been reported in Germany, linked to visitors and immigrants from Bosnia and the Middle East. In 2001, Germany experienced over 6,000 cases. Other sources of measles outbreaks include China and the Philippines. In the U.S., while the overall vaccination rate is 91%, “pockets” of unvaccinated children can lead to localized outbreaks.
For myeloma patients, vaccination rates are generally high. During the measles virotherapy trial at the Mayo Clinic, which uses a high dose of engineered measles vaccine to treat myeloma, it was noted that most myeloma patients have strong measles antibody levels and don’t need revaccination.
Cases of measles among myeloma patients are extremely rare—I’ve never encountered or heard of one. Even though myeloma patients have compromised immune systems, measles does not seem to pose a significant risk.
Most myeloma patients, particularly those born in the U.S. before 1957, would have received the standard two doses of the measles vaccine, providing 90-95% protection. Because the measles vaccine is a live virus vaccine, revaccination is not recommended for patients undergoing active myeloma treatment. Those on prednisone or dexamethasone should especially avoid measles revaccination.
So, what precautions should be taken? The primary recommendation is to avoid crowded places and daycare centers where unvaccinated children may contribute to outbreaks. While vigilance regarding fever and infection is always important, the risk of measles for myeloma patients remains very low.
