Today I write to you with the first update since beginning antibody testing where I feel truly empowered by data, instead of drowning in it or just bewildered by it. What I'm about to share is not—I repeat, NOT—going to change precautions, safeguards, or reduce your risk of getting CoVID-19. But for the first time, we have signs that a relatively low-risk action may decrease our risk of serious illness or death if infected with SARs-CoV-2, the virus that causes the disease known as CoVID-19.
We all have watched with hope and Olympic-level head scratching as kids and teens are largely spared from the most serious consequence of CoVID-19: death. There have been many theories, but most would settle on some benefit due to the current immunization schedules.
In a paper submitted to Dr. Fauci and NIAID in March, and updated in May, several researchers from world.org describe powerful evidence that the MMR vaccine confers protection against severe disease and death from CoVID-19. This is correlative data, based on well-established, published epidemiological data.
What does this data mean for us? Well first, MMR immunity does NOT protect you from getting CoVID-19 (read that aloud if you need to) – it changes nothing about the urgent need to social distance, mask, hand-wash, and quarantine. But beyond that, understanding what MMR immunity CAN do for you requires some background. And some action.
Are you a skimmer? Here are the essentials.
New and emerging research suggests that MMR (Measles, Mumps, Rubella) immune status appears to correlate with a patient's ability to recover from CoVID-19. Higher MMR vaccine use has reduced some countries' rates of death (but not rate of infection).
MMR immunity does not mean immunity to CoVID-19 and does not reduce your ability to contract or spread CoVID-19. Those with MMR immunity (such as a recent MMR booster shot) should not change precautions and must continue vigilant social distancing, masking, and hand-washing.
Call our office at 610-363-0100 to request a blood test to check MMR status, or to request an MMR booster series. Both can be done in our outdoor tent (no need to come inside). Some patients are not eligible due to contraindications.* Insurance coverage will vary; we'll help you determine out-of-pocket expenses.
First, background. MMR stands for Measles, Mumps, and Rubella. This vaccine protects against three of the most highly contagious viruses known. It was introduced in 1971. Recently, we have seen more outbreaks of measles and mumps as some people and communities withhold this vaccine. This discussion is for a different time. Suffice it to say, for those that ascribe to science, any theory that MMR leads to autism has been debunked repeatedly and for a very long time. If you are fuming mad at this statement, please stop reading now.
Scientists have now compared death rates from CoVID-19 in countries that had robust booster programs for MMR, against countries that had not. It turns out that some of the countries with the LOWEST death rates had the highest MMR booster rates, and vice versa.
For example, Madagascar, a country of 26 million people, vaccinated 26% of its population against MMR in 2019 and already had a high rate of immunity to MMR. They have had ZERO deaths. Hong Kong did the same in 1997 for all 19 year-olds, and continued an aggressive schedule of immunization into 2020. Despite being 500 miles from Wuhan, the epicenter of CoVID-19, they have had just FOUR deaths.
On the other end of the spectrum, Belgium, with a population 54% higher than Hong Kong’s had nearly 8,000 deaths. They had not begun giving two doses of the combined vaccine until 1995. Italy, the European country with one of the lowest rates of MRCV (measles/rubella combined vaccine) has, as we all know, one of the highest death rates.
Lastly, consider the USS Roosevelt. Of the 1,102 on board that tested positive for CoVID-19, only 7 had been hospitalized with ONE death. The US military gives all new recruits MMR regardless of immunization history.
Twelve days after this paper was submitted, Cambridge University scientists released data that pointed to similarities between SARS-CoV2 and Rubella, suggesting the reasoning for the above findings.
Keep in mind that more research is being done as we speak, but these are excellent and reliable sources. There are always confounding variables and questions to work through but here is the kicker: in this particular case, we can take a relatively harmless action that may have a tremendous benefit. As individuals, we can update our MMR status, and we can do it now.
First, this is a good opportunity to remind everyone what the current CDC recommendations are for MMR boosters. Let's review:
Individuals born before 1957 most likely have natural immunity to MMR. Similarly, those who know for certain they had measles, mumps or rubella disease have natural immunity.
Women who have given birth and had evidence of immunity during their prenatal testing or a booster immediately after delivery, are up to date.
Anyone who does not fall into the above — ie, all men born after 1957, and women who have not had titers confirmed in routine prenatal testing (ie never been pregnant) — need evidence of immunity to MMR.
Evidence of MMR immunity can be in the form of documentation in your medical records of two doses of MMR, or serologic evidence (blood test).
Those without evidence of immunity, should consider getting an MMR booster series. This is a CDC adult immunization schedule recommendation. Exceptions are pregnant patients, those with blood disorders, and the immunosuppressed. After one dose, 93% of complete immunity is achieved. After two doses, 97% is achieved. It takes about 10-14 days after immunization to have detectable titers. And while there is little harm to getting a booster even if you have MMR immunity, people who are already MMR immune may have a local reaction (redness, swelling etc.).
The CDC recommendation is completely independent of the above information about MMR and CoVID-19.
Now, about the action. I am encouraging all patients to have a discussion with your provider and take one, or both, of two potentially beneficial steps:
A C T I O N S T E P S:
1) Check your MMR immune status with a simple blood test. We can do this here at the office as an outdoor tent service (you don't have to come inside the office). Simply call us (610-363-0100) to set up an appointment. If you are immune to MMR, a booster is not needed and would not offer any additional protection. It is presumed that patients born before 1957—pre-vaccine era—would have been exposed to measles and have natural MMR immunity. However, even those born prior to 1957—especially healthcare workers—should check their status.
2) If you are not MMR immune, and do not have any of the contraindications* listed, I would get an MMR booster series. This can also be done in our outdoor tent – no stepping foot inside the office. Many people will get MMR boosters during their lifetime. If you were going to do it at some point, this is the time. This is the moment.
Of course, every vaccine has the POTENTIAL for side effects. It all comes down to weighing the risks (less than 1% chance of reaction) against the benefits. Every individual has to do that math for themselves. Just, please use actual science to decide. Financially, some insurances are covering testing but not boosters, and some are covering boosters but not testing. Check with yours. Medicare does not cover it. In our practice, we will let you know the potential out-of-pocket costs for testing and MMR immunization if not covered by insurance.
*Patients who are pregnant or unsure of pregnancy status, those with blood disorders, and the immunosuppressed, would not be candidates for the MMR booster, but we can still check your MMR immune status. Call us to discuss your situation individually.
Now, what about the fact that this is all new, and only correlated data? Well, it wouldn't be the first time I went first, and it won't be the last. But the thing is – I'm not going first. The MMR vaccine has been protecting patients since 1971. There is an extremely low risk of harm, a benefit even absent the CoVID connection, and the worst-case out-of-pocket cost is hovering around $90 per dose, which most people would have spent on this at some point anyway to update their vaccines before travel or other occasions. This is one of those true, rare, "why-not" moments in the medical field. And I'm so glad research has revealed its potential to help this crisis.
Finally, there are a few last things I need you to hear again.
1) MMR immunity has NOTHING to do with immunity to Coronavirus. It does not make you less likely to get CoVID, it is not an antibody for CoVID, and it does not make you less contagious if you have CoVID. MMR immunity just may afford some protection against the most serious consequences of COVID-19.
2) This layer of protection does nothing to help your neighbor. You are just as able to spread Coronavirus to others, and no actions should change when it comes to social distancing, masking, hand-washing, or quarantining at home. The biggest risk of celebrating personal CoVID victories—antibodies, MMR immunity, or anything else—is that we will ease-up on precautions and expose those who are still just as vulnerable.
3) Patients with ANY signs of sickness must stay home. No exceptions.
I look forward to a flurry of phone calls and portal messages, and my staff is already preparing. If you have an appointment coming up for something else, ask about MMR at that appointment and we'll gladly handle it while you're here. The time to act is now.
This past Thanksgiving, I hosted 22 people for dinner. A few days before, I opened the fridge and almost died. It was disgusting – three different jars of pickles each with ONE sorry spear, a jug of OJ with literally ¼ of a cup at the bottom, and countless old Chinese food containers (when you can’t tell if it was rice or broccoli, it has been there way too long.) So, I chose that time to clean it out. It needed to be done weeks before, but faced with the holiday, it became imperative. There was a need, there was NO harm, AND the timing could not have been better.
Think of it like that.
See you soon,
Christine & Team