A Pediatrician’s Take on the Measles Outbreak along the Idaho-Utah Border

(POCATELLO, Idaho) —  Dr. Sumaira Arain, an Idaho pediatrician spoke with The Click about the recent measles outbreak near the Idaho-Utah border, She shared what parents need to know about vaccines, symptoms, and protecting their communities. As of October 23, the Utah Department of Health and Human Services reported 58 confirmed measles cases statewide. Meanwhile, Idaho has confirmed three infections. With cases on the rise, public health officials are urging parents to stay informed about vaccination and learn how to recognize early symptoms.

Here’s what Dr. Arain had to say about the outbreak and how families can help prevent further spread. The interview was edited for clarity and length.

The Click: Do families need to worry about their children getting measles if  they are fully vaccinated against the disease? How effective is the vaccine in real-world situations like this?

Arain : The MMR vaccine is quite effective. We typically give two doses the first around 12 months of age and the second at about four years, right before kindergarten. To prevent outbreaks, about 93 to 95 % of the population needs to be vaccinated to maintain herd immunity. Unfortunately, vaccination rates have dropped below that threshold. 

Typically, there’s what we call a “patient zero” an unvaccinated individual who becomes infected and then comes into contact with others who might have waning immunity or may not have received both doses. That’s how the virus begins to spread.

In most cases today, these outbreaks occur in communities where vaccination is intentionally declined rather than because of lack of access. The MMR vaccine has been around since the 1960s and has been proven safe and effective through decades of research. Earlier concerns about a link to autism have been thoroughly debunked by extensive scientific studies. The real issue now is vaccine hesitancy, people choosing not to vaccinate despite its proven safety and availability.

The Click: What symptoms should parents be watching for, and how can they tell the difference between measles and more common illnesses like colds or the flu?

Measles tends to cause a much higher fever, often 101°F or higher. It also includes a cough and runny nose, but what really sets it apart are the conjunctivitis (red, irritated eyes) and the presence of Koplik spots, small bluish-white lesions that appear on the inside of the cheeks, known as the buccal mucosa. These usually show up one to two days before the measles rash develops. The rash itself is the key feature. It’s very distinctive starting on the face and then spreading down to the trunk and extremities. It’s one of those classic signs every physician learns to recognize immediately. When we see a child with that rash in the ER or clinic, they’re isolated right away.

The Click: Sometimes we think of measles as a ‘childhood disease.’ Are adults also at risk in this outbreak, especially if they don’t remember their vaccination status or only had one dose?

Arain: Yes, absolutely. Adults can be just as susceptible as children, especially if they only received one dose of the vaccine or were vaccinated very early in life and have since experienced declining immunity. In fact, adults may face even more serious complications if they become infected. Diseases we often associate with childhood like measles can be more severe in adults because they’re more likely to have other chronic health conditions or weakened immune systems due to age, medications, or other factors.

The Click: Do you think more parents are choosing not to vaccinate their children after the pandemic?

Arain: Yes, a lot of it comes down to where people are getting their information. During COVID, there was an overwhelming amount of misinformation circulating online, what I sometimes call “Google doctors” sharing advice and claims that weren’t backed by medical research. It created a lot of fear and confusion for families who were previously following medical guidance and trusting their pediatricians. Pediatricians genuinely have children’s best interests at heart. We want to see kids grow, thrive, and stay healthy.

I’ve also seen more parents opting for what’s called modified immunization schedules choosing to spread out vaccines rather than receive all the recommended doses in one visit. However, the problem arises when a family can’t return perhaps due to transportation issues or other barriers. That’s when children end up partially vaccinated, which leaves them at risk.

The Click: For parents of children with autoimmune conditions there’s worry about whether their immune systems can mount enough protection. How should families in these situations think about the measles vaccine?

Arain: In general, the biggest concern is for children with severe immunodeficiencies such as congenital immune disorders, HIV or AIDS, certain leukemias or cancers, or those on long-term immunosuppressive therapies like steroids taken for more than two weeks. In those cases, the immune system may not respond fully to vaccination, and physicians have to consider alternative schedules or temporary deferrals until it’s safe to vaccinate. If there’s any uncertainty, physicians can check antibody titers blood tests that measure whether the body developed protection after a vaccine. This helps confirm whether the immune system responded appropriately.