Issue 1748: March 20, 2024

On March 18, CDC issued a Health Alert Network (HAN) Health Advisory Increase in Global and Domestic Measles Cases and Outbreaks: Ensure Children in the United States and Those Traveling Internationally 6 Months and Older are Current on MMR Vaccination. The Summary section is reprinted below.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases and to provide guidance on measles prevention for all international travelers aged ≥6 months and all children aged ≥12 months who do not plan to travel internationally. Measles (rubeola) is highly contagious; one person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact. From January 1 to March 14, 2024, CDC has been notified of 58 confirmed U.S. cases of measles across 17 jurisdictions, including seven outbreaks in seven jurisdictions compared to 58 total cases and four outbreaks reported the entire year in 2023. Among the 58 cases reported in 2024, 54 (93%) were linked to international travel. Most cases reported in 2024 have been among children aged 12 months and older who had not received measles-mumps-rubella (MMR) vaccine. Many countries, including travel destinations such as Austria, the Philippines, Romania, and the United Kingdom, are experiencing measles outbreaks. To prevent measles infection and reduce the risk of community transmission from importation, all U.S. residents traveling internationally, regardless of destination, should be current on their MMR vaccinations. Healthcare providers should ensure children are current on routine immunizations, including MMR. Given currently high population immunity against measles in most U.S. communities, the risk of widescale spread is low. However, pockets of low coverage leave some communities at higher risk for outbreaks.

Access the complete CDC HAN Health Advisory.

Paul “Polio Paul” Alexander, who spent 72 years in an iron lung after being paralyzed with poliomyelitis in 1952 at age 6, died at age 78 on March 11, a month following a hospital stay for COVID-19. A specific cause of death was not provided. The iron lung has long symbolized the terrifying consequences of polio. Patients in an iron lung lie within a sealed chamber containing a mechanical respirator that moves air in and out of their lungs by rhythmically changing air pressure inside the chamber.

As a child, Mr. Alexander developed the ability to breathe on his own for minutes and later hours at a time. But he spent most of each day inside that machine. The Guinness Book of World Records declared him the longest surviving iron lung patient in the world in March 2023.

Mr. Alexander was known for his positive outlook and accomplishments. He earned a law degree from the University of Texas, practiced law for decades, and wrote a book titled Three Minutes for a Dog: My Life in an Iron Lung. In January 2024, he launched a TikTok channel to share his life and accomplishments and to encourage perseverance in the face of disabilities. He had over 300,000 followers at the time of his death.

He was an advocate for vaccination. As CNN noted, in his first TikTok video, he said, “the millions of children not protected against polio. They have to be, before there’s another epidemic.”

Global efforts to eradicate polio through vaccination continue, fueled by hope of consigning polio and its consequences to the pages of history.



Related Links

• New York Times: Lawyer, Author and TikTok Star Spent 72 Years in an Iron Lung (3/13/24)
• CNN: ‘Polio Paul,’ Who Spent Most of the Past 70 Years in an Iron Lung, Dies at 78 (3/13/2024)

Immunize.org updated our patient resource Pneumococcus: Questions and Answers. Answers incorporate recommendations for PCV20 vaccine for children and teens. Information about the CDC PneumoRecs Vax Advisor mobile app was added. This easy-to-use app helps healthcare professionals determine the pneumococcal vaccine doses needed for their patients, in accordance with current ACIP recommendations for children and adults.

Related Links

• Immunize.org: Pneumococcus: Questions and Answers (PDF)
• CDC: PneumoRecs Vax Advisor mobile app
• Immunize.org: Clinical Resources A–Z main page, where you can filter by topic, vaccine, language, or other criteria

Immunize.org recently updated Vaccines with Diluents: How to Use Them to incorporate Valneva's Ixchiq vaccine to prevent disease caused by the chikungunya virus.



Related Links

• Immunize.org: Clinical Resources: Storage & Handling main page
• Immunize.org: Clinical Resources A–Z main page, where you can filter by topic, vaccine, language, or other criteria

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense website.

Older adults are at increased risk of severe influenza and COVID-19 illness, including hospitalization and death, especially if they are not up to date on these vaccinations. An updated fact sheet on the website, The Importance of Preventing Influenza and COVID-19, offers responses to help guide discussions with patients on the importance of preventing influenza and COVID-19.



This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the scope and severity of influenza. Resources include:

In the January 24 issue, Heart published The Role of COVID-19 Vaccines in Preventing Post-COVID-19 Thromboembolic and Cardiovascular Complications. The study included 10.17 million vaccinated and 10.39 million unvaccinated people. Vaccination was associated with reduced risks of heart failure (HF), venous thromboembolism (VTE), and arterial thrombosis/thromboembolism (ATE) after SARS-CoV-2 infection. The effect was greatest for the first 30 days after SARS-CoV-2 infection but persisted for the year after SARS-CoV-2 infection for HF and VTE.

In summary:

• COVID-19 vaccination reduced the risk of post-COVID-19 cardiac and thromboembolic outcomes
• These effects were more pronounced for acute COVID-19 outcomes, consistent with known reductions in disease severity following SARS-CoV-2 infection among vaccinated people compared to unvaccinated people

To see a graphic display of the results, see this figure.

In the January 11 issue, Lancet Respiratory Medicine published The Effectiveness of COVID-19 Vaccines to Prevent Long COVID Symptoms: Staggered Cohort Study of Data from the UK, Spain, and Estonia. The interpretation and added value sections appear below.

Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults. . . .

To our knowledge, this is the first multinational study to assess population-level vaccine effectiveness to prevent long COVID symptoms. Our study of more than 10 million vaccinated people and 10 million unvaccinated people, showed that COVID-19 vaccination reduces the risk of developing long COVID. Our findings were consistent across three different European countries and four databases, covering different health-care settings and national health-care policies. All vaccines reduced the risk of developing long COVID symptoms, with BBNT162b2 [the mRNA vaccine from Pfizer-BioNTech] showing slightly better effectiveness than ChAdOx1 [the adenovirus-vector vaccine from AstraZeneca, not distributed in the United States].