February 5, 2019

Dear Blue Fish Parents,

As you may know, Houston is now dealing with the beginnings of a measles outbreak. Five cases have been confirmed as of February 4, 2019.

Measles is a highly contagious disease caused by a virus. It spreads through the air when an infected person coughs or sneezes. Measles starts with fever. Soon after, it causes a cough, runny nose, and red eyes. Then a rash of tiny, red spots breaks out. It starts at the head and spreads to the rest of the body.

It is important to recognize that fever and rash are extremely common in children and the vast majority of fever/rash cases will not be measles.

Blue Fish Pediatrics has a patient population that is highly compliant with the CDC vaccine schedule and as such, most of our patients should have excellent protection and are at low risk for acquiring measles.

Per the CDC, two doses of the MMR (Measles/Mumps/Rubella) vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

You can check your vaccine record via your patient portal. If you follow our recommendations, we give the first MMR at the 1yo check-up and the second MMR at the 4yo check-up. Note that the 4yo MMR is typically administered as part of a combination vaccine called Proquad, while the 1yo MMR is not part of a combination vaccine – so they may show up in different parts of your vaccine record.

If you have been notified by the health department that your child has been exposed to a confirmed measles case, we suggest you follow the below protocol:

  1. Schedule your child to come in for an exam and testing at THE END OF THE DAY and please wear an N95 mask for the protection of other people. If you do not have a mask, one will be provided for you. You can purchase these at Home Depot or Lowe’s.
  2. After examining your child, labs may be ordered to test for measles.
  3. If measles is suspected, Blue Fish will contact an infectious disease doctor to help guide treatment.
  4. If labs are ordered, please quarantine your child until results come back.

At Blue Fish Pediatrics, as noted above, we follow the CDC recommendations for the MMR vaccine which is given twice: the first at the 1yo check-up and the second at the 4yo check-up (as part of the Proquad vaccine).

If you are concerned about the measles outbreak and you would like to proactively make sure your child’s MMR vaccine coverage is optimal, below are some options:

  1. If your child is under 6 months of age: MMR is not recommended.
  2. If your child is 6-12 months of age: an early MMR dose can be given for protective purposes but it will not count towards the completion of the MMR series and the normal 1yo and 4yo MMR vaccine should still be given in the future. Unless you have concern for exposure to non-vaccinating populations, at this time, this vaccine is not warranted by current CDC recommendations.
  3. If your child is 1-4 years of age: two doses of the MMR vaccine, separated by 28 days can be given. Typically the two doses are given at the 1yo and 4yo check-up; however, the 2nd MMR dose can be given early. If the 2nd dose is given early it does satisfy CDC criteria for future school enrollment. Unless you have concern for exposure to non-vaccinating populations, at this time, this vaccine is not warranted by current CDC recommendations.
  4. If your child is over 4 years of age and two doses have been given, no further MMR vaccines are recommended.

If you desire to have an MMR vaccine based on the above recommendations, please contact our office.

Please note that an MMR vaccine given outside of the normal CDC schedule may not be covered by your insurance and there may be a separate charge; however, thus far this has not been our experience.

To find out more about measles, please visit the CDC Measles FAQ page at www.cdc.gov/measles/about/faqs.html

Please let us know if you have any questions.


Blue Fish Pediatrics