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Healthcare Workers: Immune or Not to Measles? That is the question.

Many people have the attitude that once they receive a vaccine, it is “one and done”--no worries for the future. In fact, around the year 2000, measles was thought to be completely eliminated from the United States (Centers for Disease Control and Prevention (CDC), 2018a). However, measles outbreaks are becoming a nationwide crisis and we now know that some vaccines are not life-long. Healthcare workers need to know what they should do in order to protect themselves against this potentially deadly disease.

How did this happen?


Several emerging problems have developed to create a “perfect storm” for measles outbreak. With our global community, international travel brings unvaccinated individuals from other countries into our country or allows unvaccinated individuals from our country to visit other countries bringing back the disease upon return. Just this past month, UCLA and Cal State at LA had to quarantine students due to this problem (Schwartz, 2019) and just last week, the country of Saint Lucia quarantined an American Scientology cruise ship due to a measles outbreak (Held, 2019).

In addition to this problem, many communities are experiencing lower levels of herd immunity such that those that are not vaccinated can no longer depend on herd immunity to protect them. Measles is a much more contagious disease than many others, such as polio, and even just breathing the infected airspace can spread the disease (CDC, 2018b). Measles requires 90-95% of the community be immunized to provide the correct amount of herd immunity to protect those who cannot be immunized (Oxford Vaccine Group, 2016).

This, in turn, is another problem: those that cannot be immunized; either because they are too young for the vaccine, have contraindications for the vaccine (such as pregnancy) or are immunosuppressed. These groups must rely on herd immunity but when herd immunity is low, this group is automatically vulnerable to obtaining the disease.

Why has herd immunity become so low? Several problems are thought to have contributed. One is that many states have allowed opting out of vaccinations. Some of the reasons can be due to religion, personal preference, or fear of the vaccines. Some adults in their early twenties may not have received vaccination due to the 1998 publication of Andrew Wakefield’s discredited study, linking vaccines to autism (Cunningham, 2019). In addition, some healthcare providers find it difficult to have pro-active vaccination conversations with vaccine hesitant and vaccine resistant parents. One large-scale study of pediatricians, found that there was a significant number of parents who refused vaccines in 2013 compared to 2006, and that there was also a significant number of parents who were dismissed from their practices in 2013 versus 2006 due to vaccine refusal (Hough-Telford, Kimberlin, Aban, Hitchcock, Almquist, Kratz, & O’Connor, 2016).

Lastly, many thought that the measles vaccine they received in childhood would protect them for life. Depending on the vaccination dates, the vaccination may no longer be effective. About 1 million people immunized between 1963 and 1968 were given an inactivated (“killed”) virus vaccine which was found not to be effective (CDC, 2019). In addition, the CDC found that through 1980’s measles outbreaks were still occurring, with the CDC blaming vaccine failure as one of the problems. In 1989, they began recommending two doses for all children, which began to lower outbreak rates through the 1990’s (CDC, 2018a).

What should providers know for their patients?


(Click here for CDC letter to providers)

Should you become immunized?


Healthcare workers are required to know their vaccine history. If there is no written record of vaccination, it is probably best to consult a healthcare provider to determine immunity status. If there is no proof of immunization or a question about immunity status, have a titer drawn to detect immunity. However, if measles is occurring in a community where the healthcare worker resides, they can simply skip the titer and get the measles-mumps-rubella vaccine (MMR). Even if actively immune, getting the vaccine will do no harm (unless contraindicated). Vaccination for healthcare workers (and some other groups) requires two doses of the vaccine separated by 28 days (CDC, 2019). If healthcare providers do not have the vaccine in stock, it can be found at low cost at public health departments or commercial pharmacies. For healthcare workers employed at healthcare facilities, employee health departments may be able to offer titers and/or vaccines at either no cost or low cost. For others, CDC has a vaccine finder widget to help locate vaccine providers within a designated zip code area. The widget can be found here: https://www.cdc.gov/measles/vaccination.html

Click here for References

Sheryl Buckner PhD, RN, ANEF
May 4, 2019
Showcare of Regional Excellence Award

Welcome to Sigma Theta Tau, Beta Delta Chapter-at-Large!


Whether you are a current member or someone that is considering membership, we welcome you. The opportunities to become involved, to grow and develop as leaders, and to contribute to the nursing profession are virtually endless.

Sigma has supported me through scholarships and research grants from my undergraduate education through my doctoral training. In addition, they supported me, along with the CDC, in the development of my immunization website, Nursing Initiative Promoting Immunization Training (www.NIP-IT.org), a website used by over 400 nursing schools across the United States. In addition, I have had the opportunity to meet and work with internationally known nursing scholars. In return, I have enjoyed being actively involved by serving on committees and being an officer within our organization.

Each of you will experience membership in your own way. In fact, Sigma membership is an experience that is yours to design. I hope you will make use of the many opportunities that membership has to offer. Not only do you have the opportunity to be involved locally, but there are opportunities to participate in this global organization on a regional and international level as well.

Dr. Tigges, our International President, calls for Sigma’s vision is to be the global organization of choice for nursing. To do so, we need
• to connect with fellow nurses and partners and work together to share our message, opportunities, and accomplishments.
• to expand our collaborative work with other nurses and partners outside of nursing, so we can more successfully fulfill our mission.
• to serve as a catalyst to bring about, initiate, produce fundamental change.
Our final call is to use our skills as practical, innovative, and visionary nurse leaders to transform global nursing.

If you are a current member looking for ways to become connected, please feel free to contact me (see below). If you are a non-member and already an RN wishing to join Sigma, consider joining as a Nurse Leader. If you are a student who has been invited to Sigma, I encourage you to read this about one new member’s experience to help you make that decision: https://www.reflectionsonnursingleadership.org/features/more-features/if-you-receive-an-invitation-to-join-sigma-say-yes

Whether you are a member or non-member, come to our next meeting and get to know us. We look forward to meeting you!

Sincerely,
Sheryl Buckner PhD, RN, ANEF
President, Beta Delta Chapter-at-Large
sheryl-buckner@ouhsc.edu

Kathy Smith and Sheryl Buckner, STTI Leadership Conference 2018
Kathy Smith and Sheryl Buckner,
STTI Leadership Conference 2018

Chapter News

  • 2020 Partners in Quality Conference

    Each year the Beta Delta at-Large Chapter partners with OU Medical Center and others for the Partners in Quality Conference held in Oklahoma City.

    For more information, go to the Events tab and select the Partners in Quality Conference.
  • Scholarship Deadline

    Are you interested in earning a scholarship or do you have a research project in mind in need of a research grant?

    The October 1, 2019 deadline is approaching quickly!

    See the Scholarships page for more information!
  • Congratulations!

    Congratulations to the winners of the Partners in Quality presentation and poster sessions!

    1st place presentation
    Robyn Reynolds Miller, MS, RN, CCRN, CBE
    What is the Experience of Babywearing a NICU Graduate?

    2nd place presentation
    Vanessa McGuire, BSN, RN
    Decreasing avoidable NICU admissions through the use of hypoglycemia algorithm

    3rd place presentation
    Ingrid Dixon, BSN, RN, IBCLC
    Promoting Responsive Infant Feeding through Maternal Understanding of Newborn Behavior

    1st place poster
    Maureen Mannas, MD
    A Real Pain In The Neck: Combatting Delays In Cervical Spine Imaging Clearance

    2nd place poster
    Lauren Dankwa RN, BSN, APRN-CNS Student
    Clinical Nurse Specialists in Telehealth: Bridging the Gaps in Rural Healthcare

    3rd place poster
    Michelle Pope, MSN, RN, CNP, CNE
    Mitigating Electrical Risk in Neonatal and Pediatric Critical Care Areas

  • Get Involved!

    Are you a member of STTI Beta Delta Chapter-at-Large but haven't been attending meetings?  Now is your chance to meet other members and get involved in the activities of your chapter!

    For the calendar of events for 2018-2019 see the Upcoming Events section.  Make plans now to attend!

    Are you on Facebook or Twitter?  You can follow chapter activities here as well.

University Affiliation

Oklahoma Baptist University
College of Nursing
500 W University Ave
Shawnee, OK 74804 USA


Oklahoma City University
Kramer School of Nursing
2501 N Blackwelder
Oklahoma City, OK 73106 USA

Southern Nazarene University
School of Nursing
R.T. Williams LRC
4115 N. College
Bethany, OK 73008 USA

Southwestern Oklahoma State University

School of Nursing
809 N Custer St
Weatherford, OK 73096-3044 USA

University Of Central Oklahoma
Department of Nursing
100 North University Drive
Edmond, OK 73034-5209 USA

University of Oklahoma
Fran and Earl Ziegler College of Nursing
1100 N Stonewall
PO Box 26901
Oklahoma City, OK 73190-0001 USA