Scott Webb (Host): As you may know, measles has been in the news a lot lately and it's a good time to have an expert on to explain how contagious measles are and how safe and effective the measles vaccine is for kids. I'm joined today by Dr. Brad Scoggins. He's a pediatrician at San Juan Health Partners Pediatrics.

 Welcome to Celebrate Health, a podcast from San Juan Regional Medical Center. I'm Scott Webb.

Dr. So nice to have you here today. We're going to talk measles and what parents need to know, and I know there's been a lot of talk in the news lately about measles outbreaks and anecdotally it feels like it's coming back, but from an expert, is it coming back?

Brad Scoggins, DO: It certainly seems that way and coming back may be a little bit tricky because, you know, we do have outbreaks every few years. I think the most recent notorious outbreak occurred in Disneyland m aybe the late 2010s.

Host: Yeah, it is interesting we say, you know, like, is it making a comeback, so to speak? And as you say, it's happened before, but it just feels like it's very pervasive now in the news and social media and it's just all over the place. And I guess I'm wondering like, how contagious is measles? I feel like it's really contagious, but from you, how much do we need to be worried, especially if we're in the group that's unvaccinated.

Brad Scoggins, DO: Yes, absolutely. Great question. Quite worried actually, if contagion is the question because on the order of contagion, viral disease that we worry about measles is, among the most contagious. But, a single infected person, with active symptoms can infect dozens of others. It's a real worry.

Host: Yeah, it is a real worry. It's a real worry for maybe the really young who haven't been vaccinated or the unvaccinated, schools, churches, whatever it might be. So then, what are the signs and symptoms? Is it, does it mimic lots of other things, cold, flu, RSV, things like that? Or is there anything that stands out in measles where you could say, you know what, that's probably measles.

Brad Scoggins, DO: Well, unfortunately, early in the course of the illness, it looks like everything else. So we always talk about the three Cs, cough, chorizza, and conjunctivitis. So cough is self-explanatory. Chorizza is a, you know, a runny nose and then conjunctivitis is redness and irritation to your eyes. So it would look like most other colds for the first maybe week or so of symptoms. Sometimes we can look for the diagnostic lesions, in the buccal mucosa, so right inside the cheek, called Koplik spots. But those are present, I think in less than 25% of cases, if I remember the numbers correctly. Most people will break out in a rash starting at their head, making its way down toward their feet and spreading out, from the central part of your body to your arms and legs.

That's usually when we can look at a case of measles and say, oh yeah, this is definitely a case of measles.

Host: I guess I'm wondering what do you tell parents about protecting their children from getting measles? I'm assuming you recommend the vaccine, but I don't want to put words in your mouth. What do you recommend?

Brad Scoggins, DO: Absolutely. Uh, measles vaccine is one of the great triumphs of the last hundred years, as far as medicine goes. I'm sure we'll delve into complications and rates of complications of actual wild type measles here shortly. But, the measles vaccine, you may have heard of, two different types of vaccinations.

Sterilizing vaccination is what the measles is, so if we get, a sizable percentage of the population vaccinated, we can stop transmission of measles within our population, which we have been fairly successful at until recently. But yeah, absolutely, getting your measles vaccine at 12 months and again at 48 months or about four years old. Of course,

 where I'm at here in New Mexico, they have recommended that we go ahead and start vaccinating kids as young as six months old, so they get one extra dose, in that six to 12 month age range because we have so much local transmission. In fact, I was skiing with my kids up at Wolf Creek Ski Area

Scott Webb: Hmm.

Brad Scoggins, DO: we got a notification from the public health department that there had been active cases of measles there that day. So I was happy we were vaccinated.

Host: Right. Yeah. And that's the thing when we talk about, you know, measles making a comeback, it's sort of hard for me to wrap my mind around like, how did we get here? I thought measles had, you know, pretty much been eradicated, if you will. And so we're still talking about measles in 2025, and you mentioned there maybe some of the complications or reasons why folks don't have their kids vaccinated. Maybe you can take us through that as best you can.

Brad Scoggins, DO: Absolutely. We choose our experts and we have to do so carefully because there's no way we could possibly know everything. There's been a lot of reports of complications of measles vaccine. Now I'll say I, I've got 12, pediatricians and nurse practitioners, total of 12 people, here in our office, most of us have kids. All of our kids are vaccinated and were vaccinated on the regular schedule. I always joke that my kids are pretty much normal except they're mine even after the measles vaccine.

Host: Yeah.

Brad Scoggins, DO: So, y yeah, as proof of our perception that this is safe. So not only are all of our kids vaccinated, but here in the office, I mean, we give hundreds if not thousands of doses of measles vaccine a year. And I, have yet to see a case of vaccine related illness or injury that has been of any significance more than, you know, muscle aches and pains and maybe low grade fevers.

And that's actually some evidence that the vaccine is working. Of course there are additives in the vaccine that are meant to elicit an immune response because we actually want your immune system to take notice of these vaccine pieces or pieces of virus. In this case, it's a live attenuated virus or weakened virus, but we want your immune system to see it and build antibodies so that by the time you see the real thing, your body just kind of, you know, looks at it and yawns and moves on.

Host: Hmm. Yeah, I sort of feel not being an expert, of course, I feel like between me and my kids, like when you have that, you know, sort of reaction after a vaccination, whether it was COVID, whatever it is, low grade fever, maybe just don't feel great for a day or two. I sort of feel like that's my body saying, oh. I see what's going on here. You've introduced something and you want me to now do something with that. I realize this is entirely lay speak. Uh, but from your perspective, is that what you're saying basically that it's your body's reaction to like, oh, right, you want me to fight off the measles in this case?

Brad Scoggins, DO: Yeah, absolutely. So basically we're anthropomorphizing our immune system here. We're giving it some personality and independent thought. But that's exactly what's going on. And I hear a lot of talk also about the number of vaccines that young children get and, I have two answers to that.

One is that your immune system is constantly under a barrage of more things than you could possibly fathom or count. There are billions if not trillions of bacteria and viruses that live in our GI tract. Another one that gets people's attention is there's an entire area of study in the nasal mucosa with bacteria and viruses we don't even have names for yet.

And there's, again, probably millions if not billions of microbes and a pretty complex genome in that microbiome. So your body is constantly dealing with all of those a ntigens and, and that barrage of activity. So even if we were to put 10 antigens into your body at one time, 10 vaccines, it wouldn't be much of a challenge to your immune system.

The second thing I always tell people is that you're the most vulnerable to the things we vaccinate against at the ages that we give them. So it was not a thoughtless calculation that we put the vaccines where we put them in.

Host: Right. Yeah. In other words, there's a, there's a method to this, right? That there's a reason why kids are given vaccinations at certain ages, that they're on a certain schedule, and even as you say, you know, now the recommendation, as young as six months, they still need to be on their regular schedule, right? They'll still need the other two doses, if you will.

Brad Scoggins, DO: Yes, that's correct. Yeah. So if you get one dose between six and 12 months, it's an extra.

Host: Right. It's just an extra and it's just because we're having this comeback, if you will, of measles. Good stuff today, you know, a lot to worry about as parents, always, measles and otherwise. What final advice do you have, you know, as concerns continue to grow about measles?

Brad Scoggins, DO: Yeah, and particularly as you've said, lots of headlines grabbing our attention right now. I would say by all means, do your research which I, I know is a phrase that gets thrown around a lot, but I would say carefully choose your experts. There's a lot of opinions out there. There's a lot of sort of empiric data, if you will.

So, personal anecdotes, stories from friends. I would just be very choosy with who I get information from. We do see a growing movement of people that are preferring not to vaccinate their children and the people that want alternative vaccine schedules. And unfortunately, that is going to mean a comeback of some of these formerly eradicated Illnesses that cause very significant mortality and morbidity, meaning that you're either dead or, severely disabled. And, I'll leave you with just sort of a, mental image. You know, when I talk to parents who are averse to vaccinating their children; I always describe the scene of what happens at the bedside in the hospital as children are dying or becoming disabled from these infections.

It's so hard to, you know, look a parent in the eye and tell them that's what happened. So, of the options, the safest by far is to get the vaccine.

Host: Yeah. As you say, doing our own research sometimes means, you know, searching the internet, and that's the one of the things, doctor, the, one of the pleasures of my life is that I get to speak to experts like yourself, you know, in this case San Juan Health Partners Pediatrics experts. You know, I put my faith in you and your advice. And of course my kids are older, they've had all their shots, but still, it's just great to hear from an expert, your compassion, your expertise, all of that. So thank you so much.

Brad Scoggins, DO: Well, thank you. Yeah, and we're standing on the shoulders of giants here. I mean, none of us have, done this research, but we've certainly seen the effects. So, it's delightful to talk to you as well, and thank you.

Host: To schedule a vaccine for your child, contact San Juan Health Partners Pediatrics at 56 0 9 6700.

And thanks for listening to Celebrate Health, the podcast from San Juan Regional Medical Center. I'm Scott Webb. Stay well.