HEALTH  UPDATES

Measles Cases and Outbreaks.  What to know.  Updated on November 22, 2024. Starting 11/8/2024, CDC will update this page every two weeks.

History of measles cases..  Measles was officially eliminated from the United States in 2000, meaning no measles spreading within the country and new cases are only found when someone contracts measles abroad and returns to the country.  Achieving measles elimination status in the United States was a historic public health achievement.  

Measles cases in 2024.  As of November 21, 2024, 280 measles cases were reported by 32 jurisdictions:  Arizona, California, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, New York City, New York State, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, Wisconsin, and West Virginia.

There have been 16 outbreaks, 3 or more related reported cases, in 2024.  70% of cases, 197 of 280 outbreak-associated.  During 2023, 4 outbreaks were reported, with 49% of cases, 29 of 59 outbreak-associated.

MMR vaccine coverage for kindergarteners by school year (2009–2024).  The measles, mumps, and rubella, MMR, vaccine is very safe and effective.  When 95% of people in a community are vaccinated or coverage >95%, are protected through community immunity or “herd immunity.”

Vaccination has decreased from 95.2% during the 2019–2020 school year to 92.7% in the 2023–2024 school year, leaving approximately 280,000 kindergartners at risk during the 2023–2024 school year.  

At local levels, vaccine coverage rates may vary and pockets of unvaccinated people can exist in states with high vaccination coverage.  When measles gets into communities of unvaccinated in the United States, outbreaks can occur.

Measles cases surge worldwide, infecting 10.3 million people in 2023.  Release:  For immediate release: November 14, 2024.  CDC Media Relations.  media@cdc.gov.  https://www.cdc.gov/media/.  14 November 2024 | Atlanta / Geneva.  Worldwide, there were an estimated 10.3 million cases of measles in 2023, a 20% increase from 2022, according to new estimates from the World Health Organization, WHO, and the U.S. Centers for Disease Control and Prevention, CDC.  Inadequate immunization coverage globally is driving the surge in cases.

Measles is preventable with two doses of the measles vaccine; yet 22 million children missed their first dose of the measles vaccine in 2023.  Globally, 83% of children received their first dose of measles vaccine last year, while only 74% received the recommended second dose.

Coverage of 95% or greater of two doses of measles vaccine is needed in each country and community to prevent outbreaks and protect populations from one of the world's most contagious human viruses.

"Measles vaccine has saved more lives than any other vaccine in the past 50 years.  The number of measles infections are rising around the globe, endangering lives and health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.  “The measles vaccine is our best protection against the virus, and we must continue to invest in efforts to increase access” CDC Director Mandy Cohen said.

An unacceptable death toll due to rising measles cases.  New data shows an estimated 107,500 people, mostly children younger than 5 years of age, died due to measles in 2023.  Although an 8% decrease from the previous year, too many children are still dying from this preventable disease.  This slight reduction in deaths was mainly because the case surge occurred in countries and regions where children with measles are less likely to die, due to better nutritional status and access to health services.

Even when people survive measles, serious health effects can occur, some of which are lifelong. Infants and young children are at greatest risk of serious complications from the disease, which include blindness, pneumonia, and encephalitis, an infection causing brain swelling and potentially brain damage.

VARIANT  UPDATES

3 Things to Know About XEC, the Latest COVID Strain.  Family Health.  November 22, 2024.  [Originally published: Oct. 1, 2024]  Updated: Nov. 22, 2024.  Experts discuss this new, highly transmissible variant.  A new highly transmissible SARS-CoV-2, Omicron strain coronavirus subvariant, XEC, has been spreading in the United States.  XEC first appeared in Germany in June 2024 before spreading rapidly throughout other parts of Europe.

Experts say it could become the dominant SARS-CoV-2 strain in time for winter, when. 

COVID-19 infections and hospitalizations tend to peak.  The good news is there is no evidence that XEC causes different symptoms or more severe disease than other recent strains.

Late November, XEC was responsible for 38% of COVID infections in the U.S., the second most prevalent strain here, rising from seventh place at the end of September, according to a Centers for Disease Control and Prevention, CDC, estimate at the time.  It lags behind Omicron KP.3.1.1, which accounted for 44% during the same time frame.  KP3.1.1 infections have slowed, while XEC infections are rising, according to the agency.

The XEC strain is rising at a time when people are getting the updated 

2024-2025 COVID vaccines that became available in the U.S. in August.  Doctors are encouraging everyone ages 6 months and older to get vaccinated with the updated shot for protection against the virus.

How is XEC different from other recent COVID strains?  One distinguishing factor is that XEC is a recombinant strain or a hybrid resulting from a merger and rearrangement of two pre-existing COVID subvariants:  Omicron KP.3.3, a descendant of the FLiRT variants, and KS.1.1.  Such a merger can occur when one person is infected with two different strains.

The XEC strain has at least one new mutation beyond the two strains in its spike protein.  Omicron and its subvariants have generally caused milder disease than strains that surfaced early in the pandemic, such as Alpha and Delta and symptoms haven’t changed. 

Will the 2024-2025 updated COVID vaccines protect against XEC?   Vaccines are expected to work well against XEC and other variants that are rising and could be predominant in the future, such as MC.1, according to the CDC.  The MC.1 strain, a descendent of KP.3.1.1, only accounts for 6% of cases, it has caused a growing number of infections as well.

The newly updated Pfizer and Moderna mRNA vaccines, designed to target KP.2, dominant this past spring and the latest Novavax vaccine that targets an earlier strain, JN.1, should also provide protection against XEC. 

What steps can a person take to avoid an XEC infection?  Get the updated vaccine.  The summer surge appears to be winding down, and a winter wave of COVID cases expected.

It is recommend getting vaccinated by October at the latest, to have peak immunity during the holidays, when there's a lot of travel and mingling with family, most often indoors where the virus can spread more easily.

Also recommended, taking the usual precautions to avoid a COVID infection, such as staying away from people who are sick, wearing a mask in crowded indoor spaces and following other recommendations provided by the CDC.

The CDC also advises, if you test positive for COVID, antivirals such as Paxlovid are recommended and available by prescription to anyone ages 12 and up, depending on their risk of severe illness from COVID.  It is most effective when taken within the first few days of developing symptoms.

VACCINE  UPDATES

What to Know About the Updated 2024-2025 COVID Vaccines.  Family Health.  October 24, 2024. [Originally published: Aug. 27, 2024. Updated: Oct. 24, 2024.]  Three new shots are expected to protect against Omicron subvariants that are circulating right now.

Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.                                                                                                                                                                      

Summer 2024, the newly updated COVID vaccines became available for the fall and winter months, a time of year when respiratory illnesses can overwhelm hospitals. The new shots are expected to provide protection against severe illness, hospitalization, and death related to COVID.

The Centers for Disease Control and Prevention, CDC, recommends:

• Everyone, ages 6 months and older get one of the updated vaccines.
• Pfizer’s and Moderna’s updated mRNA vaccines were fully approved in mid August for everyone ages 12 and older
• Each has a Food and Drug Administration, FDA, emergency use authorization, EUA for infants and children ages 6 months through 11 years.
• The mRNA vaccines target a SARS-CoV-2 strain called KP.2.

The FDA authorized an updated COVID vaccine from Novavax for everyone 12 and older. That shot targets another strain, JN.1.  In October, the CDC made an additional recommendation those 65 years and older, and who are moderately or severely immunocompromised, receive a second dose of the vaccine six months after their first dose. The updated recommendation also allows for flexibility for additional doses in consultation with their health care provider.

How is the updated 2024-2025 COVID vaccine different from previous shots?  SARS-CoV-2, which causes COVID, continues to mutate and spawn new strains, making it important to keep up with vaccinations that match the strain that is circulating as closely as possible.  New COVID shots are called “updated” vaccines as opposed to “boosters.”  “Updated” shots are expected to be updated annually, while boosters are additional doses of the same, or previous formula to “boost” immunity.

The COVID vaccine updated in 2023 was aimed at XBB.1.5, an Omicron subvariant that had been the dominant SARS-CoV-2 variant in the U.S. and the world at that time.

How will the updated COVID shots protect me?  The shots aren’t meant to prevent every SARS-CoV-2 infection, the aim is to protect against severe illness, hospitalization, and death.  They also restore and enhance protection from previous shots, which has declined over time.

Avoiding serious illness continues to be a major concern, although infections declined dramatically since the beginning of the pandemic.  There have been periods of upticks in hospitalizations according to CDC data:

• 2023, approximately 916,300 people were hospitalized due to COVID
• 75,500 people died 
• Most of the hospitalized had not received last year’s updated shot,

Studies have shown those 50 or older are more likely to get very sick than younger people.  Those 65 and older have a high risk for hospitalization and death due.   Also at higher risk, anyone who has a compromised immune system or a chronic medical condition, such as diabetes or heart disease.   

In addition, vaccination reduces the chance of suffering the effects of Long COVID, according to the CDC.  Long COVID refers to the wide range of symptoms and conditions, which may last for weeks, months, or even years, that some people experience four or more weeks after an initial COVID infection.

Will the updated vaccines work if new variants emerge?  New strains have emerged already!   

• KP.3.1.1, dominant since August, accounting for 57.2% of cases in mid-October,
• XEC, makes up 10.7% of cases, according to the CDC’s Nowcast, which provides model-based early estimates.
• Both have surpassed KP.3, which overtook KP.2 earlier this summer

The new 2024-2025 shots, the FDA changed course from advising pharmaceutical companies to focus on an updated vaccine aimed at the JN.1 variant, to recommending one aimed at the KP.2 variant, which had been gaining ground.

The monovalent vaccine introduced for the fall and winter of 2023, targeted the XBB.1.5 strain, then JN.1 surfaced with more than 30 new mutations.  In, spite of the large genetic distance between the two strains, the vaccine elicited neutralizing antibodies against JN.1 and was effective. 

How safe are the updated COVID vaccines?  The COVID vaccines remain safe and effective, according to the CDC.  All vaccines have side effects. In most cases, the benefits of the protection against COVID continue to outweigh the risk of side effects from the vaccine.  The important thing is to weigh the benefits of vaccination against the risk of side effects.

One concern has been myocarditis, inflammation of the heart muscle, and pericarditis, inflammation of the lining outside the heart.   In rare cases, these conditions have been observed after vaccination, mostly in adolescent and young adult males.  But research has shown that cardiac complications, including myocarditis, were significantly higher after a COVID infection than vaccination for both males and females in all age groups.

• Anyone can report an adverse event related to a COVID vaccine on the government Vaccine Adverse Event Reporting System (VAERS) site.

Can I get shots for COVID, flu, and RSV (if eligible) during the same visit?  It is safe to get COVID and flu shots at the same time, according to the CDC.  September and October remain the best times for most people to get a flu shot and vaccination continues to be recommended while the flu virus circulates, typically from October through May.

There still isn’t data to say combining a COVID shot with a respiratory syncytial virus (RSV) shot is the best strategy.  RSV, an illness that causes mild cold symptoms in most people but can lead to hospitalization and death in older people and babies.  RSV vaccines were brand new in 2023 for older adults, and are recommended for anyone 75 and older or those 60 and older who are at high risk of severe RSV disease.  A new RSV vaccine also became available last year for pregnant women (who can pass the antibodies along to their newborns).

Who should get the updated COVID vaccine?  The CDC recommends that everyone get one of the updated 2024-2025 vaccines, especially if never received a COVID vaccine: 

• 65 or older,
• are at high risk for severe COVID,
• living in a long-term care facility,
• or are pregnant, breastfeeding, trying to get pregnant, or might become pregnant in the future.

If you have had COVID recently, the CDC advises waiting three months after you recover before getting another shot.

According to the CDC, vaccines are covered by insurance, including private insurance, Medicare and Medicaid plans.  Uninsured children also have access through the Vaccine for Children Program.

Where can I get the updated 2024-2025 COVID vaccine?  To find a location near you that carries the vaccine and to schedule an appointment, go to Vaccines.gov.  You can also call 1-800-232-0233 (TTY 1-888-720-7489).  Be aware that current distribution and insurance issues may delay the availability of the vaccines temporarily in some places.

How to Protect Yourself?  Getting vaccinated is your best bet!

IT’S NOT OVER!

Stay safe.  Mask.  Social distance.  Frequent hand washing.  Avoid crowds

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

• https://www.cdc.gov/measles/data-research/index.html
• https://www.cdc.gov/media/releases/2024/p1114-measles-cases.html
• https://www.everydayhealth.com/lung-respiratory/respiratory-syncytial-virus-vaccine/
• https://www.yalemedicine.org/news/updated-2024-2025-covid-vaccines
• https://www.cdc.gov/media/releases/2024/p1114-measles-cases.html
• https://www.cdc.gov/ncird/whats-new/sars-cov-2-variant-xec-increases-as-kp-3-1-1-slows.html