From ND Health and Human Services
Posted 28 days ago in ND Health and Human Services
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Prevention Partnership Providers and Other Immunization Stakeholders
Measles Outbreak Continues
As of February 28, 2025, 146 cases of measles have been identified in Texas. The majority of these cases (116) have occurred in children, 120 have been hospitalized, and all of the cases aside from 5 have been in unvaccinated individuals. The outbreak has spread into New Mexico with an additional nine cases. In the US a total of 164 measles cases have been reported by nine jurisdictions: Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City, Rhode Island, and Texas.
With the measles outbreak in West Texas and Eastern New Mexico, many providers are receiving an increase in calls regarding measles vaccination for adults. The Immunization Unit would like to offer the following recommendation.
Our highest priority group for MMR vaccination is unvaccinated children. Children, especially those under five, have the highest rate of infection, hospitalization, and severe outcomes due to measles infection.
Adults that are inquiring about measles vaccine for themselves should be advised about which category they fall into:
No doses are recommended:
- adults born before 1957 except healthcare personnel*
- adults born 1957 or later who are at low risk (i.e., not an international traveler or healthcare worker, or person attending college or other post-high school educational institution) and who have already received one or more documented doses of live measles vaccine
- adults with laboratory evidence of immunity or laboratory confirmation of measles
One dose of MMR vaccine:
- adults born in 1957 or later who are at low risk (i.e., not an international traveler, healthcare worker, or person attending college or other post-high school educational institution) and have no documented vaccination with live measles vaccine and no laboratory evidence of immunity or prior measles infection
Two doses of MMR vaccine:
- high-risk adults without any prior documented live measles vaccination and no laboratory evidence of immunity or prior measles infection, including:
- healthcare personnel*
- international travelers born in 1957 or later
- people attending colleges and other post-high school educational institutions
- close contacts of immunocompromised people
- people with HIV
People who previously received a dose of measles vaccine in 1963–1967 and are unsure which type of vaccine it was, or are sure it was inactivated measles vaccine, should be revaccinated with either one (if low-risk) or two (if high-risk) doses of live MMR vaccine.
* Healthcare personnel born before 1957 should be considered for MMR vaccination in the absence of an outbreak but are recommended for MMR vaccination during outbreaks.
The VFA program provides MMR vaccine for un/underinsured adults but unfortunately cannot provide vaccine for individuals who are not routinely recommended to receive a dose of MMR, regardless of insurance coverage.
North Dakota residents can check their NDIIS records by following the steps on this webpage: https://hhs.nd.gov/IIR. They should be encouraged to use the online application “Docket” for self-service access to their own records and records for their children under 18 years of age. NDIIS records may be incomplete for individuals who received vaccinations outside of North Dakota, at facilities that do not share information with NDIIS, or who received vaccinations before 1996 when the NDIIS was first available.
Reports of Pediatric Influenza-Associated Encephalopathy
Influenza-associated encephalopathy or encephalitis (IAE), including acute necrotizing encephalopathy (ANE), is a rare and potentially fatal complication of influenza. During late January 2025, the Centers for Disease Control and Prevention (CDC) received anecdotal reports of critically ill children with IAE, including deaths with ANE. In response to these reports, North Dakota Health and Human Services, encourages clinicians to consider IAE in children with influenza and abnormal neurologic signs or symptoms. Influenza vaccination is recommended for all persons aged ≥6 months while influenza viruses are circulating.
Please contact NDHHS if you know of IAE or ANE cases that have occurred in North Dakota that meet the following criteria:
- Age <18 years
- Admitted to an acute care hospital or pronounced dead in an emergency department between October 1, 2024, and May 30, 2025
- Laboratory-confirmed influenza virus infection within 14 days preceding hospital presentation, during hospitalization, or in respiratory specimens collected post-mortem
- Documented neurologic abnormalities (meets one or more of the following):
- Diagnosis of encephalopathy or encephalitis
- Neurologic signs or symptoms including but not limited to seizures, altered mental status, delirium, decreased level of consciousness, lethargy, hallucinations, or personality changes lasting >24 hours
- Neuroimaging abnormalities such as brain edema, brain inflammation, or brain lesions
- Electroencephalogram abnormalities
- Abnormal brain autopsy findings, if available, for children who died
VFC/VFA Enrollment Due Friday, March 13, 2025
Don’t forget to enroll your facility before the due date! Enrollment Signatures can be emailed to vaccine@nd.gov. Please refer to the attached enrollment email for more info.
Educational Opportunities
ND HHS Immunization Unit March Lunch and Learn: New NDIIS Tips and Tricks
- Wednesday, March 12th at 12 PM CST
- Join the meeting now
Registration is now open for the first ever North Dakota Public Health Conference
- May 19 – 21, 2025 in Bismarck, ND
- Register here
The American Cancer Society and the ACS National HPV Vaccination Roundtable invite rural healthcare partners to join a collaborative learning community aimed at connecting partners and improving on-time HPV vaccination rates among adolescents aged 9–13. Attached is a flyer with program details.
- Second Wednesday of every Monday (March – December)
- First session March 12th at 1:00 PM CST
- Register here
A series of six short training videos created by Boost Oregon demonstrate motivational interviewing tools providers can utilize in talking about immunizations with patients. These videos are now available on the ND HHS website at Immunizations - Provider Video Series | Health and Human Services North Dakota.
If you have any questions please email vaccine@nd.gov.
Abbi Berg
VFC/QI Manager