MMR vaccine is critical, but not to help with COVID
DEAR DR. ROACH: We have friends who got the measles-mumps-rubella vaccine believing it will help with exposure to COVID-19. What are your thoughts on their thinking? -- P.H.
ANSWER: The World Health Organization has reported an increase in measles deaths since 2016, and that trend has accelerated in the past year. The COVID-19 pandemic certainly is having an effect on measles vaccination, and with a drop in vaccination comes a loss of herd immunity, meaning that a measles epidemic could spread in the population. Mumps and rubella are important too, but measles is incredibly infectious, far more so that COVID-19. And it is fatal in perhaps 1 case in a thousand. At a global level, getting children immunized against measles remains critical.
A study published in November 2020 showed that people with high antibody titers to mumps had less severe COVID-19 symptoms than those who had low antibody titers. It's possible that people with generally strong immune systems, as evidenced by high titers to mumps, will have better outcomes if infected by COVID-19, rather than it being a specific effect of mumps antibodies. The authors of the paper do not currently recommend booster shots for MMR.
At the time of this writing, several COVID-19 vaccines have been shown effective and at least two have been approved by the Food and Drug Administration in the U.S.. I suspect that they will be in the process of being given to the highest risk groups on the day you are reading this. They are much more likely to provide protection than an MMR booster, in my opinion.
DEAR DR. ROACH: I have a pink rash of only three spots on my upper, inner left arm with skin sensitivity and some pain in the area. A couple of weeks ago, it was a paler rash, with less defined spots and discomfort that felt like there was glass there. I am a female in my 70s and have had both shingles shots. I wonder if this could be a mild case of shingles. -- S.H.
ANSWER: Shingles is caused by a recurrence of the chickenpox (varicella-zoster) virus. It is restricted to one side and one body area. In fact, the word "shingles" is thought to come from the Latin word "cingulatum," or belt, reflecting the distribution of lesions along a narrow pathway on the body. People who have had the vaccine may get a very mild case, so your thinking is quite reasonable.
The classical appearance of a shingles lesion, just like for chickenpox, is a blister filled with clear fluid on reddened skin. If you see a doctor at the time you have the rash, the laboratory can make the diagnosis of varicella-zoster virus for certain.
However, I don't think it is shingles. The lesions in shingles are crusted over within seven to 10 days, and your rash has been there, even if paler and less defined, for three weeks. There are too many other possibilities to name, but if it continues to bother you, a visit to your regular doctor or a dermatologist should get you the answer.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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