Welcome to paging Doctor Gupta. You know, I just got back from West Texas. I was covering the measles outbreak there, and it was really interesting to be on the ground in the middle of all that. There is a sense of frustration among a lot of the citizens, a lot of the health care workers that were experiencing this sort of outbreak at all. I think there are people who are really frightened about what is unfolding, especially people who have members of their family or who they themselves are immunocompromised, and they're worried about contracting measles. And then I think there's a real sense of just trying to figure out what is going to happen next. Like, how much is this measles outbreak likely to grow? We obviously don't know the answers to those questions, but I will tell you that if you talk to health officers on the ground, they will tell you that this outbreak is probably going to last for months, and there's going to be several hundred people, ultimately, who do get the measles. So that's what they're sort of preparing for. You know, we don't talk about measles much anymore. And that's in large part because it was considered eliminated in the United States back in 2000. That means they hadn't seen a new case of measles for many years in the United States. Many of the doctors who are now caring for these patients with measles. This is the first time they've actually seen a patient with measles. So I think that's the source of frustration that these are vaccine preventable diseases. And here we are taking care of them. A big part of the reason why we're seeing an uptick in numbers is because of lower vaccination rates. That's what's allowed these cases to pop up again. And it's also led to a lot of questions. So to start sharing them is one of our producers Kyra. Kyra, what's the first one?

Hey, Sanjay. So Kathleen wants to know why is the vaccination rate so low in that part of Texas and New Mexico?

Yeah, this is a good question. You know, most of the cases are actually occurring in the under vaccinated community, a community which does not traditionally seek traditional health care. It's largely a Mennonite community. It is rural. It is close knit. It is insular. And what we know when we look at the vaccination rates there is that they are close to 82%. That's in Gaines County, Texas, where the epicenter of this outbreak has been, 82%. So that means roughly 1 in 5 incoming kindergartners, for example, did not get the vaccine in that particular area. Many of them, by the way, are homeschooled, so they're not required to get the vaccine as part of attending a public school. But that is typically what you see is that you see pockets of under vaccinated communities versus a broad swath of a population that is under vaccinated. But when you have a viruses as contagious as measles, one of the most contagious viruses that exists on the planet, you can run into problems once you start to drop below sort of 95% coverage, for example. That is one of the big concerns here. Public health officials want the vaccination rates to be above 95% by the time kids are 4 or 5 years old, by the time they start to attend school. That is the number they're shooting for to try and get herd immunity. Nearby counties stand closer to that, not you know, 92, 93%. But again, the under vaccinated communities in this area can have an impact on the community overall. So that is what we're really running into. And it's not just West Texas, not just New Mexico. There are other places around the country where we see this. Back in 2019, I covered a large outbreak that occurred in Brooklyn, New York. There have been outbreaks in Minnesota. There was an outbreak in Disneyland in Southern California. So it's not just West Texas, but what I just described is typically what drives at least the initial outbreak. And then it just grows from there. Okay, Kyra, what's next?

Next, Elizabeth said I'm 72 years old and had measles as a child, but I don't remember children dying from this disease. So has measles become more virulent?

Yeah, Elizabeth asks a really important question for a lot of people. Again, they never seen measles or they don't remember how bad it once was. The virus has not become more virulent. In fact, the measles virus has stayed pretty stable over the decades. Unlike flu, which shifts and drifts every year, or Covid, which has a lot of mutations. Measles has been pretty stable, and the average complications of measles or the death rates occurred just infrequently enough that the average person may not have been aware of them even before widespread vaccination. So if you go back to the mid 60s, early 70s, when we really started to vaccinate robustly in the United States, there are about 400 to 500 people dying a year. Those numbers had come down from the decades earlier, in large part because of better medical care. We could treat medical care better, but then 400 to 500 people were still dying every year. A lot of people were ending up in the hospital, a lot of people getting sick. If you looked around the world, measles would typically claim around 2.5 million people every year, sadly, 2.5 million people would die. These days, the comparative figure is closer to 107,000 measles deaths every year, and those typically occur in countries with low vaccination. So, you know, that's really what you have to sort of keep in mind. A few hundred people were dying every year before vaccination and after vaccination, there were just a few people, period, dying in the United States every year. So, Elizabeth, it should not be surprising that maybe you did not know people dying of the disease, but it was happening. And because of vaccination, those numbers have come down very, very significantly. There are many vaccine preventable diseases out there. Measles is one of them. And the vaccines really do work. They've been around a long time and they've made a huge difference.

Okay. Coming up after the break, a question a lot of you've been asking if you got the measles vaccine as a child, are you still protected?

Okay, Kyra, who's paging us next?

So, Sanjay, a lot of people actually had this question, including Mary, and she asks: I'm 59 years old. Does the measles vaccine I got as a child still protect me now?

So, Mary, the short answer to the question is yes, you should still be protected now. Measles vaccine is typically two doses, one dose around a year of age or so, and the second dose before you start school, so 4 to 5 years of age. One dose usually is about 93% effective against measles. Two doses, 97% effective. You've probably heard those numbers. But the number you may not have heard, and this sort of answers your question, is that less than 1% of people who receive those two vaccines will have waning immunity to measles to the point where they are now susceptible to infection. You know, you make antibodies in response to the vaccine. Again, most people, they will maintain those antibodies. You'll still have antibodies years, decades later. But less than 1%, those antibodies do tend to wane. One thing I'll point out a little nuances that the first version of the vaccine came out in 1963, and that version was used until 1968. So many people like Mary and myself for that matter, probably got that first version of the vaccine. The CDC does recommend the people who got the first version of the vaccine get at least one dose of the newer MMR vaccine. Now, if you're wanting to be sure before you do that, you can get your titers checked. It's a blood test and it basically is checking for your antibodies against measles. I actually had that done recently, because working on a documentary about transplant surgery, and as part of being in the operating room with these immune compromised folks, they wanted to make sure that I was still protected against measles. I had my titers checked. I'm in my mid 50s now and my titers were fine. So if you're curious, if you're worried, if you just want to make sure you can get that blood test done. And also, you know, people who have weakened immune systems, they may in particular want to get this checked out. Okay, we got time for one more question. Kyra, what's the last one?

Alright, this one's coming from Laura, who asks, should my two year old grandson get his second dose of the measles vaccine now? Instead of waiting until he's 4 like he normally would.

Okay, this is a question that I heard a lot, even when I was on the ground in West Texas. Again, first dose 93% effective, second dose sort of boosts your immunity to 97% protection. The reason that the vaccine schedule exists the way that it does in the United States, which by the way is different than a lot of other countries around the world. But that first dose given again around a year of age, and then the second dose was to be given before kids start school. So around 4 or 5 years of age, because most kids start school shortly thereafter. Now, Laura did not share where her two year old grandson lives, but if he lives in the midst of a measles outbreak such as Gaines County, Texas state health officials are now recommending that children over 12 months who have received one dose now get their second dose as soon as possible. Again, the normal vaccination schedule would be for Laura's grandson to get that second dose of 4 to 6 years of age. But where an outbreak is occurring, the thinking is let's increase the measles immunity and prevent more occurrence of the disease as much as possible. Now, if your grandson, Laura, or if anybody who's listening, this child does not live in one of the communities impacted here, then waiting for that second shot until 4 to 6 years old is fine. Again, there are countries around the world where they say get a shot at 12 months of age and another shot at 18 months of age. There's no harm in advancing the timing of that second shot. But the reason they wait is they want to make sure it's given as close to the time is when they're starting school as possible. So bottom line, the most important thing is to be fully vaccinated, because getting that second shot does boost your immunity even more. And it's really important to be thinking about these things, especially when you're in the midst of a measles outbreak. So, Laura, thank you for that question.

'And that is all for today's episode. You know, we've only been doing this for a few weeks now, and so many of you are sending in questions. I had no idea there were so many questions out there about these topics. So keep them coming in. Do you got a health question? I want to hear it. Record a voice memo. Email it to asksanjay@cnn.com or give us a call (470) 396-0832 and leave a message. Thanks so much for listening and I'll be back next Tuesday.

Chasing life is a production of CNN Audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, Grace Walker, Lori Galaretta, Jesse Remedios, Sofía Sánchez, and Kyra Dahring. Andrea Kane is our medical writer. Our senior producer is Dan Bloom, Amanda Sealey is our showrunner, Dan Dzula is our technical director, and the executive producer of CNN Audio is Steve Lickteig. With support from Jamus Andrest, Jon Dianora, Haley Thomas, Alex Manasseri, Robert Mathers, Leni Steinhardt, Nichole Pesaru and Lisa Namerow. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Katie Hinman.