There is currently an outbreak of measles in mostly unvaccinated individuals in several states in the United States (including a large outbreak in western Texas and surrounding states). As of April 19, 2025, Virginia also has its first reported case of measles, in a 3 year old, details here (The Virginia Register) : "A child is the state's first confirmed case of measles among Virginia residents, the Virginia Department of Health said Saturday. While the agency did not release specifics about the child's identity or where they live, it did say the child was under four years old and lives in the northwest portion of Virginia. It also said VDH was coordinating efforts to identify anyone who could have been exposed by the child and their family. The child had recently travelled internationally, VDH said. Specifically, the agency is looking for anyone who may have been at the following locations earlier in the week: Kaiser Permanente Caton Hill Medical Center, Advanced Urgent Care, located at 13285 Minnieville Road in Woodbridge on Tuesday, April 15 from 10 a.m. to 1:30 p.m.; or Kaiser Permanente Fredericksburg Medical Center, Pediatrics Department, located at 1201 Hospital Drive in Fredericksburg on Wednesday, April 16 from noon to 5 p.m. 'This first case of measles in Virginia this year is a reminder of how easily this highly contagious disease can spread, particularly with international travel,' VDH State Epidemiologist Dr. Laurie Forlano said in a statement. 'Vaccination remains our best defense against measles and is safe and highly effective at protecting people and preventing outbreaks. We urge Virginians, especially those planning to travel, to check their vaccination status, talk to their health care provider, and get the MMR vaccine if needed.' " The Centers for Disease Control (CDC) website is only being updated weekly at this point, so please check the Virginia Department of Health (VDH) for the most up-to-date information in our area , as well as national news or local health department websites for the latest information on case numbers for each state. The Healthy Children website has a comprehensive description of measles and the vaccine schedule for children here. Remember that the measles vaccine is extremely safe and protective. However, it is a live attenuated vaccine and so some who are immunocompromised or pregnant cannot get the shot (if they were not immunized previously). Also, the first dose is typically administered at 12 months of age, so most infants are at high risk for getting infected. Infants, other unvaccinated, and immunocompromised individuals all rely on herd immunity to keep them safe, so it is important to keep communities protected against measles to protect everyone. When herd immunity drops below 95%, outbreaks are likely to happen once someone with measles enters the community (often from international travel). Some measles facts: Measles is considered one of the most infectious diseases (airborne) on earth. If 10 unvaccinated people are exposed to someone with measles, 9 will get infected. It can also make children very sick - for people without immunity, 1 in 5 will be hospitalized, 1 in 20 will develop pneumonia (the most common way measles kills young children), 1 in 1000 will develop encephalitis (infection of the brain, sometimes causing permanent brain damage), and 1-3 in 1000 will die. It can cause “immune amnesia,” where the immune system loses its ability to fight other viruses that people were previously immune to. Children are normally vaccinated against measles with the Measles, Mumps, Rubella (MMR) vaccine at 12 months and again at 4-5 years of age, but can get an accelerated schedule in case of outbreaks. Accelerated schedule in case of community outbreaks: Extra dose for 6-11 month old infants , with second dose at 12+ months of age (28+ days after the first dose) For children who have only had the 12 month dose , they can get their second dose of vaccine 28+ days after the first dose. The vaccine is fully protective approximately 10-14 days after administration (93% protection after 1 dose, 97+% protection after the second dose.) People born before 1957 might not require vaccination because measles was so widespread in the mid-1950s and earlier, it is assumed that everyone already had the disease and has natural immunity. However, during an outbreak it might be worth checking immunity (IgG to measles) or getting an MMR booster, particularly if you are a healthcare worker. People born between 1957 and 1968 may have gotten only 1 dose of killed measles vaccine (less effective than the current vaccine) and should check immunity (IgG to measles) or get an MMR booster if they have not previously gotten a second shot. Because MMR is a live attenuated virus vaccine, those who are pregnant or significantly immunocompromised cannot get the vaccine. Find more measles information at HealthyChildren.org . More links: ~ What to Know During a Measles Outbreak: FAQ, from UVA Health ~ Vitamin A Can't Prevent the Measles, from UVA Health ~ Measles: Separating fact from fiction, from Sentara Hospital Also please review this PDF from The Unbiased Science Podcast for more detailed information about measles immunity (a special thank you to @unbiasedscipod for their generous share of their slides). We will continue to update this site.

With measles on the rise globally, the Centers for Disease Control (CDC) is recommending that all international travelers get 2 doses of MMR (measles, mumps, rubella) vaccine at least 2 weeks before travel. Infants under 12 months old should get an early MMR dose at 6-11 months of age, with a second dose at 12-15 months, and a final dose at 4-6 years of age. Children over 12 months of age should get their first dose immediately, with a second dose 28+ days after the first dose. Teens and adults with no evidence of immunity (written documentation of adequate vaccination, laboratory evidence of immunity, or birth in the United States before 1957) should get their first dose immediately, with a second dose 28+ days after the first dose. Find more information on travel protection at this CDC link:

The original Consumer Reports article about Baby Formula: "We Tested 41 Baby Formulas for Lead and Arsenic" Breakdown and analysis of the Consumer Reports article by Unbiased Science (Dr. Jess Steier, David Higgins, MD/MPH, and Jeff Dewey, MD/MHS): "Should We Cry Over Spilled Baby Formula" Their summary: "What Should Parents Do? If you're currently using infant formula, consider these evidence-based recommendations: 1. Keep perspective: Environmental pollutants are unfortunately widespread in our food supply. The findings don't suggest that formula is suddenly unsafe if it wasn't before. Currently, pediatricians have not encountered an increase in heavy metal poisoning in formula-fed babies. To reduce exposure to heavy metals, if your baby is also on solid foods, offer a variety of fruits, veggies, and grains, and limit exposure to foods that tend to have higher levels of heavy metals, such as rice. (A note from co-author, Dr. Dina DiMaggio: The good news is that the majority of formulas tested at low levels of contamination, and thankfully, although we should always strive to be close to zero contamination, I have never had a baby with arsenic or mercury poisoning throughout my clinical practice.) 2. Check the list (Consumer Reports link above): Most standard formulas tested well, with low or undetectable levels of contaminants. If you're concerned, Consumer Reports published their complete findings, which you can reference. 3. Consult your pediatrician: If you're considering switching formulas, talk to your child's doctor first, especially if your baby is on a specialized formula for medical reasons. If concerned, your pediatrician can guide you on whether a change is indicated and ensure that if you change, you choose a similar type of formula. 4. Never attempt to make homemade formula or change the formula recipe: The risks of improper nutrition including severe health problems and even death far outweigh any potential benefits. Commercial infant formulas are specifically formulated to meet precise nutritional requirements according to strict FDA guidelines, with carefully balanced proteins, carbohydrates, fats, vitamins, and minerals essential for infant development. (One of our co-authors, Dr. David Higgins shared that he has hospitalized several babies whose parents tried homemade formula and sadly even saw one die.) 5. Use clean water: If mixing powdered formula, ensure you're using properly filtered or tested water, especially if you use well water."

Beyfortus (nirsevimab) is an FDA approved and American Academy of Pediatrics (AAP) recommended injection that helps prevent serious lung disease caused by Respiratory Syncytial Virus (RSV) . This monoclonal antibody shot is available for all infants younger than 8 months of age during RSV season (typically October through the end of March). It is also available for some children 8 months to 19 months of age who are at increased risk for severe RSV disease and who are entering their second RSV season. Infants under 8 months of age whose mothers received the RSV vaccine (Abrysvo) during the 32nd-36th weeks of pregnancy should be protected for the season and will not need to get Beyfortus (as long as the vaccine was given 2 weeks before delivery). Because we are no longer in official RSV season, we have stopped giving the immunization at this time (after March 31). If you would like your child to get this recommended immunization this fall, please contact your insurance company to ensure coverage, then, after the summer, call our office at 434-975-7777 to schedule an appointment. At this time, we can only offer Beyfortus at the Charlottesville (Rio Road) office, but hope to offer it in the Crozet office in the future.

The newest COVID-19 Moderna 2024-2025 season vaccine is now available in our offices for all children 6 months old through 11 years of age!

The American Academy of Pediatrics (AAP) just released a new policy and clinical report on PANS. Click here for more information here.

In September 2024, Consumer Reports tested for lead in ground cinnamon products and spice blends that contain cinnamon and found that 12 of 36 products measured above 1 part per million of lead—the threshold that triggers a recall in New York, the only state in the U.S. that regulates heavy metals in spices. The results from the CR study are linked in the NPR article (below) that also discusses the recall of applesauce pouches from October 2023: