City speeds up measles vaccinations for migrants as cases continue to rise

In response to a continuing measles outbreak, city officials are speeding up the process for migrants living at a densely populated Lower West Side shelter to become fully vaccinated and protected against the disease.

Previously unvaccinated migrants will receive a second dose of the measles vaccine 28 days after the first dosage, extending a quarantine period for children under age 5 that was instated to monitor and protect the most vulnerable population, the Chicago Department of Public Health said Monday.

There have been 31 confirmed cases of measles in Chicago this year, 21 of which are in children under 5. Seven cases have been reported in the city in the past week despite an initial wave of vaccines administered two weeks ago.

Measles outbreak in Chicago: What to know about the virus

Most of the cases are concentrated in the city’s largest shelter, which houses families and many young children at 2241 S. Halsted St. in the Lower West Side, officials said. There are currently over 23 active shelters run by the city and state, housing more than 10,400 migrants as of Tuesday.

The uptick in confirmed measles cases comes even as the city says it has administered 4,500 vaccines since the first case was detected on March 7. Young children are especially vulnerable to disease after receiving the first dosage of the measles-mumps-rubella (MMR) vaccine, said the city’s health commissioner, Dr. Olusimbo Ige.

“While the MMR vaccine is the best protection against the virus, children are at highest risk for contracting breakthrough measles after receiving one dose of the vaccine, especially those less than 5 years old. We’re seeing some of these cases at the Halsted shelter (on the Lower West Side) which isn’t surprising,” Ige said in a release.

Over the weekend, Lake and Will County reported a measles case in each county. Both were said to have been associated with the outbreak in Chicago.

Symptoms for measles typically occur roughly 10 to 14 days after exposure and can cause a rash and high fever and, in some cases, can cause serious illness in young children, pregnant women and people with weakened immune systems, according to health officials.

While measles is one of the most contagious pathogens, vaccination protects against the disease “in almost every circumstance,” said University of Chicago Medicine pediatric infectious disease specialist Dr. David Zhang.

“There’s a very easy fix and that’s getting vaccinated,” Zhang said. “It starts and ends with vaccination.”

Vaccination can also help protect people who were recently exposed to the disease. If an exposed person receives the first dose of the vaccine within 72 hours, evidence shows that complications could be less severe and less contagious, Zhang said.

Most Americans are protected with the MMR vaccine, which is a requirement to attend K-12 schools in Illinois unless students have religious or medical exceptions or have previously contracted the disease. Students living in temporary housing can also receive exemptions if they have difficulty accessing vaccines.

However, the migrant population is largely from Venezuela, where experts say there is no public health data due to a crippled economy and health infrastructure under the leadership of far-left President Nicolas Maduro. As a result, it is difficult to know exactly how many migrants are vaccinated when they arrive. And many have lost their documentation along their journeys here.

Earlier this month, a report provided to the Tribune by the Chicago Coalition for the Homeless showed that fewer than half of Chicago Public Schools students without stable housing had met all of the district’s immunization requirements. It’s possible not all of those students were missing the measles vaccination, coalition leaders said.

The U.S. Center for Disease Control and Prevention recommends children receive the first dose of the vaccine after they turn 12 months old. Typically, children receive the second dose between the ages of 4 and 6, but it can be given as soon as 28 days after the first dose, according to CDC recommendations.

The shelter where the outbreak occurred houses families and many young children are staying there.

In the days following the shelter’s initial outbreak, the city’s Public Health Department said it vaccinated more than 900 residents in a vaccination campaign that included assistance from the CDC and aldermen. Another 700 migrants were “found to already be immune from previous vaccination or infection,” health officials said.

The city is instructing migrant families to quarantine children ages 1 to 5 eligible for the vaccine until at least 21 days after they receive a second dosage of the vaccine, which means keeping them home from day care or school. That brings the total quarantine time to 49 days after the first dosage for about 50 young children enrolled in early learning programs residing at the shelter, according to the Public Health Department.

Dr. Colleen Nash, chief of pediatric infectious diseases at Rush University Medical Center, said if children or pregnant women didn’t have the vaccine at the time of the infection, they could be at greater risk.

“Those patients, if they are susceptible to infection, might be at risk for more severe infection,” she said.

Medical professionals also warn that quarantine in the midst of an outbreak could put stress on migrant families new to the city.

“They just had a treacherous journey, were put in conditions that may not be familiar, maybe they don’t speak the language, so communicating what’s happening to them, and how it’s happening and what’s happening is really important,” said Dr. Aarati Didwania, an adult physician and associate professor of medicine at Northwestern University Feinberg School of Medicine.

Children in quarantine and exposed patients should also be monitored and assessed, Didwania said, with plenty of medicine and supplies available.

“We also have to make sure we have the medicines to treat some of the symptoms that they’re having,” she said. “Are we taking care of them individually by giving them things like Tylenol and things to make them feel more comfortable?”

Maria Perez, a volunteer with Southwest Collective, passed out milk formula to mothers staying inside the shelter on the Lower West Side on a recent afternoon. She said there is a lot of uncertainty among the asylum seekers.

“It’s not their fault they never got medical attention,” she said. “Now they’re afraid they’re going to have to pay for it … but they’re also afraid of catching it and not knowing what long-term effects it could have.”

While Nash said she hadn’t seen this situation before, she had seen similar outbreaks in different areas of the country.

“With every infection, there will be cases,” she said. “It would be expected and not unusual.”

Nubia Willman, chief programs officer for Latinos Progresando and former director of the Office of New Americans for former Mayor Lori Lightfoot, said that during COVID-19, the mayor’s engagement team administered vaccines in churches and prioritized specific areas around the city with high infection rates.

She said those efforts were localized and done through trusted stakeholders.

“We saw success with COVID, ensuring that we were engaging with communities in a way that (responded to) their cultural identity,” she said. “It’s important that is happening here.”

Willman stressed the importance of having medical providers who engage with asylum seekers in a culturally competent way. Most of the 37,000 migrants who have arrived in Chicago since August 2022 have walked or ridden buses across several countries to arrive in the United States. Many say they have witnessed death or experienced abuse along their journeys.

“It’s very easy to group Latinos together and think that we’re a monolith. The reality is that we’re all very diverse,” Willman said.

But Willman said it is more challenging for immigrants in the country without legal permission, not just migrants, to get access to health care resources.

“It’s always complicated to ensure that federal resources — however they come to us — are accessible for people without insurance and people without citizenship,” she said.