Transplant patients, stay on guard for measles and other outbreaks

It was five years ago this month that COVID-19 was beginning to consume the headlines. Around the world, those headlines provided an early view of what a pandemic might look like here in the U.S. In fact, five years ago school systems here began shutting down because of the threat. We learned a lot from that crisis.

So who had a growing measles outbreak on their bingo card for 2025? More about that in a minute.

When I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, I suddenly had a lot to handle from a health perspective. I’ve told you before that from the day of my diagnosis forward, I wanted to learn everything I could about IPF and the possible road ahead.

During the winter of 2019 and into early 2020, I underwent transplant evaluation, leading to my presentation to the transplant team that March. I was approved for the procedure, but deferred because the team felt I could wait a little longer to be listed. And at the time, cases of COVID-19 were beginning to be seen in my area; the hospital was starting to pivot to accommodate patients with that disease, which could spread even in a healthcare setting.

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My condition continued to worsen. My supplemental oxygen requirements continued to increase. My home oxygen concentrator was switched from a model of 5 liters per minute (LPM) to a model of 10 LPM. Even though I walked every day for exercise, by late 2020 I was at 7 LPM just to walk across the room.

As 2021 arrived, COVID-19 was still present. Still, my situation was changing. By March of that year, I’d fallen squarely in the lung-transplant window: sick enough to need the transplant but not sick enough to be at risk of not surviving it. On July 10, 2021, I received a bilateral lung transplant.

I avoided contracting COVID-19 for more than three years, until April 2023, when it finally caught up to me. I was an immune-suppressed, post-transplant patient, so COVID-19 threatened my life. My care team acted quickly and had me admitted to the hospital after hours, through the emergency room. There I was given three infusions of Veklury (remdesivir) over a three-day period and then was released to go home.

Today

The impact of the COVID-19 pandemic still lingers today as the virus continues to mutate, though the worst of it is more controlled. But now there’s a new threat for the immune-suppressed population: a resurgence in the number of cases of measles in the United States.

Any patients who are immune-suppressed may be more susceptible to measles, making this outbreak worrisome. A note from my care team last week recommended I mask up in all healthcare settings or when I find myself in a large crowd. As each of us is on a unique journey, consult your care team for guidance on how you should prepare for or handle the threat of measles.

The measles, mumps, and rubella (MMR) vaccination is not recommended for post-transplant patients because it’s a live-attenuated vaccine (LAV), meaning that a weakened virus is in the dose. Given that, the LAV can be harmful or even deadly to a post-transplant patient.

For pre-transplant patients, the MMR vaccine is a two-injection dose taken four weeks apart and completed at least two weeks before the transplant date. Post-transplant patients, however, should avoid the MMR vaccine and any other LAV, as they may lead to rejection.

In the years since COVID-19 arrived, the rare disease community has been proceeding cautiously. Just as our community is emerging from the pandemic, we must be aware of the potential impact of measles on our community members. I’ll follow my care team’s advice and wear a mask. Protecting my lungs is how I can make every breath count.

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.